RESUMEN
Treatment of a patient with acute cardiac failure due to a contusio cordis after polytrauma by an interdisciplinary team is reported. Shortly after admission to our shock room, the patient developed cardiogenic shock caused by an extended coronary dissection. After interim cardiopulmonary resuscitation, the patient was stabilized by venoarterial extracorporeal membrane oxygenation (ECMO) and subsequent complex coronary artery intervention in the heart catheter laboratory. Despite the increased left ventricular function which enabled partial weaning from the ECMO, the patient died of multiple organ failure 10 days after admission.
Asunto(s)
Disección Aórtica/complicaciones , Disección Aórtica/terapia , Aneurisma Coronario/complicaciones , Aneurisma Coronario/terapia , Oxigenación por Membrana Extracorpórea , Insuficiencia Cardíaca/terapia , Lesiones Cardíacas/complicaciones , Lesiones Cardíacas/terapia , Comunicación Interdisciplinaria , Colaboración Intersectorial , Traumatismo Múltiple/terapia , Cateterismo Cardíaco , Procedimientos Endovasculares , Resultado Fatal , Humanos , Masculino , Persona de Mediana EdadRESUMEN
HISTORY AND ADMISSION FINDINGS: A 37-year-old man complained about a lack of strength, an unproductive cough and myalgia predominantly thigh-focused with subfebrile temperatures for days. INVESTIGATIONS: Laboratory investigations indicated rhabdomyolysis with acute kidney injury (AKI). Drug misuse was denied. Exertion and trauma could be excluded as well as rheumatologic or other infectious causes often responsible for rhabdomyolysis. PCR of a nasopharyngeal swab was positive for influenza A virus subtype H1N1. TREATMENT AND COURSE: Because of a progressive course of AKI haemodialysis was initiated. Levels of creatine kinase declined and urinary excretion rised. Hypocalcaemia due to secondary hyperparathyreoidism was substituted. During hospitalisation two seizures appeared. After performing a magnetic resonance imaging (MRI) the seizures could be attributed to a posterior reversible encephalopathy syndrome (PRES) secondary to influenza infection. A medication with valproic acid was initiated. CONCLUSION: Extrapulmonary manifestations of an influenza A (H1N1) virus infection are rare but have to be considered after exclusion of differential diagnosis in younger patients in particular. In addition to a therapy with neuraminidase inhibitors a symptomatic treatment is of paramount significance.
Asunto(s)
Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/terapia , Gripe Humana/diagnóstico , Gripe Humana/terapia , Síndrome de Leucoencefalopatía Posterior/diagnóstico , Síndrome de Leucoencefalopatía Posterior/terapia , Rabdomiólisis/diagnóstico , Rabdomiólisis/terapia , Lesión Renal Aguda/etiología , Adulto , Anticonvulsivantes/uso terapéutico , Terapia Combinada , Diagnóstico Diferencial , Humanos , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/complicaciones , Masculino , Síndrome de Leucoencefalopatía Posterior/etiología , Diálisis Renal , Rabdomiólisis/etiología , Resultado del Tratamiento , Ácido Valproico/uso terapéuticoRESUMEN
STUDY DESIGN: A case report describing a patient presenting with papilloedema, headache and saddle hypoesthesia caused by a lumbo-sacral intraspinal extradural lipoma in the presence of a bilateral chronic subdural haematoma (cSDH). OBJECTIVE: The aim of this report is to discuss the pathophysiology of papilloedema in spinal tumours and the effect of the cSDH on the development of papilloedema. A search of the Medline database yielded no case reports describing papilloedema arising from spinal extradural lipoma in the presence of intracranial cSDH. SETTING: Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany. CASE REPORT: We report a clinical case of cauda equina compression due to an extradural lipoma presenting with papilloedema. Cranial computer tomography (CT-scan) additionally revealed a thin, bilateral cSDH. The patient underwent surgical excision of the lipoma subsequent to an L5-S3 laminectomy. On duratomy, a membranous thrombus formation was discovered between the nerve filaments. The patient experienced clinical improvement with regression of his neurological symptoms. Histological findings confirmed the diagnosis of lipoma and intradural thrombus. CONCLUSION: Spinal tumours may cause complex cerebrospinal fluid (CSF) dynamic and resorptive changes. These changes are mechanical, physiological or combined in their effect. Patients with papilloedema or increased intracranial pressure should be carefully examined by clinical and neuro-radiological means for cranial and spinal pathologies. The treatment of the primary cause might save the patient a series of unnecessary procedures.
Asunto(s)
Hematoma Subdural Crónico/complicaciones , Hipertensión Intracraneal/etiología , Lipoma/complicaciones , Papiledema/etiología , Neoplasias de la Columna Vertebral/complicaciones , Adulto , Cauda Equina/patología , Cauda Equina/cirugía , Presión del Líquido Cefalorraquídeo/fisiología , Enfermedad Crónica , Descompresión Quirúrgica , Diplopía/etiología , Diplopía/patología , Diplopía/fisiopatología , Duramadre/patología , Duramadre/fisiopatología , Espacio Epidural/patología , Espacio Epidural/fisiopatología , Espacio Epidural/cirugía , Lateralidad Funcional/fisiología , Hematoma Subdural Crónico/patología , Hematoma Subdural Crónico/fisiopatología , Humanos , Hipertensión Intracraneal/patología , Hipertensión Intracraneal/fisiopatología , Laminectomía , Lipoma/patología , Lipoma/fisiopatología , Dolor de la Región Lumbar/etiología , Dolor de la Región Lumbar/patología , Dolor de la Región Lumbar/fisiopatología , Imagen por Resonancia Magnética , Masculino , Papiledema/patología , Papiledema/fisiopatología , Polirradiculopatía/etiología , Polirradiculopatía/patología , Polirradiculopatía/fisiopatología , Neoplasias de la Columna Vertebral/patología , Neoplasias de la Columna Vertebral/fisiopatología , Espacio Subdural/patología , Espacio Subdural/fisiopatología , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Neurosurgical therapy aims to minimize secondary brain damage after a severe head injury. This includes the evacuation of intracranial space-occupying hematomas, the reduction of intracranial volumes, external ventricular drainage, and aggressive therapy in order to influence increased intracranial pressure (ICP) and decreased P(ti)O2. When conservative treatment fails, a decompressive craniectomy might be successful in lowering ICP. From September 1997 until December 2004, we operated on 836 patients with severe head injuries, of whom 117 patients (14%) were treated by means of a decompressive craniectomy. The prognosis after decompression depends on the clinical signs and symptoms at admission, patient age, and the existence of major extracranial injuries. Our guidelines for decompressive craniectomy after failure of conservative interventions and evacuation of space-occupying hematomas include: patient age below 50 years without multiple trauma, patient age below 30 years in the presence of major extracranial injuries, severe brain swelling on CT scan, exclusion of a primary brainstem lesion or injury, and intervention before irreversible brain stem damage.
Asunto(s)
Traumatismos Craneocerebrales/epidemiología , Traumatismos Craneocerebrales/cirugía , Craneotomía/estadística & datos numéricos , Descompresión Quirúrgica/estadística & datos numéricos , Hipertensión Intracraneal/epidemiología , Hipertensión Intracraneal/cirugía , Traumatismo Múltiple/epidemiología , Comorbilidad , Femenino , Alemania/epidemiología , Humanos , Masculino , Traumatismo Múltiple/cirugía , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina , Pronóstico , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Neurosurgical therapy aims to minimise the secondary brain damage after a severe head injury. This includes the evacuation of an intracranial space occupying bleeding, the reduction of intracranial volumes, in hematocephalus an external ventricular drainage, and the conservative therapy in order to influence an increased intracranial pressure (ICP) and a decreased p(ti)02. When conservative treatment fails to act a decompressive craniectomy might be successful in lowering ICP. From September 1997 until July 2004 we operated on 737 patients with severe head injuries. 103 patients (14%) were treated by means of a decompressive craniectomy. The prognosis after decompression depends on the clinical signs and symptoms on admission, the patients age and the existence of major extracranial injuries. Our guidelines for an indication for decompressive craniectomy after failure of conservative interventions and evacuation of space occupying hematomas include a patients age below 50 years without multiple trauma, a patients age below 30 years in the presence of major extracranial injuries, a severe brain swelling on CT scan, the exclusion of a primary brainstem lesion or injury and the intervention before irreversible brainstem damage and secondarily while monitoring ICP and p(ti)02 in an interval up to 48 hours after the accident before irreversible brainstem damage or generalised brain damage has occurred.
Asunto(s)
Edema Encefálico/mortalidad , Edema Encefálico/cirugía , Lesiones Encefálicas/mortalidad , Lesiones Encefálicas/cirugía , Craneotomía/estadística & datos numéricos , Descompresión Quirúrgica/estadística & datos numéricos , Traumatismo Múltiple/mortalidad , Adulto , Comorbilidad , Femenino , Alemania/epidemiología , Humanos , Masculino , Traumatismo Múltiple/terapia , Prevalencia , Pronóstico , Medición de Riesgo/métodos , Factores de Riesgo , Índices de Gravedad del Trauma , Resultado del TratamientoRESUMEN
In patients with communicating or normal-pressure hydrocephalus, ventricular volume decreases following implantation of differential pressure valves. We implanted hydrostatic (Miethke dual-switch) valves in 60 patients with normal-pressure hydrocephalus (NPH) between September 1997 and December 2001. The patients underwent CT 1 year after operation, and we measured the Evans index. Although 83% of the patients showed no change in ventricular volume as assessed by this index, 72% nevertheless showed good to excellent and 16% satisfactory clinical improvement, while 12% showed no improvement. Moderate or marked reduction in ventricular size was observed in 17%, of whom 40% of these patients showed good to excellent and 20% satisfactory clinical improvement; 40% showed unsatisfactory improvement. The favourable outcome following implantation of a hydrostatic shunt thus did not correlate with decreased ventricular volume 1 year after operation, better outcomes being observed in patients with little or no alteration in ventricular size than in those with a marked decrease. Postoperative change in ventricular volume in NPH thus does not have the same significance as in patients with high-pressure hydrocephalus.
Asunto(s)
Ventrículos Cerebrales/fisiopatología , Ventrículos Cerebrales/cirugía , Hidrocéfalo Normotenso/etiología , Hidrocéfalo Normotenso/cirugía , Derivación Ventriculoperitoneal , Anciano , Ventriculografía Cerebral , Femenino , Humanos , Hidrocéfalo Normotenso/fisiopatología , Masculino , Satisfacción del Paciente , Índice de Severidad de la Enfermedad , Estadística como Asunto , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
It is well known that in patients with communicating hydrocephalus or normal pressure hydrocephalus, ventricular volume decreases following implantation of differential pressure valved shunts. Hydrostatic valves (Miethke dual-switch valves) were implanted in 60 normal pressure hydrocephalus patients at Unfallkrankenhaus Berlin between September 1997 and September 2001. One year postoperatively, these patients underwent CT scan, and their ventricular size was ascertained using the Evans index. Although 77% of these patients showed no postoperative change in ventricular volume, 65% nonetheless showed good to excellent clinical improvement, 13% satisfactory improvement and 22% no improvement. A moderate reduction in ventricular size was observed in 17% of the patients in our cohort. 40% of these patients showed good to excellent clinical improvement, 20% satisfactory improvement, and 40% unsatisfactory improvement. A marked reduction in ventricular size was observed in 6% of our patients. Of these latter patients, 50% showed good to excellent outcomes, while 50% had unsatisfactory outcomes. The favorable outcomes following implantation of a hydrostatic shunt in patients with normal pressure hydrocephalus did not correlate with decreased ventricular volume one year after operation. Better clinical outcomes were observed in patients with little or no alteration in ventricular size than in patients with a marked decrease in ventricular size. Postoperative change in ventricular volume should be assessed differently for patients with normal pressure hydrocephalus than in patients with hypertensive hydrocephalus.
Asunto(s)
Ventriculografía Cerebral , Derivaciones del Líquido Cefalorraquídeo , Hidrocéfalo Normotenso/cirugía , Tomografía Computarizada por Rayos X , Estudios de Cohortes , Diseño de Equipo , Femenino , Humanos , Hidrocéfalo Normotenso/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Resultado del TratamientoRESUMEN
Neurosurgical therapy aims to minimize the secondary brain damage after a severe head injury. This includes the evacuation of an intracranial space occupying bleeding, the reduction of intracranial volumes, in hematocephalus an external ventricular drainage, and the conservative therapy in order to influence an increased intracranial pressure (ICP) and a decreased p(ti)02. When conservative treatment fails to act a decompressive craniectomy might be successful in lowering ICP. From September 1997 until August 2001 we operated on 439 patients with severe head injuries. 50 patients (11%) were treated by means of a decompressive craniectomy. The prognosis after decompression depends on the clinical signs and symptoms on admission, the patients age and the existence of major extracranial injuries. Our guidelines for an indication for decompressive craniectomy after failure of conservative interventions and evacuation of space occupying hematomas include a patients age below 50 years without multiple trauma, a patients age below 30 years in the presence of major extracranial injuries, a severe brain swelling on CT scan, the exclusion of a primary brainstem lesion or injury and the intervention before irreversible brainstem damage and secondarily while monitoring ICP and p(ti)02 in an interval up to 48 hours after the accident before irreversible brainstem damage or generalized brain damage has occurred.
Asunto(s)
Traumatismos Craneocerebrales/cirugía , Craneotomía , Descompresión Quirúrgica , Adulto , Traumatismos Craneocerebrales/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Traumatismo Múltiple , Pronóstico , Resultado del TratamientoRESUMEN
Intracranial endoscopy as minimal invasive surgery for the treatment of hydrocephalus and intracranial cysts cannot be disregarded after 10 years of clinical practicing. The advantages are low traumatization of brain tissue and good visual control of the operation field. Neuronavigation qualifies as a method of increased operation safety for lesions which are deep seated or difficult to access. A combination of both systems partially neutralizes the respective disadvantages. On the one hand, the neuronavigation ensures the endoscopic approach up to the intracranial caverns and especially supports the endoscopy in cases of bad vision or pathologic anatomy. Endoscopy, on the other hand, enables the surgeon to recognize discrepancies and mistakes of the neuronavigation due to optical control. Increased expenses and time and staff requirements are counterbalanced by the increased cumulated operation safety. An advantageous side-effect of the combination of neuronavigation and intracranial endoscopy is the high learning potential for assistants. For all these reasons the application of neuronavigation in intracranial endoscopy is considered very important and strongly recommended.
Asunto(s)
Encéfalo/cirugía , Procedimientos Neuroquirúrgicos/normas , Endoscopía/normas , Humanos , Garantía de la Calidad de Atención de SaludRESUMEN
A retrospective analysis of 58 patients with spontaneous SAH was conducted. 33 patients suffered on severe SAH, clinical grading IV and V (Hunt, Hess). 11 died without treatment due to decerebrate rigidity. 22 patients were treated, 16 underwent a clipping procedure and 6 were selected for endovascular coilembolization. A total of 14 SAH were associated with intracerebral, intraventricular or subdural hemorrhages. In fact of these in 10 patients first an evacuation of the haematoma or a ventricular drainage was necessary, two times combined with a decompressive craniectomy. In 4 patients the removal of haematoma was combined with clipping of aneurysm in one operation. After occlusion of aneurysm decompressive craniectomy was required in 3 patients, an evacuation of an intracerebral bleeding in 1 patient. 6 patients needed a permanent shunting system. The outcome according the Glasgow Outcome Score was: 4 died (GOS1), 12 were severely disabled (GOS3) and 6 were moderately disabled (GOS4).
Asunto(s)
Aneurisma Roto/terapia , Hemorragia Cerebral/terapia , Aneurisma Intracraneal/terapia , Adulto , Anciano , Anciano de 80 o más Años , Aneurisma Roto/clasificación , Aneurisma Roto/mortalidad , Hemorragia Cerebral/mortalidad , Embolización Terapéutica , Femenino , Estudios de Seguimiento , Escala de Consecuencias de Glasgow , Humanos , Aneurisma Intracraneal/clasificación , Aneurisma Intracraneal/mortalidad , Masculino , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos/métodos , Reoperación , Estudios Retrospectivos , Instrumentos Quirúrgicos , Tasa de Supervivencia , Procedimientos Quirúrgicos VascularesRESUMEN
In the department of Neurosurgery of the Unfallkrankenhaus Berlin, experiences with neuronavigation and intraoperative computed tomography were acquired and reviewed on a descriptive basis. The main parameter for the evaluation was target point accuracy for the neuronavigation and image quality for the intraoperative ct. Additionally, both systems were evaluated about the requirement of time, staff and technical equipment. The analysis shows that both techniques are apted for quality control with the operation of intracranial lesions. Most problems with the handling of the new methods decreased with growing experience. On the technical aspect there are still problems with target accuracy for the neuronavigation and image quality for the ct-scans. However, solutions due to future technical improvement are perceived. The increase of time requirement is compensated with the rise of operation security. An even higher quality control is achieved with combination of both systems.
Asunto(s)
Encéfalo/cirugía , Monitoreo Intraoperatorio , Neurocirugia/métodos , Neurocirugia/normas , Tomografía Computarizada por Rayos X , Encéfalo/diagnóstico por imagen , Alemania , Humanos , Garantía de la Calidad de Atención de SaludRESUMEN
Interventional treatment by neuroradiological embolisation of cerebral arteriovenous angiomas has become an alternative to surgical exstirpation especially in problematic localisations and large-size malformations. Clinical results showing a marked reduction in attacks and recurrent haemorrhages, evident from a three-year report on 17 patients, confirm the value of the method even in case of only subtotal occlusion of the malformation.
Asunto(s)
Neoplasias Encefálicas/terapia , Cateterismo/instrumentación , Embolización Terapéutica/instrumentación , Hemangioma/terapia , Malformaciones Arteriovenosas Intracraneales/terapia , Neoplasias Encefálicas/diagnóstico por imagen , Angiografía Cerebral , Hemorragia Cerebral/diagnóstico por imagen , Hemorragia Cerebral/terapia , Estudios de Seguimiento , Hemangioma/diagnóstico por imagen , Humanos , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Examen Neurológico , RecurrenciaRESUMEN
From 1987-1991 we performed 20 balloon occlusions in 15 patients with intracranial aneurysms. In 9 patients procedures were technically successful however long term complications included three deaths. In spite of the advancements in the balloon catheter technology fatalities occur restricting the use of percutaneous balloon occlusion to patients with unclippable aneurysms.
Asunto(s)
Cateterismo/instrumentación , Embolización Terapéutica/instrumentación , Embolia y Trombosis Intracraneal/terapia , Adulto , Anciano , Angiografía Cerebral , Femenino , Humanos , Embolia y Trombosis Intracraneal/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Recurrencia , Hemorragia Subaracnoidea/diagnóstico por imagen , Hemorragia Subaracnoidea/terapia , Tomografía Computarizada por Rayos XRESUMEN
Intraoperative angiography allows for control procedures for exstirpation of arteriovenous malformations and clipping of problematic aneurysms during the entire operation. During intraoperative embolizations, it is especially helpful to see whether the occlusion of the nidus of an arteriovenous malformation is complete. The method is easy to perform; there were no complications in 19 cases.
Asunto(s)
Angiografía Cerebral/instrumentación , Embolización Terapéutica/instrumentación , Aneurisma Intracraneal/terapia , Malformaciones Arteriovenosas Intracraneales/terapia , Complicaciones Intraoperatorias/terapia , Cateterismo/instrumentación , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Complicaciones Intraoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagenRESUMEN
The application of a new, miniaturized portable digital data recorder "Thermoport" (Institute for Reproductive Medicine, Münster, West Germany) for continuous determination of scrotal temperatures revealed great variations of scrotal temperature during 24 hours in normal men. Maximum temperatures approached body core temperatures. Mean scrotal temperatures of 10 normal men rose during sauna from 32.72 +/- 0.23 degrees C to 37.53 +/- 0.38 degrees C. During treadmill running, scrotal temperatures increased by more than 2.5 degrees C. Minimal scrotal temperatures were increased in some men with varicocele compared with normal fertile men indicating impaired cooling mechanisms. The continuous temperature measurements facilitate assessment of temperature dynamics. The miniaturized design of the Thermoport makes it suitable for routine use in outpatients of infertility clinics, in occupational medicine for evaluation of heat hazards, and for investigations of body temperatures under various experimental conditions.
Asunto(s)
Temperatura Corporal , Diagnóstico por Computador/instrumentación , Monitoreo Fisiológico/instrumentación , Escroto/fisiología , Adulto , Ritmo Circadiano , Humanos , Pierna , Masculino , Escroto/irrigación sanguínea , Temperatura Cutánea , Supinación , Factores de Tiempo , Varicocele/fisiopatologíaRESUMEN
22 patients were operated on because of a benign mesenchymal tumor in the spinal canal. 14 women and 8 men were affected, the average age being 37 years. Preoperatively 7 patients showed an incomplete or complete transverse lesion with a mean duration of the disease being 30 months. After the operation 19 patients showed an improvement, of these 17 were able to walk by themselves. 10 patients became again fit to work. One patient died after the operation.
Asunto(s)
Complicaciones Posoperatorias/diagnóstico , Compresión de la Médula Espinal/cirugía , Neoplasias de la Columna Vertebral/cirugía , Adolescente , Adulto , Quistes Óseos/patología , Quistes Óseos/cirugía , Condroma/patología , Condroma/cirugía , Femenino , Fibroma/patología , Fibroma/cirugía , Estudios de Seguimiento , Tumores de Células Gigantes/patología , Tumores de Células Gigantes/cirugía , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Examen Neurológico , Osteoma/patología , Osteoma/cirugía , Osteoma Osteoide/patología , Osteoma Osteoide/cirugía , Compresión de la Médula Espinal/patología , Neoplasias de la Columna Vertebral/patologíaRESUMEN
Among 400 patients with a spinal tumour 61 were children. 36 patients were male and 25 female. In 26 patients the operation brought an improvement. 14 patients are in need of care. The total mortality within an after-observation period of three years amounted to 27.8% (17 patients).
Asunto(s)
Complicaciones Posoperatorias/mortalidad , Neoplasias de la Columna Vertebral/cirugía , Adolescente , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Neoplasias de la Columna Vertebral/mortalidad , Neoplasias de la Columna Vertebral/secundarioRESUMEN
20 patients (9 women, 11 men) were operated on because of dysontogenetic tumour in the spinal canal. The average age at the time of operation being 23 years. 9 patients already showed an incomplete transverse lesion with a mean duration of the disease being 51 months. After the operation 15 patients showed an improvement. 12 patients became again fit to work. Two patients are in need of care. Within a after-observation period of three years one patient died.
Asunto(s)
Neoplasias de Células Germinales y Embrionarias/congénito , Complicaciones Posoperatorias/diagnóstico , Neoplasias de la Columna Vertebral/congénito , Adolescente , Adulto , Niño , Quiste Dermoide/congénito , Quiste Dermoide/diagnóstico , Quiste Dermoide/cirugía , Evaluación de la Discapacidad , Quiste Epidérmico/congénito , Quiste Epidérmico/diagnóstico , Quiste Epidérmico/cirugía , Femenino , Estudios de Seguimiento , Humanos , Lipoma/congénito , Lipoma/diagnóstico , Lipoma/cirugía , Masculino , Persona de Mediana Edad , Neoplasias de Células Germinales y Embrionarias/diagnóstico , Neoplasias de Células Germinales y Embrionarias/cirugía , Neoplasias de la Columna Vertebral/diagnóstico , Neoplasias de la Columna Vertebral/cirugía , Teratoma/congénito , Teratoma/diagnóstico , Teratoma/cirugíaRESUMEN
32 patients were operated on because of vascular processes in the spinal canal. 12 woman and 20 men had fallen ill, the average age at the time of operation being 38 years. Preoperatively 18 patients already showed an incomplete or complete transverse lesion with a mean duration of the disease being 37 months. After the operation 62.5 per cent of the patients showed an improvement. 46.8 per cent were able to walk on their own, 15.6 per cent needed support. 10 patients (31%) became again fit to work. Six patients (18.8%) are in need of care. The total lethality, related to three years post operation, was 18.8 per cent.
Asunto(s)
Hemangioma/cirugía , Hemangiosarcoma/cirugía , Neoplasias de la Columna Vertebral/cirugía , Adulto , Anciano , Evaluación de la Discapacidad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiologíaRESUMEN
Within a period of 27 years, 65 patients were operated on because of a spinal neurinoma. 34 women and 31 men had fallen ill, the average age at the time of operation being 42 years. Preoperatively 33 patients already showed an incomplete or complete transverse lesion with the mean duration of the disease being 40 months. After the operation 75.3 per cent of the neurinoma patients showed an improvement. 66.1 per cent were able to walk on their own, 9.2 per cent needed support. 41.5 per cent became again fit to work. Six patients (9.2%) are in need of care. The total lethality, related to three years post operationem, was 10.7 per cent.