PubMed Health⌕ Search

Biomedical subjects

V Grunert

Publications and source records attributed to V Grunert.

At least 37 records · Page 2Linked to original sources
PubMed1985

Treatment of cerebral vasospasm following severe head injury with the calcium influx blocker nimodipine.

8 patients suffering from severe head injury (Glasgow Coma Scale score of 3-5) were treated with the calcium influx blocker nimodipine (2-3 mg/h) for a traumatic cerebral vasospasm. In every case the spasm involved the frontal region of the circle of Willis with the first two segments of the anterior and middle cerebral artery. Control angiograms, recorded in 6 patients, revealed a dilated or normalized lumen of the vessels that the first angiography had revealed to be spastic. The intracranial and the mean arterial pressure were not altered by nimodipine during simultaneous neurosurgical intensive care therapy (dexamethasone, mannitol, relaxation, and controlled respiration for 2-3 days). Monitoring of the somato-sensory evoked potentials (SEP) showed a distinct improvement of the cortical response within 7 days. One patient died of sepsis 8 days after the accident and one remained in a vegetative state. The remaining patients reached Glasgow Coma Scale scores of 13.0 +/- 1.1. within 8.6 +/- 2.2 days, the initial scores having been 4.1 +/- 0.8. One year after their accident all the patients were once again fully able to work. The survival quality was therefore better than that reported in the literature for patients in similar conditions. We conclude from these preliminary results that calcium influx blockers can be used successfully in the therapy of traumatic vasospasm and of severe head injuries. A study involving a larger number of patients is currently in progress.

Adolescent↗
PubMed1985

Subarachnoid metastases from a prolactinoma.

A 37-year-old man developed a left frontal metastasis from a prolactin-secreting pituitary tumour, which had been operated on nine years before. The metastatic tumour was totally excised. One and a half years later he was found to have multiple left temporal and parietal subarachnoid metastases. Because treatment with bromocriptine for five months and subsequent radiation proved ineffective, the tumour nodules were removed surgically.

Adenoma, Chromophobe↗
PubMed1985

Multiple intracranial metastases from a prolactin secreting pituitary tumour.

A 28 year old man presented with partial hypopituitarism and signs of a pituitary tumour. A chromophobe adenoma was partially removed by right frontal craniotomy. Seven years later complete hypopituitarism and hyperprolactinaemia were documented, at which time there was no evidence of tumour recurrence of CT scan. The patient was treated with bromocriptine but the pituitary tumour redeveloped a year later. Nine years after the original operation the first metastasis was demonstrated together with very high prolactin levels. The intracranial metastasis, and the pituitary tumour were removed at a second craniotomy following which the prolactin concentration fell. Further metastases developed subsequently and the patient died 12 years after the initial diagnosis. At autopsy multiple metastases were found in the brain, tumour cells were present in the subarachnoid space and in cerebral veins. The pituitary tumour and secondaries were shown by immunocytochemistry to contain prolactin but not ACTH or growth hormone. This appears to be the third well documented case of a metastasizing, prolactin secreting pituitary tumour.

Adenoma, Chromophobe↗
PubMed1984

[Neuropsychologic aspects of spastic torticollis].

On behalf of the limited number of patients, statistical analysis and correlations had not been possible. It was evident however that two groups of patients can be differentiated: One with depressive-neurotic mechanisms and the other without signs of any neurotic-depressive state. It can be concluded that patients with depressive-neurotic signs give poor results after surgical procedures, whereas the other group gives satisfactory surgical results.

Adult↗
PubMed1984

[Clinical experiences with nimodipine (Bay e 9736)].

In 27 patients, who suffered from SAH from a ruptured cerebral aneurysm direct operation and treatment with Nimodipine (Bay e 9736) was performed. Nimodipine was given intravenously over ten days (30 micrograms/kg bodyweight/hour) and thereafter orally over four days in diminishing dosages. There were no noteworth side effects. In comparison with a group of nine similar patients who were not given Nimodipine the study shows that Nimodipine is not able to reduce angiographic spasm or brain oedema in CT-scan. In spite of that the general recovery with Nimodipine was better than in the control group. The worse the initial neurological symptoms are, the more effective Nimodipine seems to be. The study shows that treatment should begin between the first and sixth day after SAH, at least two days before operation and at the latest two days after the onset of secondary spasm.

Calcium Channel Blockers↗
PubMed1984

[Spontaneous healing of a carotid-cavernous fistula].

In a posttraumatic carotid-sinus cavernous fistula, spontaneous healing occurred which was angiographically demonstrated. After this closure had occurred, an aneunysmal enlargement of the internal carotid was proved to exist and confirmed even two weeks later together with a concomitant spasm. The author is of the opinion that the cause of a carotid-sinus cavernous fistula is in most cases a ruptured aneurysms. By partial thrombosing of the aneurysm, a closure of the fistula occasionally takes place and thus the above mentioned spontaneous healing is reached.

Adolescent↗
PubMed1983

[Tumors of the 3d ventricle, clinical aspects and treatment].

Our last 30 patients, who were operated upon 3rd-ventricle-tumors, are discussed on symptomatology, diagnosis and therapy. Depending on the localization we classify oral, basal and caudal tumors. The peak of these tumors is found in the first ten years of life. They are distributed as followed: spongioblastomas, ependymomas, pinealoma and other rare tumors. Mainsymptom is the sudden diffuse headache depending on this skull's position. The three groups show different symptomatic features, the oral one sepecially that headache described above. The symptoms of the caudal group are due to signs of raised intracranial pressure and content the typical syndrome of the lamina-quadrigemina. Basal tumors lead to diencephalic disturbances. The CT scan should be done as the first diagnostic step, eventually connected with ventriculography or ventriculotomography. In any case therapy should be started by implantation of an atrio-ventriculare shunt. If the disease is progressing an invasive procedure has to be done. Irradiation therapy is bound to a clear histologic diagnosis or to a clear inoperability. Our 5-years survival was 40% in average.

Adolescent↗