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Biomedical subjects

M B Pritz

Publications and source records attributed to M B Pritz.

At least 73 records · Page 4Linked to original sources
PubMed1984

Treatment of cerebral vasospasm. Usefulness of Swan-Ganz catheter monitoring of volume expansion.

A practical approach to the treatment of neurological deficits associated with cerebral vasospasm by means of volume expansion and hypertension is illustrated by the management of two patients. In each instance, monitoring of cardiac and volume status was performed with a triple-lumen thermodilution Swan-Ganz catheter to determine what mean pulmonary artery wedge pressure would generate the greatest cardiac output. Intravascular volume was expanded with increased fluids, albumin, and blood. Neurological deficits in both patients were reversed completely. Neither patient developed pulmonary hypoxia, congestive heart failure, pulmonary edema, myocardial infarction, or symptoms of intracranial hypertension.

Adult↗
PubMed1984

Treatment of tandem lesions of the extracranial carotid artery.

The authors present a patient with bihemispheric transient ischemic attacks attributed to stenosis of the left common carotid origin and stenosis and ulceration of the left cervical internal carotid artery. Because of precarious cerebral blood supply secondary to occlusions of the right common carotid and left vertebral arteries, several measures were undertaken perioperatively to provide protection from cerebral ischemia during vessel occlusion. These included Swan-Ganz catheter monitoring to maximize cardiac output and maintain satisfactory hydration, normocarbia, satisfactory oxygenation, and moderate hypertension and barbiturate infusion. With these adjuncts, both lesions were treated together. Retrograde balloon angioplasty under fluoroscopic control of a significant stenosis of the common carotid artery origin was performed before carotid endarterectomy. Postoperative digital subtraction angiography demonstrated a satisfactory technical result. The management of tandem lesions of the extracranial carotid artery is discussed. Balloon angioplasty coupled with extracranial vascular reconstructive procedures may allow the management of lesions not treated safely or effectively by either technique alone.

Angioplasty, Balloon↗
PubMed1984

Monitoring cardiac function and intravascular volume in neurosurgical patients.

Evaluation of cardiac function and intravascular volume has proved essential in two broad groups of neurosurgical patients: those with cerebrovascular disease and those with intracranial hypertension. For accurate assessment of cardiac function and intravascular volume, determinations were made by a dye dilution technique. This approach was used in 68 patients, in whom 215 dye dilution measurements were made. Useful parameters of left ventricle function included cardiac output, cardiac index, stroke volume, and mixing time. Important measures for the assessment of intravascular volume were mixing volume, dispersion volume, total peripheral resistance, central venous pressure, and mean pulmonary artery wedge pressure. Cardiopulmonary monitoring by this dye dilution technique has proved useful, relatively noninvasive, rapid, and easily repeatable in a wide variety of clinical situations in which cardiac function and state of hydration require accurate assessment. By adding this dye dilution technique to the more commonly used methods for evaluating intravascular volume and cardiac function, more accurate monitoring of critically ill neurosurgical patients can be carried out.

Adolescent↗
PubMed1983

The dorsal column nucleus in a reptile, Caiman crocodilus.

The dorsal column nucleus of Caiman crocodilus was identified by using standard orthograde techniques to trace the degeneration that resulted from dorsal rhizotomies in brachial and lumbar regions. Although the dorsal column nucleus was difficult to locate in Nissl and fiber preparations, it was easily identified in histochemical material because it stained intensely with succinate dehydrogenase and acetylcholinesterase.

Animals↗
PubMed1982

Perioperative management of high risk patients with cardiopulmonary disease undergoing carotid endarterectomy or extracranial-intracranial bypass.

Among a large group of patients who underwent either carotid endarterectomy or extracranial-intracranial (EC-IC) bypass were 13 patients who had cardiopulmonary monitoring performed by a dye dilution technique either with or without a thermodilution Swan-Ganz catheter. Each patient had at least two significant medical problems that were thought to place him or her at increased risk. The usefulness of this monitoring approach in the perioperative management of these patients is demonstrated by several clinical examples. No patient sustained myocardial infarction, congestive heart failure, or new neurological deficit during the perioperative period. Our experience suggests that high risk patients can safely undergo either carotid endarterectomy or EC-IC bypass provided that careful attention is paid to myocardial function and the state of hydration.

Aged↗
PubMed1981

Vertebral artery disease: radiological evaluation medical management, and microsurgical treatment.

The neuroradiological evaluation, perioperative medical management, and microsurgical treatment of variously located vertebral artery lesions are presented. Four types of surgical procedures were undertaken: proximal vertebral artery to common carotid artery end-to-side anastomosis; external carotid artery to midcervical vertebral artery end-to-side anastomosis; external carotid artery to distal cervical vertebral artery end-to-end anastomosis; and occipital artery to posterior inferior cerebellar artery end-to-side anastomosis. Each case is used to demonstrate the evaluation and management involved, the type of and rationale for the surgical procedure selected, and the patency of the anastomosis performed. Two points are emphasized. One is that, after careful angiographic evaluation and improved perioperative medical management, lesions of the vertebral artery are indeed amenable to microsurgical intervention with relatively low risk to the patient. The other is that, whenever possible, anastomosis of the largest caliber of vessels with the least number of suture lines is the surgical treatment of choice.

Carotid Arteries↗
PubMed1975

Anatomical identification of a telencephalic visual area in crocodiles: ascending connections of nucleus rotundus in Caiman crocodilus.

Nucleus rotundus receives a major input from the optic tectum in crocodiles, Caiman crocodilus. Telencephalic projections of nucleus rotundus were studied in Caiman by means by the Fink-Heimer procedure after anodal, stereotaxic lesions. Efferent axons of nucleus rotundus assemble on the ventromedial aspect of this nucleus and swing ventrolaterally to enter the dorsal peduncle of the lateral forebrain bundle. These ascending fibers continue rostrally in the dorsal peduncle of the lateral forebrain bundle to enter the telencephalon where they remain restricted to a lateral portion of the lateral forebrain bundle. At more anterior levels, these fascicles turn dorsally, pass through the ventrolateral area, and terminate massively in a lateral part of the rostral dorsolateral area. The results of this experiment are compared with similar studies on thalamotelencephalic connections of diencephalic visual areas in other amniotes. Parallels in fiber connections of thalamic auditory and visual areas and the segregation of these modalities in the telencephalon of Caiman are discussed. These similarities in neural circuitry and synaptic elements of auditory and visual systems that synapse in the midbrain of Caiman form the basis for a different interpretation of sensory system organization in amniotes.

Alligators and Crocodiles↗