Biomedical subjects
Publications and source records attributed to T Wencel.
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The concentrations of noradrenaline, 5-hydroxytryptamine, dopamine, 5-hydroxyindoleacetic acid and homovanillic acid were determined in the tissue of gliomas, meningiomas and neurinomas of the brain obtained during operations. Significantly higher levels of noradrenaline and 5-hydroxyindoleacetic acid were found in gliomas than in non-malignant tumours.
In 14 patients with supratentorial tumours and symptoms of intracranial hypertension the concentrations of HVA and 5-HIAA were determined in cerebrospinal fluid obtained by lumbar tap. Significantly raised levels of both these metabolites were demonstrated in the cerebrospinal fluid in these patients in relation to controls. The cause of this rise could be excessive production of serotonin or dopamine, increased turnover of these amines or impaired absorption of 5-HIAA and HVA by the choroid plexus of the fourth ventricle.
Two patients with subacute epidural haematomas without shifted ventricular system are described in whom the diagnosis was made by computer tomography 8 and 9 days after trauma. Both patients were treated successfully checking the progress with computer tomography and using agents reducing brain oedema.
A case is reported in which chronic subdural haematoma developed in association with a glioma of the left temporal lobe. The stroke-like onset of symptoms one month before surgical intervention, encapsulated liquid subdural haematoma, necrotic cerebral cortex over the tumour and easily bleeding peripheral parts of the tumour suggested a primary haemorrhage into the peripheral part of the tumour followed by penetration of the haematoma into the subdural space.
A 22-year-old patient is described in whom sudden deterioration developed on the 9th day after severe craniocerebral trauma. Left common carotid angiography demonstrated an aneurysm on a cortical branch of the middle cerebral artery and subdural haematoma. During the operation the aneurysm was excluded from the circulation.
A female patient is described in whom symptoms of cholecystitis developed after operation for intracranial aneurysm. Enlarged polycystic kidney was recognized erroneously as gallbladder and this error led to laparotomy. In another case meningocerebral haemorrhage developed in a hypertensive patient with polycystic kidney degeneration.
The authors describe a case of acute traumatic epidural haematoma in an infant aged 5 months after slight head injury Acute anaemia coexisted. In view of the rarity of this complication after craniocerebral trauma in this age group and clinical distinctness of epidural haematomas in children this possibility should be considered in the differential diagnosis of sequelae of head trauma in infants.
A case of a rare post-traumatic complication of haemophilia A is reported. Similarly as other authors an atypical clinical course and growing internal hydrocephalus were observed in the present case. Haemorrhagic diathesis prolonged only the period of healing of the surgical wound.
Head trauma is the leading cause of morbidity and death in paediatric population. The authors present an outline of contemporary knowledge on the paediatric head injury on the ground of literature and own experience. The value of Glasgow Coma Scale, its modifications and other prognostic factors in children's population after head trauma is discussed. The management of mild head injury is also disputed. In conclusion it is stressed that since many differences in epidemiology, mechanism, pathophysiology and outcome of head injury in childhood and adults exist the separation of "paediatric neurotraumatology" is reasonable.