Biomedical subjects

R Stendel

Publications and source records attributed to R Stendel.

23 records · Page 2Linked to original sources

PubMed1998

Neoplasm of endolymphatic sac origin: clinical, radiological and pathological features.

This paper reports on a 55-year-old female who had undergone middle ear surgery 12 years previously and was admitted with a 6-months history of unilateral hearing loss and facial weakness. MRI and CT demonstrated a space-occupying lesion arising from the temporal bone and extending into the posterior fossa. Treatment consisted in complete tumour removal. Temporal and mastoid bone destruction associated with typical histological features led to the diagnosis of neoplasm of endolymphatic sac origin. Clinical, histological, radiological and intra-operative features of these rare tumours are described and discussed. The pertinent literature is reviewed.

Cholesteatoma, Middle Ear↗

PubMed1998

The value of intraoperative angiography for surgical treatment of cerebral arteriovenous malformations in eloquent brain areas.

Intraoperative digital subtraction angiography (DSA) allows intraoperative assessment of outcome of cerebral arteriovenous malformations (AVM). This study reports on 21 patients with AVMs in eloquent areas of the brain extirpated between July 1995 to March 1998. Extirpation was always followed by intraoperative DSA. Intraoperative angiography disclosed an occult residual nidus in 4 cases (19%). Complete extirpation of the AVM was achieved in all cases. Following surgery the neurological condition improved in 15 cases (71%), remained unchanged in 5 (24%), and worsened in 1. There were no secondary postoperative haemorrhages, nor complications related to the angiography. These results indicate that intraoperative DSA should be considered in the course of surgical treatment of cerebral AVMs in eloquent areas of the brain.

Adolescent↗

PubMed1997

Periradicular therapy in lumbar radicular syndromes: methodology and results.

Periradicular therapy (PRT) has become popular in the treatment of lumbar radicular complaints, both primary, due to disc herniations (Group 1), and postoperative, following disc surgery (Group 2). However, hitherto reported data on 'periradicular injections' are more of a technical nature. The present study was designed to evaluate the therapeutic success of CT- versus fluoroscope-guided periradicular injections of local anaesthetics and corticoids, and to investigate the impact of imaging procedures on the results. We report on 80 patients who underwent CT-guided (n = 40) or fluoroscope-guided (n = 40) PRT for lumbar radicular irritation since April 1993. Forty patients had primary nerve root irritation due to disc protrusion, and 40 suffered from postoperative epidural fibrosis. Follow-up consisted in a clinical examination and an interview one day after each injection as well as 1 and 6 months later. Assessment was based on a score taking into account the clinical findings, the patient's complaints, and the patient's evaluation. Six months following treatment there was a significant reduction of ischialgia in both Groups 1 and 2 (p < 0.001). However, the results were significantly poorer in Group 2 (postoperative). Among the patients not operated on, those who underwent CT-guided injections had a significantly better outcome (p < 0.001). PRT had no significant influence on low back pain or pseudoradicular syndromes. The improvement of sensory disturbances achieved by both CT- and fluoroscope-guided injections in patients not previously submitted to surgery is statistically significant (p < 0.05). As compared to Group 1 (no surgery), the positive effects in patients of Group 2 were of significantly shorter duration (p < 0.05). Motor deficits were not influenced by the treatment. Long-term follow-up shows that there is no positive effect in those patients in whom the first two PRT attempts had failed. Thus, PRT represents a useful long-term therapeutic alternative for lumbar radicular syndromes, particularly when due to primary discogenic compression. CT-guided injection is superior to fluoroscope-assisted treatment for both its visualization and its longer-lasting effect.

Adult↗

PubMed1997

The relationship between cortical injury and brain tumour. Report of two cases and review of the literature.

We report on two cases of brain tumour and discuss the possible relationship to previous cortical trauma. The first patient, a 67-year-old male patient developed a glioblastoma at the same site of an open shell-splinter injury of the brain after a latency of 48 years. The second patient, a 55-year-old male, had a malignant anaplastic astrocytoma in the right frontal lobe 10 years after clipping of an aneurysm of the anterior communicating artery. Both cases fulfill the criteria of Zülch [52] for the correlation between cortical trauma and tumour. We believe that the development of a brain tumour following a cortical injury is very rare, although possible. Probably the brain must display some form of predisposing genetic alteration for a tumour to develop following a cortical injury.

Aged↗

PubMed1994

[A case of diastematomyelia (split cord malformation type I) with clinical manifestation in adulthood].

We present the case of a female patient with split-cord malformation type I (diastematomyelia) who developed first symptoms as an adult and worsened markedly after intramedullary injection of local anaesthetics. Our own observations are compared with the small number of cases known from the literature. We are using the morphological and clinical classification of spinal malformations of Pang et al. (1992), which is based on a uniform disturbed embryonal development [18, 19]. The 52-year-old patient presented to her family physician in September 1991 with pain in the region of the vertebral column which had developed gradually over a period of two weeks. Following unsuccessful analgetic and muscle-relaxing therapy, the family physician had the patient transferred to the orthopedic department of a hospital. Lumbar peridural infiltrations were carried out there in February 1992 for a suspected disc prolapse. Since June 1992, she had no longer been able to walk. In addition, there had also been a progredient urinary incontinence since April 1992. The spinal CT scan reveals a duplication of spinal cord starting at the level of L4 as well as a bony spur dividing the spinal cord at levels L4 and L5. MRI of the vertebral column likewise reveals a duplication of the spinal cord starting at L4 as well as a low conus and a bone spur extending from L4 to L5 is also visualized here. Each primordial spinal cord is surrounded by its own dura mater. Altogether, this led to the diagnosis of split cord malformation type I according to Pang et al. [18].(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗