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Biomedical subjects

O Busse

Publications and source records attributed to O Busse.

At least 55 records · Page 3Linked to original sources

Acute non-communicating hydrocephalus after spontaneous subarachnoid haemorrhage.

Five patients, who developed progressive neurological deterioration within hours due to subarachnoid haemorrhage (SAH) are reported. The computertomographic (CT) appearance of a noncommunicating hydrocephalus (n.c.h.) was a unique feature in 4 cases. CT during the early phase of neurological deterioration after SAH permits the differentiation between an ischaemic, an oedematous, a haemorrhagic-compressive lesion and an increase in intracranial pressure (ICP) due to n.c.h.

Acute Disease↗

[Characteristic cerebrospinal fluid findings and clinical aspects of lymphocytic meningoradiculitis].

Clinical data and Cerebrospinal fluid (CSF) findings of 20 patients suffering from a meningoradiculitis were analyzed. Most patients had a tick bite or an erythema migrans before neurological symptoms occurred. All suffered from severe radicular pain. Predominant neurological symptoms were peripheral palsies of the facial nerve followed by motor paresis of the trunk and the extremities of mostly asymmetric distribution. Predominant CSF alterations were a long lasting inflammatory cellular reaction and an impairment of the blood-CSF barrier. In contrast to the CSF of 17 patients suffering from a polyradiculitis Guillain Barré with a similar total protein content, an intrathecal immunoglobulin IgG synthesis could be confirmed for the majority of the patients. CSF finding would be compatible to a viral as well as a borrelia etiology.

Bites and Stings↗

Cerebellar infarcts in the area of the supply of the PICA and their surgical treatment.

The authors report seven cases of cerebellar infarcts in the distribution of the PICA, of whom six were treated surgically. Only one patient died and he was not operated on. Although of the remaining six patients four were comatose, and two presented obvious signs of midbrain decerebration, all of them subsequently showed a really good quality of survival. In addition to the clinical details of the cases which are set out in tabular form, a survey of the literature is given and the indications for surgical treatment discussed. The exact interpretation of the CT scan and, in this context, particularly of the brain stem and its surrounding cisterns, above all the cisterns of the quadrigeminal plate and of the vein of Galen, gives decisive help in assessing the indications for suboccipital decompressive craniotomy. In view of the small number of cases, expressing the mortality rate in percentages would seem to be pointless. However, it appears appropriate to describe our experiences of the last two years and to recommend surgical treatment.

Adult↗

[Obstructive hydrocephalus in cerebellar infarcts].

Large cerebellar ischaemic infarction may act as a space-occupying lesion and cause acute ventricular dilatation secondary to brain stem compression. 8 cases are regarded and the clinical course and therapy are discussed. After acute onset with vestibular and cerebellar symptoms, signs of progressive clouding of consciousness, accompanied often by signs of brain stem compression develop leading finally to decerebration syndrome. CT reveals an extensive hypodense area, usually in the lower part of the cerebellar hemisphere, compression and shift of the IVth ventricle and dilatation of 3rd and lateral ventricles. Drainage of ventricular fluid alone is not sufficient and the therapy of choice is the resection of infarcted tissue. Even in patients, who were operated in the early phase of decerebration excellent recovery was noted.

Adult↗

[Prognostic criteria on the cranial computed tomogram of an ischemic cerebral infarct].

Two hundred and eighty-three cranial computer tomograms in 214 patients with supratentorial ischaemic infarcts were analysed with reference to the prognosis. Patients with large infarcts often have a poor prognosis. Contrast accumulation indicates a poor prognosis only in the first week. Enhancement in the second and third week was more common and more intense. Diapedesis from necrotic capillaries is thought to be responsible for early enhancement and increased pinocytosis in regenerated endothelium for late enhancement.

Cerebral Infarction↗

[Importance of cerebrospinal fluid lactate determination in neurological diseases].

Lactic acid concentration has been determined in the cerebrospinal fluid (CSF) of 715 patients suffering from various neurological diseases. It was found to be most often elevated in cases of ischemic cerebral infarction, cerebral contusion, arteriosclerotic dementia, metastatic encephalitis, bacterial meningitis, menigiosis carcinomatosa and after epileptic seizures. In fewer cases lactate levels were increased with brain tumors, encephalitis, viral meningitis and radiculitis. Diagnostic relevance of CSF lactic acid determination is discussed with regard to ischemic cerebral disorders, differential diagnosis of viral and bacterial meningitis and for the confirmation of epileptic seizures.

Central Nervous System Diseases↗

Peripheral nerve damage following isolated extremity perfusion with cis-platinum.

Of 16 patients treated, all who could be examined after isolated hyperthermic lower limb perfusion with cis-platinum showed peripheral nerve damage, particularly of the lower leg and foot. We found a close correlation between the severity of neurological deficit and the perfusion temperature. The dose of cytostatic agent also plays a role in development of the nerve lesion. The major cause of the nerve damage seems to be the neurotoxicity of cis-platinum. The edematous swelling in the compartments in the lower leg have an influence. The reversibility of the pareses was generally very small.

Chemotherapy, Cancer, Regional Perfusion↗

Changes in CSF blood-brain barrier parameters in ischaemic cerebral infarction.

Total CSF protein and CSF/serum albumin and alpha 2-macroglobulin ratios as indicators of a disturbed blood-brain barrier were determined in 39 cases of ischaemic cerebral infarction proved by computed tomography (CT). About 50% of the patients had a barrier disturbance, whereat the CSF serum albumin ratio was shown to be the most sensitive parameter. A disturbed blood-brain barrier was more often found in cases of large infarction, as shown by CT, and occurred most frequently in the first 2 weeks of illness. No correlation was seen between enhancement in CT and disturbance of the blood-brain barrier.

Blood-Brain Barrier↗

Protein pattern of cerebrospinal fluid in various neurological diseases.

CSF/serum albumin and immunoglobulin G ratios were determined in 520 patients suffering from various neurological diseases. Blood-brain barrier impairment was detectable in most cases of spinal tumour, meningitis, Guillain-Barré syndrome and in two-thirds of the patients with cerebral infarctions. A local IgG formation in the CNS has to be assumed for some cases of meningitis considering the course of the protein dysequilibrium. Autochthonous IgG production together with a barrier dysfunction was found in patients with encephalitis, meningoradiculitis and neurosyphilis. In cases of multiple sclerosis local IgG formation in the CNS was the predominant finding.

Blood-Brain Barrier↗

[Polyneuropathy caused by disulfiram poisoning].

Disulfiram is known to produce toxic encephalopathy and peripheral neuropathy. The case of a 37-year-old alcoholic who attempted to commit suicide by taking 22.5 g disulfiram is described. During the first 6 days after the intoxication he was stuporous and had cerebellar ataxia and dysarthric speech. Then he became comatose, and as he recovered from coma, he showed peripheral neuropathy including diplegia faciei and severe tetraparesis. Denervation potentials were detected in both facial muscles and distal muscles of the upper and lower limbs, while conduction velocity was normal. Axonal degeneration was verified by sural nerve biopsy. In addition neurofilamentous axonopathy was documented. The recovery from his paresis lasted 2 years.

Adult↗

[Prognosis of cerebral ischemia. Significance of the cerebrospinal fluid lactate level and computer tomographic findings].

In patients (n = 120) with supratentorial ischemic cerebral infarction CSF lactate was determined and a CT was carried out on the 1st, 3rd and 7th day after the stroke. On the 3rd and 7th day the comparative investigation revealed a close correlation between the measure of the ischemic edema and the level of CSF-lactate. Thus the lactate-concentration can be regarded as a measure for the spread of the edema after cerebral infarction. Already on the 3rd day CT- and CSF-lactate results allow a relatively reliable prediction for the course of the stroke. An edema grade III in CT and a CSF-lactate concentration more than 4 mmol/l were prognostically critical. On the other hand good chances of survival were indicated by a CSF lactate level under 2,5 mmol/l and an edema grade I.

Brain↗

Recurrent cerebral embolization from a carotid bifurcation aneurysm.

In addition to heart disease and ulcers of the carotid artery, partially thrombosed large or giant aneurysms of the carotid territory may be the source of emboli into the middle cerebral distribution. Recurrent ischaemic attacks, characteristic of embolization, ceased after clipping of a sclerotic carotid bifurcation aneurysm that had never bled. Relevant literature is reviewed.

Carotid Arteries↗