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Biomedical subjects

P Nadvornik

Publications and source records attributed to P Nadvornik.

At least 19 recordsLinked to original sources
PubMed2005

Neuroendoscopic management of haematocephalus.

The purpose of the paper was to publish the results of endoscopic treatment of primary and secondary haematocephalus in the group of 23 patients, treated by means of Wolf endoscopic system combined with frame based navigation with the aid of virtual reality environment. The procedure is aimed to remove blood clots from the cerebral ventricles and to reduce the volume of parenchymal haematoma in secondary haematocephalus during single surgical session. In the majority of the treated patients septostomy was added to make revision of both lateral ventricles possible from a single approach, and the operation was completed with endoscopic third ventriculostomy to reduce the amount of blood in the basal cisterns and to reestablish the patency of cerebrospinal fluid pathways, so that lumbar puncture can be safely done to facilitate the process of cleaning blood away from the cerebrospinal fluid. The surgery always facilitates the resorption of residual blood as well as blood degradation products, therefore late complications, such as posthaemorrhagic hydrocephalus, membranes and stenosis formation was prevented. Improvement of the clinical condition was obtained without the need for permanent drainage systems insertion. Lethal outcome in one patient and unfavourable clinical result in another three patients were unrelated to the endoscopic treatment. (Tab. 1, Fig. 2, Ref: 10.)

Adult↗
PubMed2004

Stereotactic evacuation of spontaneous infratentorial hemorrhage with monitoring of intracerebral pressure.

INTRODUCTION: Based on our experience with stereotactic evacuation of spontaneous supratentorial hematomas this method has also been used for evacuation of spontaneous infratentorial hematoma by the transtentorial approach. MATERIAL AND METHOD: The authors present a series of 6 patients with spontaneous intracerebral hematomas evacuated by the frame-based stereotactic technique, with monitoring of intracranial pressure (ICP) during the stereotactic evacuation. This method was indicated in patients with stable neurological status according to Glasgow Coma Scale (GCS), more than 10. The frame-based stereotaxy with the Riechert-Mundinger apparatus with CT localisation of target and optimal trajectory was used. RESULTS: The presented values after stereotactic evacuation show reduction of the initial intraparenchymal ICP in all patients to values less than 20 mmHg. CONCLUSION: The measuring of the ICP and the analysis of dynamic changes during stereotactic evacuation suggest that this procedure can significantly reduce the ICP performed in connection with ICH and we believe that our results can improve management of patients with spontaneous infratentorial and supratentorial intracerebral hematoma. (Fig. 1, Ref. 21.).

Aged↗
PubMed2000

[Neurosurgery--an instrument for stereotaxic surgery].

The authors presents their experiences with simple stereotactic instrument. There are presented possibilities of using stereotactic equipment, when taking aut biopsy, from deep structures of brain, evacuation of cerebral hematoma, aspiration of the brain abscess and stereotactic quidance resection of tumor in functionally important parts of brain.

Aged↗
PubMed2000

The function of the cerebrospinal fluid space and its expansion.

In addition to its nutritive and protective effects, the basic function of the cerebrospinal fluid space resides in dynamic equilibration of pressure fluctuations caused by volume changes in three compartments contained within the rigid skull cavity: brain tissue, blood and cerebrospinal fluid. An increase in volume in one of them brings about a compliant withdrawal in volume in the other two. The degree of cerebrospinal fluid compliance can be expressed by means of the pressure/volume index which is directly proportional to this compliance. On the other hand an expansion of fluid space which forces the brain to withdraw its tissue, brings about the dilatation of brain ventricles. The degree of their dilatation depends on the effective pressure of cerebrospinal fluid which counteracts with the resistance of brain venous collectors. The blood in the venous network of the brain and cerebral extracellular fluid play a reversible role in cerebral mass restoration and reduction. These facts explain the reason why, from the physical point of view, the brain is considered to represent a viscous and elastic spongious matter. (Ref. 21.)

Absorption↗
PubMed1991

On the rupture of an aneurysm.

The intracranial aneurysm, with an estimated occurrence of up to 4% in the general population, belongs among the most dangerous of cerebrovascular diseases. Although less than one-fifth of these cases results in a subarachnoid haemorrhage, the resulting disability and mortality rate is too high. More understanding is needed regarding aneurysm rupture and its deleterious effects. This study presents a physiologically-feasible explanation for the development of an enormous haemodynamic stress in the vicinity of the aneurysm in the cerebrovascular bed. Using a computer circulation model, this build-up of pressure was developed by sequentially imposing a series of interventions on the normal system.

Computer Simulation↗
PubMed1987

[Results of stereotactic treatment of drug-resistant epilepsy].

After a brief review of results reported so far regarding the stereotactic treatment of seizures, the author describes the results achieved with eight patients on whom stereotactic coagulation was performed in the right or left amygdala-hippocampus complex between 1976 and 1983 on account of drug-resistant partial seizures. Except for one case, in which the indications were purely clinical and it proved impossible to influence the frequency of seizures, seizures either ceased or their frequency was reduced. With a mean duration of 15 years, the period of pharmacoresistance until surgery was indicated was far longer than reported in the literature.

Amygdala↗
PubMedDate not supplied

[Combined stereotaxic surgery (methodologic remarks)].

The experience in stereotaxic operations performed in two neurosurgical institutions (Madras, India, and Bratislava, CSSR) indicated that an important part of them were combined interventions. From a methodological point of view the stereotaxic operations can be classified as one- and multi-stage, symmetrical, asymmetrical and unilateral procedures. A stereotaxic intervention differs from the traditional concept of an operation that is expected to lead to a recovery after a single procedure. Stereotaxic treatment, as a rule, comprises a succession of such interventions that form the strategy of the whole therapy.

Electroencephalography↗
PubMedDate not supplied

[Analysis of coordinate systems of intracerebral structures and optimization of sterotaxic computations for the posterior longitudinal approach to the hippocampus].

In studying the three-dimensional interrelationship of the thalamic and temporal systems of co-ordinates it was proved that one of them cannot be used in calculating the stereotaxic co-ordinates of structures associated with the other. In combined stereotaxic operations it is necessary to construct combined independent systems of co-ordinates. The possibility of exact construction of the co-ordinate systems of intracerebral structures depends to a great measure on the positive contrasting of the ventricular system.

Cerebral Ventriculography↗
PubMedDate not supplied

[Stereotaxic combined dentate-thalamotomy in the treatment of spastic-hyperkinetic forms of subcortical dyskinesias].

The work is based on the results of operations on the cerebellar dentate nuclei in 92 patients. In 42 of them, combined manipulations were carried out on the cerebellar dentate nuclei and the diencephalic structures (relay nuclei, median centre, pulvinar and subthalamus). Analysis of the results showed that stereotaxic destruction of the ventrooral parts of the cerebellar dentate nucleus is a very effective surgical manipulation in various forms of spastic dyskinesia. A natural decrease in the spastic component of the muscular hypertonia is the principal clinical effect of dentatotomy. Its effect on the rigid component of muscular hypertension is negligible. Combined manipulations on the cerebellar dentate nuclei and diencephalic structures are indicated in cases with combined spastic conditions and hyperkinesia which cannot be corrected by dentatotomy. The analysis of the results of combined interventions on the nuclear structures of the thalamus shows that pulvinarotomy is most effective, it reduces or corrects hyperkinesia in infantile cerebral paralysis and, in addition, causes diminution of the general hypertonia, of the upper extremities before all else. Proper rehabilitation treatment is the decisive factor in the final outcomes of stereotaxic intervention on the cerebellar motor systems and on those of the diencephalon in spastic forms of hyperkinesia.

Cerebellar Nuclei↗
PubMedDate not supplied

Critical remarks on the stereotaxic treatment of epilepsy.

The analysis of experiences with 43 patients treated stereotaxically for epilepsy, shows that the stereotaxic method can play an important role 1) in the investigation of the structures in epileptic activity; 2) in proper management of these cases. According to deep electrode records, the epileptic focus seems to be like a system of anatomical structures, which are functionally interdependent, and its relationship can be plotted on a schematic graph, which must be calculated in the strategy of treatment with the combined performances. In spite of this results are not satisfactory. New methodological approaches should be devised, such as longitudinal stereotaxic hippocampectomia, which is suggested as promising.

Brain Stem↗