Incidence and follow-up of patients with space-occupying cystic lesions after surgery of malignant gliomas are demonstrated. Aetiological aspects and therapeutic possibilities are mentioned.
Two patients underwent continuous lumbar cerebrospinal fluid (CSF) drainage during craniotomy. In one patient a pituitary adenoma was extirpated through a transnasal trans-sphenoidal approach and the other had a frontal craniotomy for extirpation of an a-v malformation. In these two cases the catheters for the CSF drainage disappeared partly and were forgotten within the spinal canal. These patients were later admitted for spinal cord compression syndromes.
Spasticity is an expression of a damage of the motor neurone associated with velocity dependent increase of the muscle tone. Since 1986 21 patients with severe spasticity mainly in multiple sclerosis were treated with an implantable pump system to administrate continuously Baclofen intrathecally. Even with a very small dosage of Baclofen patients who were previously treated until intoxication without success there was a favorable reduction in spasticity. Therefore we propose to perform this procedure before using surgical methods or stimulating methods.
The recent advances in the surgery of intramedullary tumors are due to the strategy of a total removal by microsurgical techniques and the early diagnosis by MRT. 84 patients with intramedullary tumors with a long-term follow-up up of more than 20 years were retrospectively analysed so that subgroups e.g. macroscopic versus microscopic, palliative procedures versus whether or not new technology like the ultrasonic aspirator and the CO2-Laser were used were included.
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