Biomedical subjects

Marek Zawirski

Publications and source records attributed to Marek Zawirski.

11 recordsLinked to original sources

PubMed2003

Colloid-like cyst located in the prepontine region.

BACKGROUND: The term "colloid cysts" refers to nonneoplastic lesions located in the anterior part of the third ventricle. However, cysts morphologically identical to colloid cysts are found, albeit extremely rarely, through the neuraxis. CASE DESCRIPTION: We report a case of a 44-year-old man with a short history of headache and 5 years of bilateral hearing loss. Computed tomography (CT) and magnetic resonance imaging (MRI) scans showed an oval lesion located at the anterior surface of the pons. The tumor was excised through a right pterional transsylvian approach. Postoperatively, the hearing deficit remained unchanged. Otherwise, the patient made an excellent recovery. Histopathological examination showed a colloid-like cyst. CONCLUSIONS: Colloid-like cysts growing in the prepontine region are extremely rare. To date, only two similar cases have been reported in the literature. Patients present with headaches, hearing loss, or blurred vision.

Adult↗

PubMedDate not supplied

[Use of needle electromyography for diagnosis of radiculopathies].

Radiculopathy is sometimes evaluated with needle electromyography as additional examination to radiographic imaging. The purpose of this study was to determine the optimal needle electromyography protocol and the use of needle electromyography in the diagnosis of radiculopathy. The authors analysed English language writings from years 1981-2000. The selected studies reported a wide range of needle EMG abnormalities--from about 30 to 100% of pathological EMGs. That is caused by wide variety of patient populations and various EMG protocols. EMG of leg muscles in radiculopathy can consist of the assessment of the spontaneous activity only or be completed with the assessment of motor unit potential (MUP). The EMG of paraspinal muscles assesses spontaneous activity only. The number of abnormalities in needle EMG grows with the presence of characteristic radiculopathy symptoms, but positive EMG examinations are of importance only in cases where diagnosis is complicated. The rate of pathological results is higher when needle electromyography is used in the muscles of paraspinal region and extremities at the same time. The assessment of the spontaneous activity in extremity muscles alone minimizes the influence of error- causing factors on the EMG result. Nevertheless lack of assessment of motor units potentials makes electromyographic investigation of chronic radiculopathy impossible. Sensitivity and specificity of the method have to be determined before the clinical use of the assessment of MUP in chronic radiculopathy, especially in patients without motor weakness. Needle EMG abnormalities correlate with radiological findings in limited range as would be expected from the occurrence of radiological findings in asymptomatic patients and overlapping innervations of myotomes.

Electromyography↗

PubMedDate not supplied

[Sixteen-year experience in the treatment of trigeminal neuralgia by percutaneous retrogasserian thermorhizotomy].

The authors present a series of 143 consecutive patients with trigeminal neuralgia who were treated with percutaneous retrogasserian thermorhizotomy between 1984 and 2000. Long time results (follow-up of 16 years) revealed full pain relief in 80% of patients, mainly in those with postoperative sensory deficit, 16% suffered pain recurrence and required additional treatment.

Adult↗

PubMedDate not supplied

[Awake craniotomy and brain mapping for eloquent cortex in patients with supratentorial tumors: a preliminary report].

Malignant brain tumours are incurable at present. Since none of the hitherto used treatment methods allows to significantly extend these patients' survival time, the basic aim is to improve their quality of life. Intraoperative brain mapping seems to be an approach enabling to minimize the risk of irreversible damages to functionally important structures of the brain. In the Department of Neurosurgery of the Medical University of Łódź awake craniotomy with stimulation of eloquent cortex was attempted from May 1999 to July 2000 in 13 patients aged 16 to 77 years. In two patients the attempt of intraoperative awakening was unsuccessful. In 8 out of the 11 awakened patients intraoperative brain mapping had a significant effect on the course of surgery (i.e. on the resection magnitude and "safe corridor"). Out of six patients with tumors situated in the neighbourhood of motor cortex--one developed a severe and permanent paresis of the upper limb. On the grounds of the literature and the authors' own experience an algorithm of awake craniotomy and intraoperative brain mapping was worked out.

Adolescent↗

PubMedDate not supplied

[Trigeminal neuralgia due to lengthy AVM treatment. A case report].

The authors presented a case of iatrogenic trigeminal neuralgia in a 46-year-old man with a dural arteriovenous malformation (AVM) previously treated by means of intravascular embolization. At first, microvascular decompression (MVD) in the posterior fossa was performed, but unfortunately the pain persisted. Subsequently, percutaneous stereotactic radiofrequency rhizotomy was carried out. The procedure was uneventful and brought about an immediate pain relief.

Brain↗

PubMedDate not supplied

[Hemifacial spasm as an early symptom of posterior fossa meningioma].

A rare case of a 47-year old female with hemifacial spasm of the one-year duration as the initial and only symptom of posterior fossa meningioma is reported. At first the patient did not consent to surgery and was unsuccessfully treated with anticonvulsants. A month prior to her admission she started to complain of headache and balance disorder, and developed sensory loss to light touch in II and III branches of the right V nerve. CT revealed a huge posterior fossa meningioma. After a total removal of meningioma, the patient's hemifacial spasm disappeared.

Cranial Fossa, Posterior↗

PubMedDate not supplied

[Intraoperative assessment of cognitive and executive functions in patients with brain tumors].

BACKGROUND AND PURPOSE: The aim of this paper was to evaluate the usefulness of selected methods of intraoperative neuropsychological assessment. In order to investigate the influence of the direct cortical stimulation and tumor resection on the patients' intraoperative performance, we examined selected areas of cerebral cortex involved in cognitive activity in patients undergoing awake craniotomy for brain tumors. MATERIAL AND METHODS: The analyzed group consisted of 21 patients (11 men, 10 women) with tumors located in eloquent areas of the left hemisphere. All patients had intact understanding of speech and relatively minor neurological deficits. We applied both experimental methods as well as certain standardized tests (WAIS-R, AVLT) for the investigation of verbal and nonverbal functions. The tests were performed during direct cortical stimulation and tumor resection, and also before and one week after the operation. RESULTS: Verbal areas were identified in 10 patients, sensorimotor strip in 3, whereas both of them in 3. Even though in 5 out of 21 subjects we were unable to identify the eloquent cortex, there was no difference between pre- and postoperative assessment in these patients. Similarly, there was no statistically significant difference in pre- and postoperative tests among patients with successful cortical mapping. CONCLUSIONS: We showed that the presented methods of intraoperative assessment of cognitive activity were useful and appropriate for the identification of the eloquent areas of the brain.

Adolescent↗

PubMedDate not supplied

[Supplementation of cranial defects by an autologous bone flap stored in the abdominal wall].

BACKGROUND AND PURPOSE: The aim of this paper is to present an alternative method of cranioplasty with the use of an autologous cranial bone flap stored between primary and restorative surgery in the subcutaneous pocket in the lateral hypogastric region. MATERIAL AND METHODS: Between January 1999 and April 2002, in the Department of Neurosurgery of Medical University of Łódź we performed 36 procedures of the bone flap implantation into the abdominal subcutaneous fat tissue. These procedures followed craniectomy, mainly in cases of acute subdural hematomas and ruptured intracranial aneurysms. RESULTS: After storage, the bone flap was reimplanted in 28 patients. The mean time between operations was 14 days (range 8-53 days). In the cranioplasty group we had only one infection of the bone flap. Among patients excluded from the bone flap restoration we observed one inflammatory complication in the abdominal wall and one subcutaneous hematoma requiring evacuation. CONCLUSIONS: In our opinion, the presented method of the cranial defect's supplementation may be competitive to procedures utilizing synthetic prostheses in the population of patients for whom reimplantation of the bone flap will be expected in 2-3 months after the primary operation. Advantages of the procedure are: the autologous bone graft, the excellent cosmetic effect, low costs of the procedure and low rate of inflammatory complications.

Abdominal Wall↗

PubMedDate not supplied

[Role of proteoglycans and glycosaminoglycans in the intervertebral disc degeneration].

Proteoglycans and glycosaminoglycans are the main components of the extracellular matrix of the nucleus pulposus. Intervertebral disc degeneration due to aging and excessive mechanical loads results in adverse quantitative and structural changes to the macromolecules. Metalloproteinases induced by inflammatory mediators play a key role in degrading proteoglycans. Progressive matrix breakdown decreases water content in the disc. Dehydration compromises disc cells function and impairs resistance to compression. Biochemical changes may result in disc prolapse. Modifying the metabolism of proteoglycans and glycosaminoglycans might be an effective therapeutic strategy.

Disease Progression↗

PubMedDate not supplied

[Suprascapular nerve entrapment. A case report].

We present a case of a 35 year-old man, an office employee, who got ill when working hard building his own house. At the same time shoulder pain and fever occurred, the latter due to the tooth apical abscess. Several months later atrophy of the left supraspinatus and infraspinatus muscles was found. The imaging study (MRI, USG) did not show changes which might affect the suprascapular nerve. Electromyography of the left infraspinatus and supraspinatus muscles revealed fibrillation and positive sharp waves. Distal motor latency to the infraspinatus and supraspinatus muscles, examined by electroneurography, was normal. Mechanical irritation of the spinoglenoid notch is only one of possible mechanisms of the suprascpular nerve impairment in this case. The second is the inflammatory process. Suprascapular nerve impairment does not play an important role in pathogenesis of shoulder pain, but probably it is taken too rarely into consideration in differential diagnosis of shoulder pain.

Adult↗

PubMedDate not supplied

[The usefulness of fused MRI and SPECT images for the voxel positioning in proton magnetic resonance spectroscopy and planning the biopsy of brain tumors: presentation of the method].

BACKGROUND AND PURPOSE: Progress in neurooncology suggests a need to combine information from anatomical-morphological and functional imaging in diagnosis and management. It is not always possible to establish a correct diagnosis using MRI imaging techniques alone, especially in the case of recurrent brain tumors. It is suggested that the results of different imaging techniques should be combined especially in these circumstances. The aim of this study was to evaluate the usefulness of fused post gadolinium MRI and single photon emission tomography (SPECT) images for planning 1H MRS. MATERIALS AND METHODS: 19 patients with a histopathological diagnosis of glial brain neoplasms were examined. SPECT was performed after i.v. administration of iodine-alpha-methyltyrozine (IMT). Fused SPECT and post Gd MR images were obtained on a peripheral console (Linux, PC), using a self developed technique. 1H MRS was performed on a 1.5 T scanner with the single voxel (SVS) technique using STEAM (TE 20 ms, TR 2000 ms) and (PRESS TE 136 TR 2000 ms) sequences. RESULTS: 1H MRS with a volume of interest positioned in the most metabolically active areas on fused images, gave a more accurate diagnosis of tumor type and grade that was clinically relevant in 3 patients. CONCLUSIONS: The authors conclude that planning 1H MRS with the use of fused MRI and SPECT images improves the diagnosis.

Adult↗