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Biomedical subjects

M Sramka

Publications and source records attributed to M Sramka.

At least 19 recordsLinked to original sources
PubMed1992

Stereotactic technique and pathophysiological mechanisms of neurotransplantation in Huntington's chorea.

In Huntington's chorea, embryonal brain tissue (striatum) was implanted in the caudate nucleus bilaterally, using stereotaxy assisted by CT. A special cannula allowed the placement into the brain of 3 or 4 grafts of embryonal tissue along the determined trajectory by one introduction of the cannula. The pathophysiological mechanism of neurotransplantation in Huntington's chorea is to compensate for the degenerated striatal tissue by embryonal striatum, so it is necessary to supply a quantity of embryonal striatal tissue which enables the whole functional integrity. Therefore, we use material from several embryos.

Brain Tissue Transplantation↗
PubMed1992

[Long-term results in patients with stereotaxic surgery for psychopathologic disorders].

Long-term results (5-20 years) recorded in 304 patients operated on stereotactically for psychopathologic disorders are presented. The largest group of 260 surgically treated subjects represented aggressive patients. This group consisted of 150 patients with mental retardation, 70 with epilepsy, 20 with schizophrenia, and 20 patients with sexual deviations. Amygdalectomy for patients with normal intellect and posterior hypothalamotomy for those with reduced intellect proved to be the most effective procedure. Symmetrical operations were also effective. In some cases a combination of two target was necessary. In epileptics with aggressivity the combination of amygdalectomy and hippocampectomy yielded the best results. In aggressivity with sexual deviations anterior hypothalamotomy was the most effective operation. Favorable results in aggressivity therapy were recorded in 60% of patients. In patients with criminal sexual deviations, in drug addicts, and in alcoholics, anterior hypothalamotomy was found to be most effective, with favorable results in 50% of patients. In patients with depression, thalamotomy or stimulation of the limbic regions of the thalamus decreased the depression, with favorable results recorded in 66% of patients. The results of the surgically treated patients show that target-oriented stereotactic operations remove psychopathologic symptoms, improve the effectiveness of psychoactive drugs and the social adaptability of patients. (Ref. 15.)

Aggression↗
PubMed1990

Clinical experience in intraoperational determination of brain inhibitory structures and application of implanted neurostimulators in epilepsy.

Therapeutic brain stimulation was applied in 74 patients with resistant forms of epilepsy. It was shown that low frequency stimulation of certain zones of the head of the caudate nucleus and higher frequency stimulation of the dentate nucleus of the cerebellum lead to a marked suppression of interparoxysmal epileptic activity and to a disruption of both focal and generalized epileptic discharges. It is necessary to determine, by means of stereo-electroencephalography, the variability for localizing the inhibitory zones of the structures to implant the neurostimulators exactly.

Caudate Nucleus↗
PubMed1989

Pathophysiological mechanisms and results of stereotactic treatment of generalized epilepsy.

The paper describes pathophysiological mechanisms and analyzes the results of surgical treatment of severe forms of drug-resistant generalized epilepsy in 150 patients who underwent surgery at the departments of stereotactic and functional neurosurgery in Tbilisi and Bratislava. The epileptic system of all patients was localized stereoelectroencephalographically (SEEG) by recording spontaneous activity or evoked aparoxysms. SEEG examination indicate that pacemakers of epileptic activity are most frequently localized in the mediobasal structures of the temporal lobes. The long-term results of stereotactic treatment of generalized forms of epilepsy show recovery in 50% of patients and marked improvement in 30%. An individually determined strategy of surgical procedures is the main principle of surgical treatment of severe drug-resistant forms of epilepsy. Depending on indications it can include resection of the cortex or lobes of the brain, single or repeated stereotactic destructions of the pacemaker structures of the epileptic system and the pathways of spread of the spasm discharge, as well as therapeutic electrostimulation of the brain inhibitory systems.

Adolescent↗
PubMed1988

Herpes simplex virus DNA in the brain of psychotic patients.

Herpes simplex virus (HSV) DNA was found by spot blot hybridization in the right nc. amygdalae of 3 out 10 patients who underwent curative stereotactic surgery for severe mental retardation with aggressive behavior and/or paranoic schizophrenia. Of these, 6 were also tested for the presence of CMV DNA sequences with negative results. Biopsy specimens from nc. amygdalae of another 7 psychotic patients were cultured in vitro but no virus was isolated.

Amygdala↗
PubMed1977

Combined transtentorial dentatotomy with pulvinarotomy in cerebral palsy.

For frequently associated spasticity with involuntary movements in cerebral palsy operations on cerebellar nuclei or on the pulvinar of the thalamus are recommended. We combined both approaches in 45 patients. The combination was possible after experiences with transtentorial dentatotomy, in which the electrodes are introduced into the deep structures of the cerebellum from a burr-hole on the lambdoid suture. The same lambdoid approach may equally well be applied for introducing electrodes into the pulvinar of the thalamus. The lesion in the pulvinar may moreover be combined with the target in the centrum medianum or in the nuclei VIM-VCP or VOP. Lesions are always asymmetric and multilocular. Their influence on the clinical picture is quite favourable.

Cerebellar Nuclei↗
PubMed1976

Contribution to surgical terminology in epilepsy.

The classifications of the World Health Organization used in epileptology do not contain any aspects of surgical treatment. The introduction of stereotactic techniques make it necessary to include in the classification such terms as multifocal epilepsy, modified epilepsy and iatrogenic epilepsy. Epilepsy classification will most likely be affected also by the neuro-histological changes found from epileptogenic zones with bio-chemical analysis of brain structures as well as from the zone of epileptic focus.

Epilepsy↗
PubMed1976

Effects of stereotactic operations in the treatment of epilepsies--neurological aspects.

In 81 patients with intractable epileptic seizures 121 stereo-electroencephalographic (SEEG) examinations and 91 operations with stereoencephalotomy (SET) were carried out. SEEG and SET targets were chosen in 22 different subcortical structures and in the medial frontal cortex. In 6 of 18 temporal epilepsy cases SET was followed by classical hippocampectomy. With the exception of temporal lobe cases all others were unsuitable for classical neurosurgery. Of 61 controlled patients 24.5% were cured or greatly improved cured, 39.5% improved and 36% unimproved; Correlations among the clinical, EEG and SEEG findings; SET and therapeutic effects are discussed together with the role of stereotactic procedures. In our experience (Cigánek 1962) among patients unsuccessfully treated by conservative methods over 60% are unsuitable for classical procedures based on the criteria of the Montreal neurosurgical school, because of the absence of leading epileptogenic area or because they represent cases with completely or almost completely generalized seizures. In these cases stereotaxy offers prospects diagnostic refinement and treatment.

Electroencephalography↗
PubMed1976

Some observations in treatment stimulation of epilepsy.

In a group of 10 patients suffering from epilepsy therapeutic stimulation was applied by means of chronic electrodes and a technical stimulator three times in nucleus dentatus, five times in nucleus caudatus, once in both structures simultaneously. Once chronic electrodes were introduced into the amygdalo-hippocampal complex and non-specific thalanic system bilaterally. One patient was stimulated by means of a pacemaker and once by normal rhythm from the hypothalamus of the same patient using magnetic tape. The patients were subjected to stimulations once a day for a period of 1-8 days. The results obtained are being discussed with respect to Goddard's kindling phenomenon.

Caudate Nucleus↗
PubMed1976

Graphic representation of the epileptic focus.

On the basis of systematic examinations of electrical activity of brain deep structures in 87 epileptic patients, an experiment was carried out to replace the concept of the epileptic focus by the graph of functional grouping of structures with epileptic activity. In order to make the graph as realistic as possible, the multi-lead electrodes have to be introduced into the brain systematically and under standard conditions. In this case, the results obtained are comparable. At the same time, the graph proves to be the basis of indications for stereotactic treatment.

Amygdala↗