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R Meyendorf

Publications and source records attributed to R Meyendorf.

35 records · Page 2Linked to original sources
PubMed1977

[Psychiatric and neurological complications associated with cardiac surgery (author's transl)].

The following problems are discussed as the result of an own investigation done with 150 patients after cardiac surgery: 1. the differences in incidence of cerebral complications understood as 2. a probleme of qualitatively different psychopathological and neurological syndromes. 3. Causes and relationship between the clinical stages of heart-disease and neuropsychiatric complications with special regard to the question 4. congenital heart-disease versus aquired heart-disease. 5. The role of extracorporeal circulation. 6. Remarks on the role of microembolism associated with open cardiac surgery. 7. Hereditary factors as the cause for specific psychopathological reactions.

Adult↗
PubMed1976

[Mental and neurological disorders associated with heart operations. Pre- and postoperative studies].

Long before the era of heart surgery began, "cardiac psychoses" were known and described. They do not differ at all from postoperative psychoses after heart-surgery. On the other hand heart-surgery carries a far higher incidence of psychiatric complications than general surgery (general surgery 0,1--1,0%; heart surgery 10--60%). There is no reason to believe that the intensive care unit plays a decisive role in the origin of postoperative cardiac psychoses. Among 150 patients there were 60=40%, who did not show any psychiatric symptoms after surgery. These were exposed to the same environment of the intensive care unit as were the patients who developped symptoms. There were however correlations of statistical significance between "cardiac psychoses" and 1. an occurrence of endogenous psychoses in the family with first degree relatives or in the life history of the patient himself, 2 higher grade of severity of heart disease, 3. extra corporal circulation, 4. higher age, 5. male sex. Postoperative cardiac psychoses are mainly of the type of exogenous psychoses (akuter exogener Reaktionstyp Bonhoeffer). There is no doubt that psychological, reactive and environmental factors do play a certain role too. This is shown by the character of delusions and hallucinations which frequently reflect the postoperative situation. Persecutory delusions with the fear of being killed and ideas and fears of severe body mutilation are the most common motives. Similar motives are frequently observed in postoperative dreams. The manifestations of mental disease in the family or personal history of the patient is considered a significant presupposition of developing a cardiac psychosis of the type of endogenous depression, acute delirium or with schizophrenia like delusions.

Adolescent↗
PubMed1976

[Cerebral embolism and psychosis with special reference to cardiac surgery (author's transl)].

Cerebral embolism can manifest itself in certain cases as pure psychosis. In the absence of neurological symptoms it might be mistaken for schizophrenia or manic-depressive psychosis. Cardiac disease and cardiac surgery involve a high risk of embolism. Microembolism plays a special role with extracorporal circulation. There is a significant increase of postoperative psychosis in cases with E.C.C. in comparison to closed heart surgery. Immediately post-operatively there occurs what has been described as the "catastrophic reaction" or "immobilization syndrome". This reaction is in fact an akinetic, parkinsonian-like state for which there is good evidence that it is due to transient microembolism of the basal ganglia ("striatum apoplexy"). After its disappearance around the 3rd--5th day "cardiac psychoses" (cardiac delirium) may manifest themselves. Patients who develop these "late" psychoses have a significantly higher correlation with endogenous psychoses in their family histories. On the psychopathological level--in the absence of disturbances of consciousness and orientation--it is not possible to differentiate between "exogenous" and "endogenous" psychosis. A special type of psychopathological reaction is dependent, as in neurological disease, on the severity of brain damage, its localization and on hereditary factors.

Basal Ganglia↗
PubMed1976

[Criteria of the efficacy of therapeutic measures in alcoholic delirium. Study on the effectiveness of aprotinin in alcoholic delirium].

30 patients with delirium tremens were given in a double-blind trial--beside the basic treatment with chlormethiazol (Distraneurin)--aprotinin (Trasylol) or placebo. Duration of the delirium and the amount of chlormethiazol used were the criteria for successful treatment. It was shown that the additional application of aprotinin did neither shorten significantly the duration of the delirium not save the amount of chlormethiazol used. Methodologically, special attention was given to the question of duration of the delirium and of registering symptoms. A delirium-rating scale was devised and its analysis showed a good randomization of the items. One main question was as to what extent the individual items were good indicators of a delirium. An item intercorrelation showed that there were two clusters of symptoms: psychological and sympathetic nervous system symptoms. It could be shown that the items 'consciousness, orientation, hallucinations and short-term memory' were good indicators of the delirium, while items of the autonomous nervous system, as tremor of hands and body, facial muscular twitching and exteroceptive reflexes, were less indicative of delirium. The duration of the delirium seems to be the best criterion for the question as to whether a drug is effective or not in delirium tremens. There is a highly significant correlation between the degree of the severity of the delirium and its duration. Other significant predictors for the severity of the delirium were the maximal pulse rate and change in blood pressure. Age, duration of alcoholism and psychological or physical depravation showed no influence on the duration of the delirium.

Adult↗