A seven month old boy suffered fron an inoperable extensive bilateral vascular malformation of the dura and the sinus system. This congenital lesion was artificially embolised in two sessions by injecting several hundred small steel spheres through the external carotid arteries. Clinical and neuroradiological reexaminations revealed a favourable result in this case. The technique and risks of this method which so far had not been applied in infants are demonstrated.
Over a 1 1/2 year period computerized tomographical examinations were performed on 104 patients suffering from brain concussions. The evaluation of findings resulted in the following classification: Type 1: severe generalized brain oedema without visible contusional foci, Type IIa: typical contusion with solitary or multiple contusional foci, Type IIb: typical contusion with severe, locally pronounced oedema, Type IIIa: contusion with flat subdural contusional bleeding, Type IIIb: contusion with minor intracerebral contusional bleeding, Type IIIc: contusion with intraventricular bleeding. Space-occupying haemorrhages were excluded. The comparison of computerized tomographic findings with the clinical course justifies such a classification. There are significant correlation between CT findings and the clinical picture, especially with the degree of clouding of consciousness as well as with further prognosis.
Computer tomography enables exact diagnostic clarification of intracranial lesions in trauma of the neurocranium. Subdural or epidural as well as intracerebral haemorrhages can be localised, and a circumscribed contusion and cerebral oedema become tangible. The article reports on 90 patients subjected to computerized tomography following trauma of the neurocranium. In about 50% of the cases, the trauma had been caused by a traffic accident. About 27% of the accident victims were children and adolescents. In about one-half of the examined persons, subdural or epidural haemorrhages were found, whereas in about 20% of the cases, contusions, partly with mild haemorrhages, were seen. In about 10% of the cases a more or less severe oedema was seen. About 20% of the patients yielded no abnormal finding by CT in accordance with the age of the patient.
The article reports on twenty patients with thoracic prolapsed discs treated by surgery within a period of ten years. The incidence in relation to prolapses at all levels was 1.2%. The average age was 50.3 years and there was no definite sex predominance. The segments Th 10-11 and Th 11-12 were the preferred sites. The period of the disease varied from a few hours to nine years. Among the most frequent subjective complaints were radiating pain, paraparesis of the legs and disturbed micturition. A definitely traumatic cause of the disease was present in one case only. Besides exact neurological diagnosis it is imperative to effect myelography with positive contrast medium, revealing the typical circular or oval-shaped filling defects. In our patients, laminectomy was performed 17 times, and hemilaminectomy three times. Besides removal of the prolapse, the dentate ligament was always divided. In some cases we also performed rhizotomy. Operation improved 15 patients, whereas in two patients the condition got worse and three patients showed neither improvement nor deterioration.
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