The translaminar approach is an effective and minimally invasive technique in both canalicular and cranio-dorsolateral disc herniations. It gives an additional possibility to avoid partial removal of the facet joints, can be performed in all lumbar segments and preserves structures important for segmental spinal stability. The approach allows access to the extruded disc fragment and intervertebral disc space comparable to classical approaches and is a frequently used operative technique in our department.
Summary24 hours following a cold induced oedema in cats rCBF was measured in the lesion area, the bluish stained cortex immediately adjacent to the lesion, a cortical area remote from the lesion, and in the eontralateral uninjured hemisphere. Thereafter the brain was frozen and the respective tissue areas were removed and analyzed for water and electrolyte content as well as metabolite concentrations. It seems, that in the neighbourhood of a local lesion at least 3 different brain regions can be differentiated with regard to their characteristic pattern of data. In non-oedematous regions either hyperaemia or hypoaemia could be observed. In areas with local brain oedema rCBF was reduced inversely proportional to the tissue water content. It seems that the "luxury perfusion syndrome" represents only one of several possibilities of regional flow pattern around a local brain lesion and its occurrence is confined to non-oedematous areas.l~eduction of rCBF by 20~o in the remote and by 33~o in the adjacent oedematous areas does not cause significant changes in the tissue concentrations of phosphoereatine, ATP and ADP, while lactate and the L/P ratio are clearly elevated. A significant drop of the high-energy compounds is found in the lesion, where the flow was reduced by about 62~o. This indicates that the local tissue hypoxia occurs as a result of the diminution in local mieroeirculation.
Brain abscess evolution was studied in an experimental model in the cat correlating the computed tomographic scan appearance with intracranial pressure, brain edema and histopathological findings. Brain inflammation was produced by direct inoculation of Staphylococcus aureus into the white matter. Abscesses developed in all animals. The ring enhancement around the necrotic focus seen at an early stage after contrast-medium injection cannot be equated with capsule formation as long as the abscess diameter increased. Parallel to the acute stage of abscess, the intraventricular pressure increased due to the rising mass effect and the spreading edma. The morphological investigations revealed on the seventh day an extreme enlargement of extracellular spaces with immense amount of edema fluid, rich in protein and fibrin. Some blood vessels in the close vicinity of the abscess showed gaps within the endothelial cell layer. When encapsulation developed, ring enhancement became more homogeneous and decreased in diameter. In spite of encapsulation, a circumscribed disturbance of the blood-brain barrier persisted which was responsible for a belated resolution of edema and a slow decrease of intracranial pressure. Only therapy with dexamethasone could effect a marked change in the course of the disease.
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