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Z Heinrich

Publications and source records attributed to Z Heinrich.

6 recordsLinked to original sources
PubMed2000

The difference between ultrasound-guided and stereotactic-guided neurosurgical procedures.

We evaluate two different methods, ultrasound (US) guidance and stereotactic guidance, routinely used in our Department for navigation in various neurosurgical procedures. We have performed 53 US-guided and 101 stereotactic-guided procedures. These procedures were intracranial lesion biopsies, intracranial cysts and abscesses puncture and evacuations, ventricular punctures for hydrocephalus shunt operations, stereotactic-guided microneurosurgical resections, and stereotactic-guided endoscopic operations. Advantages of the US-guided operations are the shortness of the procedure, simplicity (no need for moving patient for additional CT scanning), no irradiation and the possibility of real-time imaging. The disadvantages of the US-guided procedures are worse resolution of the images in deep-seated and small lesions as well as the need for a bigger trepanation because of the transducer's dimensions. Stereotactic procedures are time-consuming but more precise and usually done in local anaesthesia because only a small trepanation is required. Main disadvantage of the stereotactic-guided procedures when compared with the US-guided procedures is a lack of real-time intraoperative control. According to our experience, both methods are complementary and safe and they do not cause any additional complications when used as a navigation tool in microneurosurgical operations. Both methods are highly reliable when used in properly selected patients.

Brain Diseases↗
PubMed1999

Radical surgery of a giant Galen's vein aneurysm using total circulatory arrest: case report.

BACKGROUND: Arteriovenous malformations of Galen's vein are a rare type of vascular anomaly. The complex anatomy of these lesions creates an extremely difficult management dilemma. We report successful surgical treatment of a 7-year-old patient with a Galen's vein aneurysm. METHODS AND RESULTS: A 7-year-old patient with slowly progressing gait disturbance, emotional instability, and strange behaviour is presented. A computed tomography scan revealed a high-density mass in the pineal region and cerebral angiography showed an aneurysm of Galen's vein. We decided to perform surgical excision of the aneurysm. The operation was performed under hypothermic circulatory arrest with barbiturate cerebral protection. The patient had no signs of postoperative ischemic deficits, hemorrhage, or neurologic deterioration. CONCLUSIONS: Various techniques have been described for the obliteration of Galen's vein aneurysms, including direct surgical approach, staged operation, and transarterial, transvenous or transtorcular embolization. We present this patient to illustrate the use of hypothermic circulatory arrest and barbiturate cerebral protection for successful surgical excision of this complex vascular lesion. The combination of these techniques allowed us, in this case, to operate with reasonable safety on otherwise, difficult to treat aneurysm of Galen's vein.

Cerebral Veins↗
PubMed1999

[Endoscopic ventriculocisternostomy of the third cerebral ventricle].

Endoscopic third ventriculocisternostomy (ETV) is a minimally invasive technique that establishes a communication between third ventricle and interpeduncular cistern. We analyzed clinical files of eleven patients (7 males and 4 females) operated on between September 1996 and February 1998. Patients' age ranged from 3 to 61 years. ETV was performed in hydrocephalic patients with neurological signs of increased intracranial pressure (ICP) and CT or MRI diagnosed noncommunicating hydrocephalus (aqueductal stenosis). The fenestration instrument was a monopolar coagulation wire and dilation instrument was a balloon catheter. Post-operative decrease in the third ventricle diameter is the most reliable neuroradiological sign of successful operation. All patients, but one, were able to remain independent of the shunt system after the ETV. ETV is a low-risk neurosurgical technique that should be considered as the initial treatment of noncommunicating hydrocephalus. Features that increase ETV probability of success include age over 1-year, relatively recent obstruction, no meningitis or subarachnoid haemorrhage history and normal ventricular anatomy. ETV excludes mechanical complications and lowers the risk of biological complications which are characteristic for CSF drainage operations. Economic aspect is also very important because drainage devices are very expensive.

Adolescent↗
PubMed1998

Neuroendoscopic fenestration of arachnoid cysts.

The authors report 6 patients with arachnoid cysts treated endoscopically. The series includes 6 patients with temporobasal arachnoid cysts. The age of the patients at the time of diagnosis ranged from 5 to 71 years. The patients' symptoms included headache, seizures, vomiting, nausea, dizziness, and problems with balance. The authors performed cystocisternostomies via burr holes with the aid of a universal neuroendoscopic system. In 4 cases the endoscopic fenestration was a unique treatment which enabled the avoidance of a definitive cystoperitoneal shunt. In the two cases treated subsequently, cystoperitoneal shunts were performed. The surgical endoscopic technique and the postoperative radiological findings which indirectly confirm the patency of the fenestration are discussed. The authors conclude that endoscopic fenestration of intracranial fluid cysts represents the treatment of preference. In cases where the endoscopic procedure fails a microneurosurgical procedure or cystoperitoneal shunting is recommended to avoid exposing the patient to additional risk.

Adolescent↗
PubMedDate not supplied

[Breech birth].

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Breech Presentation↗