Biomedical subjects
Publications and source records attributed to V Reinhardt.
Acute and chronic ear infection can lead to intracranial complications, brain abscess and meningitis being the most serious. The clinical picture, diagnosis and therapeutic guidelines are discussed. The important role of interdisciplinary management is emphasised by a case report.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Unexpected subarachnoid hemorrhage with a fatal outcome was seen in two patients in intensive care in association with trauma and an intracranial inflammatory abscess. The cause of SAH was disclosed at autopsy: traumatic and bacterial aneurysms of the basilar artery respectively. In the reported cases the symptoms of SAH did not suggest an origin.
We report a case of spinal seeding of a pilocytic astrocytoma of the chiasma opticum. Microscopic examination of the optic nerve tumor and the spinal tumor showed the same pathological patterns, without any signs of anaplastic transformation. The clinical course demonstrates the low growth rate of this kind of tumor, but spinal metastasis has not yet been described. We discuss different pathophysiological explanations of this atypical biological behavior with reference to the literature.
Ten patients suffering from intramedullary pilocytic astrocytomas (WHO-classification: astrocytoma grade I) were investigated catamnesticly. Combined surgery and radiotherapy was performed. Seven patients received neutron irradiation postoperatively. In four cases the neurological symptoms were improved after follow-up periods ranging from 33 to 89 months. The three other patients died after 6 to 21 months. The autopsy findings of a 14 year old child are presented. Our results are compared with reports in the literature. In addition, long-term problems of the spinal column are discussed. It seems that the combined surgical and neutron therapy improves the prognosis of pencil gliomas.
Chondromas are rare intracranial tumours. Sometimes they occur as a manifestation of a 'generalised chondromatosis'. The authors present a case of sellar chondroma in a patient with Ollier's disease. The tumour showed a mainly suprasellar extension resulting in a chiasmatic syndrome. The pathogenesis of intracranial chondromas, their clinical features, and CT- and MRI-findings are discussed.
Alternatives to single caging of laboratory rhesus monkeys were explored. 1. Surplus infants (12-18 months old) from breeding troops were paired with 48 adult females (6-28 years old) and 12 adult males (8-28 years old) that had lived alone for several years. Adults and infants were not related. The partners were compatible in 87% (42/48) and 83% (10/12) of cases, respectively, throughout follow-up periods of 16-25 months. The young companions reached 28-44 months of age during that time. 2. Forty-six unrelated adult female rhesus monkeys (7-23 years old) and 10 unrelated adult male rhesus monkeys (8-16 years old) that had lived alone for several years were familiarized in isosexual dyads and then paired in different cages. Paired companions were compatible in 83% (19/23) and 80% (4/5) of cases, respectively, throughout follow-up periods of 9-24 months. Of all animals tested, 2% (3/176) received a bleeding but not life-threatening wound by an incompatible partner. Pairing previously individually caged rhesus monkeys did not interfere with the following research protocols: tethering of one partner for remote collection; head-cap implantation on one or both partners; chair-restraining of one partner while the other is kept close by for psychological support; in-cage venipuncture of both partners (attempted with females only); temporary (1-7 d) partner separation for timed breeding or for experimental surgery. Pairing singly caged adult rhesus monkeys with infant or with other adult companions is recommended as an effective way to promote the animals' wellbeing by enabling them to express their inherent need for social contact.
Explore the source record for details and available documents.
Indications for, and methods of, surgical treatment in patients with syringomyelia are described. In 16 patients a syringomyelic cavity was drained. Clinical, radiological and operative findings and results are reported and discussed. In six of twelve patients followed up, progressive deterioration was arrested by operation and two patients improved.
Cases of optic nerve lesions of various origins are described. These were seen in a systematic study of 59 autopsy cases with underlying neurological or neurosurgical diseases. The characteristic morphological signs of direct and indirect as well as primary and secondary lesions are discussed. Circulatory complications in cases with increased intracranial pressure are stressed.
Despite declining frequency of postmortem examinations in mental hospitals no corresponding decline in the proportion of intracranial space-occupying lesions is observed in a 30-years retrospective study. 77.5% of these lesions were meningiomas, gliomas, metastases, and subdural haematomas. 70.4% of all 71 patients had major psychiatric abnormalities during the clinical course. In 58% of these patients no clinical diagnosis of intracranial space-occupying process was made. Reasons for the diagnostic delay and for the postmortem results are discussed. The significance of psychopathological change in the group of long-term residents in mental hospitals is stressed.
On the basis of two case reports it is shown that circumstances a transitory or permanent ventriculopyeloureteral CSF shunt may be indicated in the treatment of hydrocephalus. The technique is explained. The examination methods for controlling the function during the postoperative period are explained.
Over an average observation period of 53 months 26 patients with endocrinological active microadenoma of the hypophysis (12 M. Cushing, 14 acromegaly) were retrospectively examined. Only in 11 cases did the CT-examination demonstrate intrasellar tumour expansion. Both the problems of and the criteria for CT-diagnosis of microadenoma were demonstrated. In 22 cases (84%) the microsurgical transsphenoidal exstirpation of the adenoma led to an adequate reduction in both ACTH and HGH. No postoperative deterioration of the other hypophysial functions was seen. It could be further demonstrated that where the surgical therapy failed local radiation therapy with high voltage radiation of the hypophysis region led to a reduction of the abnormal hormone secretion. The comparism of our results with those reported in the literature led us to suggest a combined therapy concept in which the indication for operative, conservative and radiation therapy is delineated.
The case of a 54-year old woman is reported to discuss problems to establish preoperatively the correct diagnosis of tuberculoma in the posterior fossa. Following surgical excision of the space-occupying lesion, antituberculotic therapy was initiated. Complete recovery was achieved.
The authors report on the rare case of the intraorbital localisation of a granular cell tumour. Nature, histogenesis and biological behaviour of this lesion are discussed. The therapeutical consequences are presented.
Explore the source record for details and available documents.
18 patients with post-traumatic visual disease of the optic nerve are presented. In the post-traumatic stage, visual evoked potentials were monitored. In amaurosis there was a high incidence of midface or frontobasal fractures. The severity of the trauma is not correlated with the severity of visual deficits. Flash evoked potential (FEP) findings were different: In most cases there was a correlation of clinical and FEP findings. In some we found false positive potentials in the acute stage. In smaller visual field deficits the alterations of FEP could not be correlated with the clinical disorders. FEP alterations depended on time. The pathophysiological mechanisms are discussed in regard to the pathological findings in 51 unselected autopsies with an investigation of the visual pathway from the intraorbital optic nerve to the visual cortex. Because of the different morphological alterations the clinical, neurological and ophthalmological examination should be followed by standard CT scanning to evaluate intracranial haematomas and by CT scanning with thin slices of the optic nerves and the soft tissue of the orbit. Visual evoked potentials (VEP) and in the unconscious patient, flash evoked potentials (FEP) do not give much more security for therapeutic decisions in comparison with former times. The histological findings do not support the hypothesis that operative decompression is successful.