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Biomedical subjects

U Kehler

Publications and source records attributed to U Kehler.

25 records · Page 2Linked to original sources
PubMed1998

How to perforate safely a resistant floor of the 3rd ventricle? Technical note.

Third ventriculostomy for acquired non-communicating hydrocephalus is an excellent alternative to shunting procedures. Nevertheless, complications can be severe and even fatal (e.g., lesion of the basilar artery), especially if the floor of the 3rd ventricle is very tough and/or opaque. The authors describe a safe method of sharp perforation of the floor, which should be applied if blunt fenestration cannot be achieved easily.

Endoscopes↗
PubMed1997

Asymmetric hydrocephalus: safe endoscopic perforation of septum pellucidum: technical note.

Asymmetric and/or loculated hydrocephalus can be treated with endoscopic septum fenestration to avoid or to simplify a shunt (1,2). In asymmetric lateral ventricles the septum pellucidum is dislocated to the opposite side and may even be in contact with the lateral wall of the contralateral ventricle (i.e., the thalamus). Perforating the septum with a catheter or a laser beam may damage the underlying tissue. The authors show a safe perforation technique: the septum is pulled towards the tip of the endoscope to enlarge the underlying space. Now the catheter can perforate the septum without the risk of damage to the underlying tissue.

Endoscopy↗
PubMed1995

Acute subdural haematoma from ruptured intracranial aneurysms.

Acute subdural haematoma (SDH) secondary to a ruptured intracranial aneurysm is a rare event. Out of a total of 292 patients with a verified aneurysm (period 1986-1992) in five cases SDH was the diagnosis on CT-evaluation. One patient was in such a bad condition that no treatment was indicated. The remaining four patients were operated on: craniotomy and haematoma evacuation in two cases, craniotomy for haematoma evacuation and aneurysm clipping in the other two cases. Two patients died and two achieved a good outcome.

Acute Disease↗
PubMed1992

Macro-aneurysm in the basal ganglia region.

A 59-year-old female patient suddenly developed vomiting and gait disturbances followed by decreasing consciousness. CT scans revealed a hemorrhage within the left basal ganglia region with rupture into the ventricles and consecutive hydrocephalus. On angiography an aneurysm in the region of the caput nuclei caudati was shown to be the source of the bleeding. On repeat-angiography 4 months later the aneurysm was no longer visualized, probably due to thrombosis. This is an extraordinary case of a basal ganglia aneurysm comparable with the aneurysms of Willis' circle, but located in a region where generally microaneurysms--mostly combined with hypertension or moyamoya disease--can be found.

Aneurysm, Ruptured↗
PubMed1991

[Abscess of the pyramidal apex].

The authors report on one case of an abscess at the pyramidal apex. The 52-year old male patient presented with pareses of the fifth and seventh cranial nerves and hypacusis on the right side. After diagnostic procedures (CT-scan, carotid angiography), a tumor at the apex of the right pyramid was expected. During surgery a large encapsulated mass was found containing pus. A bacterial agent could not be isolated. The abscess bordered on the mucosal lining of the sphenoid sinus and on the cells of mastoid bone. The starting point of an abscess at the pyramidal apex is most commonly an otitis media, most frequently caused by staphylococcus. Sterile abscesses are seen in almost 20%. Of differential diagnosis on has to keep in mind other space-occupying lesions especially epidermoid or dermoid cysts.

Brain Abscess↗
PubMed1990

Long-term follow-up of infratentorial pilocytic astrocytomas.

We present the data of 99 patients operated on for infratentorial pilocytic astrocytoma from 1955 to 1980 at the Neurosurgical Department of the University of Hamburg/West Germany. Twenty-two patients had died. From 56 patients long-term follow-up was obtained. A comparison was done for patients either operated on until 1969 or since 1970, the time when microscopes had been introduced into the operation theatre. The mortality rate clearly dropped with the beginning of the "microsurgical era", certainly due to other improvements as well, e. g. neurosurgical intensive care. The drop in mortality was not accompanied by an improvement in outcome. Future perspectives of possibly further improving the therapy of pilocytic astrocytomas are outlined.

Astrocytoma↗