The basic design and the mechanism of clip application have not changed for many years. However in cases of aneurysms located deeply inside brain structure, in narrow spaces, multiple aneurysms or those which require applying of several clips the surgeon may have problems with visual control of the position of the clamping arms on the neck of aneurysm, nearby blood vessels and nerve structures. The above mentioned problems motivated prof. Axel Perneczky to construct a new model of clip with an applying and a removing holder whose mechanism is based on the principle of inverted--spring. Between February and August 1998 in the Neurosurgical Clinic in Katowice, 12 Perneczky's clips were applied in 9 patients. Intraoperative complications were not observed in any of the cases. In two cases of aneurysms located on the bifurcation of the basilar artery, application of two clips enabled precise intraoperative control of clip position.

Basilar Artery↗

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[Cleaning of acrylic protheses from gypsum using a sand-blower].

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Acrylic Resins↗

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[Homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) levels in the cerebrospinal fluid from the lateral ventricle of patients with brain tumors].

In patients with supratentorial tumours and posterior fossa tumours or in the third ventricle the concentrations of HVA and 5-HIAA were determined in the cerebrospinal fluid from the lateral ventricle. A significantly greater concentration of HVA and 5-HIAA was found in the patients with considerable hydrocephalus caused by occlusion of the third ventricle, aqueduct or fourth ventricle as compared with the cases of supratentorial tumours and with cases of moderate hydrocephalus and partial block of fluid outflow caused by third ventricle tumorous or posterior fossa tumours.

Adult↗

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[Results of the surgical treatment of intracranial aneurysm].

In the years 1976-1984 in the Department of Neurosurgery, Silesian Medical Academy in Katowice 196 patients were treated surgically for intracranial aneurysms. In the patients with aneurysms in the anterior part of the circulus arteriosus Yasargil's craniotomy was done. In some cases of aneurysms of the posterior cranial fossa suboccipital craniotomy was performed. In 181 cases the aneurysm was isolated by clipping it, in 4 cases it was trapped and in 11 wrapped. Good results were obtained in 60% of cases and bad in 15.9%. Death from extracranial causes occurred in 3 cases. The results of surgical treatment depended on the condition of the patient estimated by the Botterell scale, age, situation of the aneurysm and number of subarachnoid haemorrhages, duration of operation and experience in qualification of patients for surgery and on surgical technique.

Adolescent↗

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[Surgical treatment of a giant aneurysm of the middle cerebral artery].

Four patients with giant aneurysms of the middle cerebral artery over 2.5 cm in diameter were treated surgically. The aneurysms were excised during operations carried out under hypotension achieved with sodium nitroprusside, with administration of large amounts of mannitol and with arrest of blood flow in the middle cerebral artery for 3-10 minutes. Two patients had reoperations for postoperative complications. After the operation the patient who was initially in grade III of Botterell's scale died, and three other patients were in a good condition after one years with moderate paresis of the upper extremity.

Female↗

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[Subarachnoid hemorrhage in acoustic neuroma].

A 32-year-old patient is reported with two subarachnoid bleedings occurring at an interval of 5 years. The cause of bleeding was a richly vascularized neurinoma of the acoustic nerve with focal necrosis. Operation was successful.

Adult↗

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