The Belgian Society for Neurosurgery.
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Academic Medical Centers↗
Biomedical subjects
R Van den Bergh
Publications and source records attributed to R Van den Bergh.
Ethical requisites of basic knowledge, diagnostic procedures and operative techniques in neurosurgical training and practice.
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Education, Medical, Graduate↗
Syringo-peritoneal shunting: results and problems in a consecutive series.
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Adult↗
Headache caused by craniospinal pressure dissociation in the Arnold-Chiari-syringomyelia syndrome.
Two patients with Arnold-Chiari malformation, associated with syringomyelia, are described. They presented with headache caused by coughing, sneezing and straining. The pathogenesis and diagnosis are discussed. The treatment of this condition consists in a fossa posterior decompression, in some cases followed by a syringoperitoneal or a syringosubarachnoid shunt.
Adult↗
The effect of exercise and in vivo treatment with ACTH and norepinephrine on the lipolytic responsiveness of guinea pig (Cavia porcellus) adipose tissue.
1. In adipose slices of the guinea pig (Cavia porcellus), adrenocorticotrophic hormone (ACTH) produced a significantly higher lipolytic response (increased Vmax and decreased Km) as compared to norepinephrine (NE), thus indicating a marked difference with human adipose tissue. 2. Exercise-training caused a significant increase in the affinity of the lipolytic response in adipose tissue towards both ACTH and NE, but had no significant effect on Vmax. 3. Prolonged in vivo treatment with both ACTH and NE significantly decreased the responsiveness (affinity and capacity) of adipose slices towards ACTH. Responsiveness towards NE was much less affected.
Adipose Tissue↗
The effect of prolonged exercise and in vivo treatment with ACTH and norepinephrine on plasma cortisol and on the levels of energy metabolites in liver, muscle and blood of the guinea pig (Cavia porcellus).
1. Exercise and in vivo treatment with adrenocorticotrophic hormone (ACTH) showed a marked tendency to increase in vivo plasma cortisol levels in the guinea pig (Cavia porcellus). 2. However, in vivo norepinephrine (NE) treatment did not have any notable effect on plasma cortisol levels. 3. Metabolite levels (glycogen, glycerol and lactate) in liver and plantaris and soleus muscle, and the levels of glucose, glycerol and lactate in blood, were determined in response to the same treatments. 4. A number of statistically significant changes, as well as certain trends, in metabolite levels were observed in response to the treatments and are discussed.
Adrenocorticotropic Hormone↗
Pathogenesis and treatment of delayed post-traumatic syringomyelia.
The role of trauma in the pathogenesis of syringomyelia has been known for a long time. Repeated microtraumata have been considered to play a role in triggering the classical syringomyelia on the basis of a congenital predisposition. It has been proven that post-traumatic arachnoiditis can cause cavitation in the spinal cord and probably syringomyelia stricto sensu as well. The delayed appearance of syringomyelia after a severe single spinal trauma resulting in contusion of the spinal cord without the complication of arachnoiditis is a more recent issue, but is now well-known. Delayed syringomyelia after a minor single spinal trauma, with at first complete recovery, is extremely rare, and is probably often disregarded as a diagnosis. Having studied such a case, with complete neuroradiological work-up, we want to draw attention to the pathogenetic aspects and the possibilities for treatment, of which the syringoperitoneal shunt seems to be the most efficient one.
Adult↗
Bilateral faciobrachial paresis as a consequence of symmetrical capsular infarcts.
A 32-year old man presented with a bilateral faciobrachial paresis, pyramidal signs in the upper limbs and dysarthria. Computer tomographic (CT-)scans showed bilateral cortical zones of contrast enhancement and strikingly symmetrical capsular hypodensities. Angiography revealed a stenosis of the left internal carotid artery and an occlusion of the right internal carotid artery. Essential thrombocythemia was diagnosed as the underlying disorder. Since there are no indications of pontine lesions, we assume that the signs and symptoms in this patient could mainly be attributed to the bilateral capsular lesions, that resemble lacunar infarcts.
Adult↗
Lateral-paramedian infratentorial approach in lateral decubitus for pineal tumours.
All classical operative approaches for pineal tumours have important disadvantages. A lateral-paramedian infratentorial approach in lateral decubitus is proposed. It has the advantage that one can reach the pineal region by way of a shorter distance and over a lower situated part of the upper cerebellar surface. Lifting of the transverse sinus becomes unnecessary. The venous vessels can be saved and there is no risk for air embolism or pneumocephalus.
Brain Neoplasms↗
Therapeutic approach of posterior fossa tumours in adults. A retrospective study.
The authors present a review of their experience with posterior fossa tumours in adults during a period of 20 years. Symptoms, physical findings, tumour histology, operative treatment and results are reviewed in 109 cases. The value of preoperative normalization of intracranial pressure by insertion of a ventriculo-subcutaneous drainage is discussed.
Adolescent↗
Syringomyelia: a retrospective study Part II: Diagnostic and therapeutic approach.
In a retrospective study of 62 cases of syringomyelia, spanning thirteen years, we investigated the diagnostic value of the different imaging techniques, and the outcome of the several forms of therapy. Magnetic resonance imaging appears to be the examination of choice, being most informative and least invasive. When surgical treatment is indicated, syringoperitoneal shunting will stabilize or improve the condition in a substantial number of cases. Indications for the other surgical procedures are discussed.
Adolescent↗
Syringomyelia: a retrospective study. Part I: Clinical features.
We performed a retrospective study of 62 patients with syringomyelia. Most noteworthy among the clinical features in our patient population are the following: segmental sensory disturbances are usually less restrictive than the classical thermoanalgesia, pain is a presenting symptom in almost 50% of cases, and skeletal abnormalities of the "status dysraphicus" are very common. The different hypotheses about the pathogenesis are also discussed.
Adolescent↗
Diagnosis of foraminal and extraforaminal lumbar disk herniation.
Thanks to the more systematical use of CT scan, more and more foraminal and extraforaminal disk herniations are discovered. Some symptoms and signs can be suggestive. Association of negative myelography with important radicular signs should receive special attention. The extremely lateral herniation can be managed easiest and safest by a combined approach, both interlaminar paramedian and lateral to the facet joint, which should be preserved.
Acute Disease↗
Clinical experience with Tc-99m HM-PAO high resolution SPECT of the brain in patients with cerebrovascular accidents.
In order to evaluate the diagnostic contribution of brain SPECT imaging with 99mTc-HMPAO in cerebrovascular disease, we examined 92 stroke cases (144 lesions), 2 hematoma cases and 30 cases with transient neurologic symptoms. Abnormal tracer distribution is visible as zones of either hypoactivity or hyperactivity (border zone hyperemia or luxury perfusion). Remote vascularization changes could also be found (crossed cerebellar diaschisis or ipsilateral cortical perfusion reduction in thalamic or capsula interna lesions). Both X-ray CT and blood flow SPECT have comparable sensitivity in the exploration of cerebral infarction, with detection in, respectively, 89.5% and 87.5% of the lesions. False negative scintitomographic images are frequently recorded in small lacunar infarcts within the basal ganglia and white matter (capsula interna). Some early infarcts and asymmetry of brain perfusion in patients with transient neurologic symptoms are frequently not detected by CT. An additional advantage of blood flow SPECT is its ability to visualize remote blood flow changes and the changing pattern of vascularization of ischemic lesions and their surrounding areas including hyperemia.
Brain↗
The glossopharyngeal neurinoma. Case reports and literature review.
Glossopharyngeal neurinomas are rare entities. Only 16 cases have been described so far in the literature. Our experience with 2 cases demonstrates the non-specific and discrete clinical presentation of the ninth nerve neurinoma, but illustrates also some typical radiological aspects, enabling a more precise preoperative diagnosis. Two cases are presented and a survey of the literature is given.
Adult↗
[Ambulatory myelography using iohexol (Omnipaque): methods and results].
Outpatient myelography with iohexol (Omnipaque) was performed in 150 patients. Side effects were noted in 28 patients (19%), with only 3 (2%) major complaints. It concerned 2 patients with severe and prolonged headache and one patient with seizures. Side effects were not more frequent in outpatient myelography than in reported series of hospitalized patients. The frequency of side effects was significantly lower with the use of iohexol than in comparable studies with metrizamide. Headache was the most frequent side effect, followed by an increase or exacerbation of ischiatiform pain, nausea and vomiting. Side effects were slightly more frequent in cervical myelography than in lumbar myelography and were not related to underlying pathology. It is concluded that outpatient myelography is feasable for as far as iohexol is used and patient surveillance is carefully organized.
Adult↗
Anterior cervical fusion and osteosynthetic stabilization according to Caspar: a prospective study of 41 patients with fractures and/or dislocations of the cervical spine.
Between June 1984 and April 1988, 41 patients with severe posttraumatic lesions of the cervical spine between the C2-C3 and the C7-T1 level seen consecutively were treated by an anterior cervical fusion and osteosynthetic stabilization according to Caspar. These patients were prospectively studied. Seven patients had a bilateral facet dislocation, 5 a unilateral facet dislocation, 9 an anterior subluxation, 9 an anterior compression fracture, 5 a hangman's fracture, and 6 a hyperextension injury at a lower cervical level. From a neurological point of view, there were 12 patients with an initial complete transverse lesion and 14 with an incomplete transverse lesion, and the remaining 15 patients did not have any deficit initially. Four patients died during the first 3 months after the operation. In 38 patients good anatomical position was obtained, generally by the intraoperative use of the vertebral distractor of Caspar. In all patients excellent immediate postoperative stability of the spine was obtained, although in 2 patients a second operation was necessary a few days after the first one. Postoperatively all patients were "immobilized" by a soft collar for 3 months. Four patients with an initial complete transverse lesion showed some neurological recovery in the postoperative period, and all patients with an incomplete transverse lesion improved. There were no postoperative neurological disturbances in the group of patients who were neurologically normal from the beginning. The mean postoperative hospitalization time was 13.6 days. These results were compared to the results from the literature, concerning other conservative and operative treatments for posttraumatic lesions of the cervical spine.
Adolescent↗