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  • 1
    ISSN: 1437-2320
    Keywords: Cerebral aneurysm ; endovascular embolisation ; complication ; surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a case involving a microsurgical approach to solving the problem of a medical cerebral artery (MCA) occlusion occuring after GDC coiling of an internal cerebral artery (ICA) bifurcation aneurysm in a 40 year old woman. We describe the clinical course of the case and discuss technical possibilities and risks of clipping a coiled aneurysm. One key to success is awareness of changes in the aneurysm's properties after coiling. With loss of elasticity the aneurysm had the effect of a tumor fixed on the vessel. The apposition of the aneurysm to the wall of the vessel, as well as the aneurysm's rigidity and increase of intracranial pressure after subarachnoideal hemorrhage (SAH), may lead to occlusion of the vessel. In cases of an mandatory operation due to the occlusion of a main arterial stem after coiling, it is primarily crucial to perforate the aneurysm's fundus, remove the coils, and, finally, to clip the slack neck of the aneurysm. An attempt to precisely prepare and clip the aneurysmal neck without removing the coils could result in the rupture of the aneurysm's neck.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1437-2320
    Keywords: Cerebral blood flow ; collateral circulation ; computed tomography ; stable Xenon ; STA-MCA bypass
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A xenon-CT examination was performed on a patient who had received a STA-MCA bypass. Evaluation of cerebral blood flow (CBF) pre- and postoperatively shows a postoperative increase of about 60%. During manual compression of STA, a decrease of 20% was observed so that one third of the total CBF increase could be attributed to anastomosis. The remaining two thirds may originate from the natural collateral circulation.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1437-2320
    Keywords: Cerebral blood flow ; computed tomography ; electroencephalography ; stable xenon
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects on the EEG of inhalation of a 33% Xenon O2 mixture over a period of 5 minutes were studied in 18 human volunteers. This dosage is similar to that used in xenon CT studies. In 4 subjects no EEG changes were observed during the study. In the 14 other subjects, EEG variations were detected, the most prominent of which was an increase in β power. No change was observed in ϑ and σ power. These findings seem to support an early induction (excitation) phase of anaesthetics. All changes disappeared rapidly following the termination of xenon inhalation. The effects reported are minimal and should not impair the clinical value of CBF measurements using the xenon CT method.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1437-2320
    Keywords: Cerebral blood flow ; stroke ; transient ischemic attack ; xenon computerized tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Several investigators have describedCT-negative low flow areas in TIA and stroke patients in the chronic phase. The emission tomographic SPECT image they employed has, in contrast to the xenon CT method, no direct relation to the x-ray transmission CT scan. The aim of our study was to study the phenomenon ofCT-negative low flow areas using the xenon CT method, a method especially well suited for such cases. 57 xenon CT examinations were performed in 40 TIA patients, and 56 xenon CT examinations in 32 stroke patients. Flow data from brain tissue which appeared to be anatomically intact in a slice 5 cm above the canthomeatal plane were analyzed. In the TIA group, the flow in the gray matter was found to be significantly lower on the clinically affected side: symptomatic side, 61.8 ± 14.7 ml/100 g/min; asymptomatic side, 66.4 ± 15.8 ml/100 g/min (p 〈 0.001). In the stroke group, the flow in the white matter was also affected; symptomatic side, 31.2 ± 9.8 ml/100 g/min; asymptomatic side, 35.3 ± 11.1 ml/100 g/min (p 〈 0.01). Gray matter: symptomatic side, 56.1 ± 11.4 ml/100 g/min; asymptomatic side, 66.0 ± 11.0 ml/100 g/min (p 〈 0.001). The findings indicate that the appearance ofCT-negative low flow areas in TIA and stroke patients during the chronic phase is the rule rather than the exception. Flow adaptation to anatomic changes not discernible by CT can be differentiated from clinically relevant flow impairment only by testing the cerebrovascular reserve.
    Type of Medium: Electronic Resource
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