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Biomedical subjects

R R Unger

Publications and source records attributed to R R Unger.

At least 19 recordsLinked to original sources
PubMed1990

[Subdural empyema].

The subdural empyema is a severe inflammatory cerebral affection and shows some diagnostic and therapeutic problems. Extracerebral infections especially in the rhinogenous and otogenic region represent the most frequent cause of the subdural empyema. Seven cases, treated between 1982 and 1986 in our department, are the base to discuss the problems of symptomatology, differential diagnosis and therapy. The treatment of choice is a sudden craniotomy in combination with a through-drainage and administration of antibiotics.

Adolescent↗
PubMed1989

[The immunohistochemistry of pituitary adenomas].

A great deal of progress has been achieved in recent years in the field of immunohistochemistry of pituitary adenoma. Continued use of more new antisera and monoclonal antibodies against numerous hormones in the adenohypophysis have resulted in new approaches to classification of pituitary adenoma. However, new problems have been discovered, on the other hand, by large-scale studies in recent years. The great number of multihormonal pituitary adenomas and possible change of the immunohistochemically detectable hormone status in cases of recurrent tumours have particularly re-emphasised the need for new thinking about patterns of classification. It would appear somewhat problematic, in this context, to uncritically accept terms, such as ACTH cellular adenoma or GH cellular adenoma. Reference is also made to the distribution pattern of cell and tissue markers in pituitary adenomas. The paper is based on thorough literature screening as well as on experience obtained by the authors from 450 cases of pituitary adenoma of which 260 had been analysed by immunohistochemistry, 131 by morphometry, and 80 by electron microscopy.

Adenoma↗
PubMed1987

[Surgery of aneurysms of the cerebral arteries--results and problems].

Surgery has been performed on 100 intracranial aneurysms during the past seven years. Of these, 96 involved the application of microsurgical techniques and could definitely be clipped. Lethality was 8%. Post-surgical deterioration of the clinical neurological status was observed in another 20 patients, but vanished subsequently in 16 of them. Immediate surgery within 48 hours of the subarachnoidal hemorrhage is recommended to avoid subsequent hemorrhage and prevent severe vasospasmic phenomena. Only patients whose general status is good (Hunt and Hess degree 1 or 2) are suitable for immediate surgery.

Adolescent↗
PubMed1987

[Aneurysm surgery in relation to secondary intracranial findings].

In 116 patients operated on because of aneurysms we found 125 aneurysms, one convexity meningioma, and one A. V. supratentorial angioma. In 9 patients (8%) more than one aneurysm were found. In 8 patients there were double aneurysms and on one case 4 aneurysms, 18 of these 20 aneurysms were clipped. If these were situated on the same side they were treated simultaneously. If they were situated on two sides, the aneurysms were clipped in two surgical interventions. In 2 patients one of the two aneurysms remained untreated. Two interventions were also carried out for the combination aneurysm/tumor. After clipping the aneurysm, the meningioma was removed after an appropriate interval.

Brain Neoplasms↗
PubMed1986

[A simple aid for the localization of intracranial tumors in cerebral computer tomography].

The exact localizing co-ordination of small intracranial, space-occupying processes is sometimes difficult. As a simple aid for exact localization of such processes a "rod headband" is presented, which consists of a leather strap with exchangeable plastic rods and can be put on the patient's forehead for a CT examination. The artifact-free representation of the little rods in the axial CT layers makes it possible to localize intracranial processes more exactly. Until now, the "rod headband" has been used for ten patients with the following indications: Needle biopsies of intracranial space-occupying processes, cerebral abscess punctures, haematoma punctures, and as a pre-operative localization aid for intracranial tumours.

Brain Abscess↗
PubMed1986

[A change in aneurysm surgery--the acute operation].

Patients who have undergone aneurysmal rupture may be endangered by recurrent haemorrhage and consequences of vasospasm. The risk of recurrent bleeding may be ruled out and favourable conditions provided for active treatment of vasospasm by immediate surgical action on a ruptured aneurysm of a cerebral artery. Such action, however, should be taken not later than three days from the event of rupture. Reported in this paper is experience obtained from eleven acute operations in a total of 110 aneurysmal operations over the past seven years. Acute operation is recommended, provided that certain conditions are met.

Acute Disease↗
PubMed1985

[Giant aneurysm--manifestations, diagnosis and therapy].

The particularities in the clinical picture, in the diagnostic regimen and in the therapeutic schedule of eleven patients with an aneurysm showing a diameter larger than 25 mm (giant aneurysm) are presented. These aneurysms become clinically manifest as space occupation, as subarachnoid haemorrhage or TIA. 3 false diagnoses in which the aneurysm was mistaken for a cerebral tumour accentuate the necessity of a complete angiographic examination. The computer tomogram yields sufficient information permitting the suspicion of an aneurysm. In 8 patients, the direct aneurysm clipping could be performed; in 2 of them an extra-intra-cranial microanastomosis was established in the same session as a preliminary intervention. The establishment of a microanastomosis was carried out in 2 other patients. After a certain time interval, a carotid ligature (A. carotis interna) in the region of the neck was established in one of these patients. As a purely symptomatic measure for the treatment of the supratentorial pressure hydrocephalus we established a ventricular-atrial drainage in a case of basilar aneurysm. Besides 1 death and 2 severe complications, very good results could be achieved in 5 patients.

Adult↗
PubMed1981

[Microsurgical anastomoses between extra- and intracranial arteries (author's transl)].

86 patients underwent microanastomoses to branches of the anterior-, medial-and posterior cerebral arteries and the inferior cerebellar artery. Intraoperative electromagnetic measurement yielded a mean flow of 33 ml/min with a velocity of 11 to 54 cm/s. The brain circulation increased by a percentage of 38. In a percentage of 90 postoperative angiographic controls turned out anastomoses to be patent. By this surgical technique unilateral brain circulation can be improved significantly.

Arteries↗
PubMed1978

[Diagnostic classification of intracranial meningiomas in the serial angiogram].

On the basis of 70 serial angiograms of surgically and histologically reliably diagnosed intracranial meningiomas and the appertaining general radiographs of the skull the following was found: 48.5 per cent of the general radiographs showed reactions, 7.1 per cent showed tumour calcifications. Basal meningiomas of the anterior and medium cranial fossae and meniogiomas of the wings of the sphenoid bone are supplied by the a. carotis interna, that is to say, they are also diagnosed by the internal carotid angiography. In serial angiograms, classification was possible in 74 per cent. The other supratentorial meningiomas require angiographies of the external or the common carotid. Infratentorial menigiomas were diagnosed in 50 per cent of the angiograms. The "early vein" is no reliable sign of malignity of the menigiomas. The same applies to "apthologic vessels", "shunts", etc. Staining does not give any secure indications of histological structures.

Cerebral Angiography↗
PubMed1978

[Meningiomas from the clinical viewpoint of first symptoms, duration of anamnesis and neurologic-ophthalmologic deficiency symptoms].

UNLABELLED: First symptoms, period of case history, neurological findings and ophthalmological findings were evaluated in 123 patients operated on because of meningiomas. Typical first symptoms were headache (42%), fits (30%) and impaired vision (28%). 70 per cent of the patients showed a case history period of up to two years, 11 per cent one of more than five years. In 25 per cent this period was less than six months. In two cases the symptoms set in an acute form. Paresis was found in cases of meningiomas of the falx convexity region. A papilledema was found in 41 per cent, reflex differences in 30 per cent and hemiparesis in 13 per cent of the patients. LOCATION: parasagittal (28 patients), falx (10 patients), convexity (31 patients), tentorium (6 patients), posterior cranial fossa (4 patients). Neither a short period of the case history nor the absence of neurological and ophthalmological changes can exclude a meningioma.

Adult↗
PubMed1977

[Leptomeningopathia chronica circumscripta adhaesiva sive cystica].

During neurosurgical operations of 73 patients alterations of the leptomeninx were found additionally other clinical diagnoses or confirming the clinical diagnosis of a chronic leptomeningopathia. In these cases tissue was taken for histological examination. In 65 cases there were alterations of all parts of the leptomeninx, mostly connected with inflammatory infiltrations. The commonly used terms "arachnitis" or "arachnoiditis" for these circumscribed chronic leptomeningopathias are not to be accepted because of different reasons. Instead of these names a describing diagnosis is recommended.

Adult↗
PubMed1977

[Cryogenic injuries of the rabbit abdominal aorta and the iliac artery].

In rabbits, cryogenic injuries of the walls of abdominal aorta and iliac arteries were histologically examined after application of a cryoprobe ob -160 degrees C for 1 minute. Seven days thereafter the animals were killed. Extended partial and circular necroses and calcifications of the vascular walls were found. The alterations were less expressed when the blood stream was maintaimed during the freezing. Maximal changes occured at additional centripetal pinching the vessels.

Animals↗
PubMed1977

[Possibilities for error in the diagnosis of craniopharyngiomas].

Age of affection, preferential seat, clinical picture and instrumental diagnosis of craniopharyngiomas are discussed on the basis of 30 observations. Although childhood and adolescence are the leading age groups, there also was a 64-year-old patient. Three courses of the disease were selected: a 6-year-old girl presented both clinically and by instrumental examination indications of a cerebellar tumour; a mandarin-sized arachnoid cyst near the midline was removed. One year later, a suprasellar craniopharyngioma of the size of a chestnut was removed subtotally. Retrospectively, the arachnoid cyst was only seen as a side-finding. A 13-year-old girl showed angiographically and in the pneumoencephalogram signs of a cerebellar tumour located in the middle; the operation showed regular conditions. Only frontal trepanation showed a plum-sized cystic retrochiasmal craniopharyngioma. Similar conditions were found in another 6-year-old girl.

Adolescent↗
PubMed1977

[Indications for relief and palliative operations].

Torkildsen and Spitz-Holter drainages and/or osteoclastic trepanation were performed on 29 patients suffering from a severe increase in intracranial pressure and/or a severely worsened general condition as a relieving intervention in order to permit a tumor operation later. The relieving measure enabled a tumor operation in 28 patients. The same procedure was used as a palliative step for another group of 73 patients suffering from inoperable tumorous processes. Evaluation in these cases showed that the release of pressure via the liquor system brought a prolongation of life while at the same time alleviating painful symptoms, in 50 per cent of the patients. Osteoclastic trepanation, on the other hand, appeared to be unsuitable as a palliative measure. The text is accompanied by tables.

Brain Neoplasms↗