Biomedical subjects
W Bonicki
Publications and source records attributed to W Bonicki.
[Internal carotid artery aneurysm in the sella turcica area simulating pituitary tumor].
A giant aneurysm of the internal artery is described which was situated in the sella and simulated hormonally inactive hypophyseal adenoma. Axial computer tomography demonstrated a hypophyseal tumour. During operation from intranasal approach through sphenoid sinus massive haemorrhage developed but was controlled with fibrin sponge. Postoperative angiography demonstrated a giant aneurysm of the internal artery situated in the sella. Although this location of aneurysm is exceptionally rare, each case of inactive hormonally pituitary adenoma should be subjected before the operation to cerebral angiography.
[So-called parietal muscular atrophy].
A case is reported of a tumour in the parietal area with atrophy of upper extremity muscles but without changes in laboratory investigations.
[A case of tumor of the pineal body treated with gamma rays of Co-60].
A 21-year-old patients was admitted to hospital with symptoms suggesting a tumour in the area of the epiphysis. Computer tomography confirmed the initial diagnosis. Since signs were present of increased intracranial pressure a Pudenz valve was implanted and in the second stage of treatment radiotherapy with radioactive cobalt was applied. A very good result was obtained with control CT failing to demonstrate presence of the tumour and hydrocephalus.
[Technical difficulties in surgical treatment of Cushing disease in children and adolescents].
Cushing disease in children and adolescents is connected with many technical difficulties in operations for removal of pituitary adenoma from the approach through the sphenoid bone which is connected with anatomical conditions specific for that age group. The greatest difficulty is related to incomplete development of the sphenoidal sinus, which is sometimes spongy or presellar. Besides that, the size of the sphenoidal sinus and sella is small. The surgical methods are analysed which make possible overcoming of these difficulties.
[Cerebrospinal fluid rhinorrhea as a postoperative complication of pituitary tumor surgery. Corrective surgery of sella turcica by own methods].
A relatively simple technically and effective own method of corrective operation of sella floor in cases of cerebrospinal fluid rhinorrhoea after transsphenoid operations for pituitary tumours is presented. This complication developed in 12 cases in a group of 720 patients operated on in the years 1973-1990. The described method was applied in 9 cases.
[Caudal tumors as a rare cause of subarachnoid hemorrhage].
A case of cauda tumour (neurolemmona) is reported in which the presenting symptom was subarachnoid haemorrhage. The investigations for suspected cerebral vascular malformation brought no results. Only after appearance of clinical signs of cauda damage vertebral canal investigations made possible the correct diagnosis and proper treatment.
[Importance of catheterization of inferior petrous sinuses in surgical treatment of Cushing's in children and adolescents].
The authors present 12 cases of Cushing disease in children and adolescents. In childhood the course of this disease differs from that in adulthood. The predominating initial signs in children are growth stunting and arrest of sexual maturation. Radiological methods (sella X-ray, CT, NMR) are normal initially in most cases and the diagnosis is confirmed exclusively by hormonal investigations. ACTH determination of venous blood samples obtained by catheterization of the inferior petrous sinuses is essential not only for the diagnosis of pituitary adenoma but also for choice of proper surgical treatment. The optimal method is selective removal of the adenoma. In case of impossibility of this removal (anterior lobe hyperplasia) hemiphysectomy is suggested (with removal of the lateral part of the anterior lobe on the side of greater secretion of ACTH into the inferior petrous sinus. This method is possible only if before the operation catheterization of these sinuses was done and a significant difference of ACTH level was found between the right and the left sinus. This is the reason why this test is essential for selection of proper treatment. Anterior lobe hypophysectomy, bilateral adrenalectomy, X-ray hypophysis irradiation are unacceptable for children because of their maiming character making impossible further somatic development and sexual maturation of children.