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Biomedical subjects

M Maliszewski

Publications and source records attributed to M Maliszewski.

At least 19 recordsLinked to original sources

Approaches to posterior circulation aneurysms and results of the operations.

Surgical approaches and operative results in 32 operations of aneurysms of the vertebrobasilar system are presented. The orbitozygomatic and temporopolar approach was used for aneurysms of the bifurcation of the basilar artery lying high in the interpeduncular fossa. In aneurysm which neck was located less than 10 mm above or less than 5 mm below the anterior and posterior clinoid processes the pterional transylvian subtemporal and pterional anterior temporal approaches were performed. A large aneurysm with the neck lying 5 mm below the line connecting the anterior and posterior clinoid processes was operated on via pterional transcavernous approach. The used approaches made it possible to clip the aneurysms. Good and very good results were obtained in 82 per cent of cases. The perioperative mortality was 9 per cent.

Adult↗

Occlusion of radicular arteries - reasons, consequences and anastomotic substitution pathways.

AIM OF STUDY: To investigate the cause of radicular artery occlusion. METHOD: Fifty specimens of spinal cords were taken at postmortem from individuals in whom no symptoms of spinal cord and spine injuries were present in life. The spinal cord arterial system was filled with colour contrast material and then each radicular antery was studied individually at 5 - 25 operative microscope magnification. RESULTS: Two hundred and fifty two anterior radicular arteries joining the anterior spinal artery and 525 posterior radicular arteries joining the posterior spinal arteries were examined. There were five obstructed vessels: four were anterior radicular arteries including the artery of Adamkiewicz and one of the initial branches of the spinal artery originating from the vertebral artery. CONCLUSIONS: As the presented examples show, the formation of a fully efficient collateral circulation is possible.

Adult↗

The accessory anterior cerebral artery: case report and anatomic analysis of vascular anomaly.

BACKGROUND: The term "accessory artery" was formulated to describe one of the developmental anomalies of the middle cerebral artery. This anomaly consisted of the incidence of a vessel that branched off close to the anterior communicating artery and supplied a part of the cortex in the region of the middle cerebral artery vascularization. METHODS: A panangiography of the cerebral vessels was carried out, using the subtraction method, on a woman who suffered from subarachnoid hemorrhage. An aneurysm of the anterior communicating artery and developmental anomaly of the right anterior cerebral artery were found. During the aneurysm operation, the existence of the developmental anomaly was confirmed. It was revealed also during a control angiography. RESULTS: An atypical branch of the right internal carotid artery was found branching off from section C2, and passing below the right optic nerve and the anterior communicating artery. This branch ended with a division into the orbitofrontal and frontopolar artery. CONCLUSIONS: The atypical branch of the internal carotid artery that partly performs the function of the existing proper right anterior cerebral artery, has been defined as the accessory anterior cerebral artery.

Adult↗

[[Microsurgical treatment of cerebral hemangioma].

The authors present the results of microsurgical treatment of 16 patients with intracranial arteriovenous malformations. The applied technique made possible considerable sparing of healthy brain tissue and closing feeders closely to haemangioma. The patients in I to III degree according to Spetzler's scale left the hospital in good condition. The patients in IV and V degree in 4 cases were operated on twice and in control examination have presented mild neurological dysfunction. Severe disability was observed only in 1 patient. Control angiography revealed in 3 of these patients the presence of small parts of haemangioma.

Adolescent↗

Sexual headaches occurring in cluster headache patients.

A number of classifications of headache have appeared in medical and professional journals. In addition to these formal diagnostic classifications, a number of articles have addressed the relationship of sexual functioning to headache etiology, course, and prevalence. To this end, many headache specialists have developed a classification for what are termed "sexual headaches." To date, these sexual headaches have been limited to migraine and muscle contraction (tension) headache patterns. We present, for the first time, two case studies documenting the role of sexual activity in both etiology and course of cluster headache.

Adult↗

Anterior chamber lens implantation after vitreous loss.

Vitreous loss is a serious complication of cataract surgery. Following vitreous loss it is common practice to perform a primary implantation of an anterior chamber lens (AC-IOL). We retrospectively analysed 642 consecutive cases of cataract extraction performed between 1983 and 1986 with special attention to those patients in whom vitreous loss occurred and an AC-IOL was placed. There were 27 such cases, and 24 of these were available for follow-up. Eighteen (75%) had visual acuity of 20/40 or better. All six patients (25%) who had a visual acuity of less than 20/40 in the operated eye had a functional visual acuity of 20/200 or less. Complications that occurred in this group are discussed. We are concerned that the complications associated with vitreous loss and with AC-IOLs may be acting in concert to cause visually disabling results.

Aged↗

More on the reliability of the kinesthetic aftereffects measure and need for stimulation.

Recently, some have argued for a renewed interest in the kinesthetic aftereffects procedure (KAE) as a personality measure even though it may show low test-retest reliability. These arguments indicate that first-session KAE is valid but later-session KAE is not, due to the supposed appearance (in later sessions) of unwanted functional similarity between different aspects of the KAE procedure. Functional similarity leads to reduced reliability and validity of the retest. Data from two new studies do not support this functional similarity hypothesis, but these data do support the KAE by showing test-retest reliability. Also, the data show some new but tentative experimental evidence for the construct validity of second-session KAE as a measure of need for stimulation. These data do support the KAE as a personality measure but, when contrasted to arguments that only first-session KAE is valid, the data indicate that this is unresolved.

Female↗

Chronic headache patients' marital and family adjustment.

The purpose of this study was to compare the marital and family adjustment of headache patients and their spouses, before pain control treatment, to couples without chronic pain. Minuchin's (1978) family systems theory of psychosomatic illness was tested, using an adult sample. This sample consisted of 117 headache-patient-and-spouse couples and a control group of 108 married couples without chronic pain. A survey design was used with marital and family assessment instruments. Marital and family questionnaires were given to headache patients and their spouses before beginning treatment and were sent to couples without chronic pain. "Headache couples" reported greater differences in consensus, cohesion, affection, and sexual relationships than did control couples. Headache patients reporting greater marital adjustment were more likely to have continuous pain than those reporting less marital adjustment. Headache patients' pain per day correlated positively with greater family cohesion and adaptability. Headache patients' severity of pain correlated positively with greater marital affection. The spouses' marital cohesion, affection, and family cohesion and adaptability correlated positively with increased severity of patients' pain.

Adaptation, Psychological↗

[Surgical treatment of intramedullary tumors: preliminary results].

Since 1995 in the Department of Neurosurgery, Mining Hospital in Sosnowiec a surgical technique has been used of total or gross total removal of tumour. It includes the use of CO2 laser for myelotomy and tumour vaporisation as well as ultrasonic aspirator, microsurgical techniques and intraoperative monitoring of SSEP. Ten patients 11-61 years of age were operated on. Four tumours were located in the cervical part of the spinal cord, three in the cervico-thoracic area while the remaining three in the thoracic part. The condition of four patients before the operation was assessed as I-II degree on the McCormick scale, of one patient as--III degree--and of the other five patients as IV-V degree. Only in two cases the removed tumour was ependymoma; in six cases these were benign astrocytomas and in two other--anaplastic tumours. After the treatment, the clinical condition of almost all patients improved. Pain and trouble some paraesthesias subsided. Five patients are completely self-dependent and three other walk with the aid of handrails. The treatment proved unsuccessful in one patient with an anaplastic tumour in whom paralysis of lower limbs occurred before the operation. Six months after the operation the patient died of tumour metastasis. The observation period ranged from 6 months to 3 years. On the basis of our own observations it is suggested that total safe removal of even infiltrating intramedullary tumours is possible when proper surgical techniques are used. Best results are obtained in patients in good clinical condition irrespective of tumour extent.

Adolescent↗

[Tethered cord syndrome in adults].

The authors present a description of three patients in whom symptoms of spinal cord injury developed late after opening of the dural sac of the spinal canal. The material comes from two female and one male patients of age 37-47 years. In the first case the symptoms included increased paraesthesia, pain, paraparesis and sphincter disorders, which appeared 16 years after stab wound of meninges and the spinal cord at Th10. In the second patient, operated on for myelomeningocele at L3-4 at the age of five, sphincter disorders, trophic changes of feet and paraparesis appeared. The third patient was operated on for intra- and extramedullary lipoma at Th9-12. Seven months after the operation symptoms of sphincter disorders, pain, paraesthesia and paraparesis developed. The MR examination showed in all patients an adhesion of the posterior or posterolateral surface of the spinal cord with the dura mater at the sites of injury, which was confirmed intraoperatively. An operative treatment improved the clinical state. The tethering of the cord by the scar was the cause of a non-physiological stretching of the spinal cord on flexion of the body and head. It led to spinal circulation disorders and symptoms of myelopathy. It has been observed that the onset of the symptoms is often caused by sudden stretching of the spinal cord during fall or intense physical exercises. In such cases operative release of the spinal cord from the adhesion is a method of choice.

Adult↗

[Dissecting aneurysm of the posterior inferior cerebellar artery].

A 23 year old woman with dissecting aneurysm of the left posterior inferior cerebellar artery located distal to the branch feeding medulla oblongata is described. Trapping of the aneurysm with the aid of 2 clips was without any influence on neurological state of the patient and prevented recurrent hemorrhage.

Adult↗

[Subacute epidural hematoma].

Eleven patients are reported who had subacute epidural haematoma diagnosed by CT 48 hours after craniocerebral trauma. These haematomas, most frequently, were located outside the temporal region. In some cases capsule of the haematoma could be recognized. The indication to surgical treatment was increasing intensity of intracranial pressure and development or persistence of the signs of focal CNS injury. Effective conservative treatment was given to patients with good general condition in whom CT showed no shifting of midline structures over 5 mm, and the fissure of the fracture was not lying transversely to the course of middle meningeal artery branches.

Acute Disease↗

[A typical syndrome of the sulco-commissural arteries].

Flaccid tetraparesis was observed in a young woman which was caused by embolism of the anterior medullary artery. Topographic investigations of the spinal arteries were carried out, and pathological examination was done confirming the presence of embolic material which was the cause of medullary ischaemia.

Adult↗