Neurinoma of the jugular foramen.
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Angiography, Digital Subtraction↗
Biomedical subjects
W Müller-Forell
Publications and source records attributed to W Müller-Forell.
Ciamexone in endocrine orbitopathy. A randomized double-blind, placebo-controlled study.
The influence of ciamexone on the activity and course of endocrine orbitopathy was investigated. Fifty-one patients with active orbitopathy classes II-VI were allocated randomly to two groups: over a period of six months, 26 patients received 300 mg/day ciamexone and 25 patients received placebo tablets. In both groups, prednisolone was administered in addition in the first four weeks. Ophthalmological investigations and clinical tests as well as orbit sonography were carried out before as well as one, three and six months after the beginning of therapy. Before and after treatment, computer tomography of the orbit was performed. Symptoms and signs did not show any significant improvement one and six months after therapy. No differences between the two therapy groups were observed. Detailed examination did not reveal any preferential action of the product on individual parameters. Sonography and computer tomography showed no significant alterations of the thickness of the oculomotor muscles. Thus administration of 300 mg ciamexone once a day as compared with placebo did not show any effect on the course and activity of endocrine orbitopathy.
Adjuvants, Immunologic↗
Significance of MRI-confirmed atrophy of the cranial spinal cord in Friedreich's ataxia.
The severity of Friedreich's ataxia was graded in ten patients by clinical examination and in five by use of posturography. These data were compared with neuroradiology findings. CT-confirmed infratentorial atrophy occured only in advanced cases of Friedreich's ataxia; the correlation with the clinical score was poor. On mid-sagittal MRI planes the diameters of fourth ventricle, brain stem at the level of the inferior olive and spinal cord at the levels of the foramen magnum and C3 were measured. Patients with Friedreich's ataxia had significant MRI-confirmed atrophy of the cranial spinal cord as compared with a normal, age-matched control group. This was also observed in patients with Friedreich's ataxia in the early stages. A reliable correlation between atrophy of the cranial spinal cord and the clinical score, however, could again not be found. MRI exploration of the cranial spinal cord may be recommended as an additional diagnostic marker in Friedreich's ataxia.
Adult↗
[Treatment of spontaneous intracerebral hemorrhage--operative or conservative?].
The current treatment of spontaneous intracerebral hematomas is reviewed, and the results in the literature as well as our own experience on the subject are discussed. It is evident that modern diagnostic methods and follow-up observation periods have led to a sharp decline in the need for operative treatment. The diverse forms of clinical treatment and the remaining indications for neurosurgical intervention are presented.
Cerebral Hemorrhage↗
[Carotid dissections].
In younger patients, the clinical symptoms of sudden unilateral headache and facial pain, often combined with Horner syndrome and the cerebrovascular symptoms of TIAs or stroke, should indicate the diagnosis of spontaneous carotid dissection. Angiographic findings can verify this diagnosis, showing various signs of eccentric, narrowing stenosis, false lumen, pseudoaneurysms, or complete occlusion. An addition to noninvasive Doppler ultrasonography, B-mode and Duplex investigations, although more or less nonspecific, give some indications of the diagnosis; modern imaging techniques, especially MRI, can image the intramural hematoma directly. As the hematoma is the source of the intracranial emboli, the therapy of choice in this rarely diagnosed disease should be anticoagulation.
Adult↗
MR imaging in tumors of the pineal region.
Ten patients with tumors of the pineal region underwent CT and MRI investigations. There were 3 germinomas, 3 teratomas and 1 of each of the following: pineocytoma, PNET, ependymoma and meningioma. Not only were tumor size and growth compared to CT, but an attempt was made to obtain knowledge of the histology of the tumor by special T2 calculations. The investigations did not lead to an improvement in type specific diagnosis.
Brain Neoplasms↗
Exophthalmos and basilar impression. A contribution to differential diagnosis of endocrine orbitopathy.
We report on a male patient with exophthalmos of unclear etiology, basilar impression, syringohydromyelia and type II Arnold-Chiari malformation. Two diseases involving the orbital region were to be considered in differential diagnostic terms: endocrine orbitopathy and osseous orbit dysplasia. The typical physical appearance associated with basilar impression as well as suppurative keratitis in Lagophthalmos was striking. Tetraspasticity with pareses, bulbar symptoms, proximally pronounced muscular atrophy as well as a left hemihypesthesia was shown neurologically. Although the orbit CT was normal, sonography revealed thickened ocular muscles. There was euthyroidism in diffuse goiter with negative thyroid autoantibody findings. Because of lack of definitive detection of muscular swelling, tumor, or vascular anomaly in the various images, orbital dysplasia in the context of a malformation syndrome affecting several organs is suggested as the cause of the exophthalmos.
Arnold-Chiari Malformation↗