Publications by authors named "Edzard Klemm"
Purpose: To analyze the role of selective middle cerebral artery (MCA) Wada tests in the presurgical workup of patients with drug-resistant focal epilepsies.
Methods: Twenty MCA Wada test procedures were performed to identify eloquent cortex (a) in nine patients with hemispheric lesions involving the motor cortex (connatal MCA infarct, n = 5; unilateral cortical dysplasia, n = 3; Rasmussen encephalitis, n = 1), (b) five patients with circumscribed neoplastic or nonneoplastic lesions adjacent to the motor cortex or classic language areas, and (c) for purely electrophysiologic reasons, in two patients with electrical status epilepticus in sleep (ESES). Sodium amobarbital and [99mTc]-HMPAO were simultaneously injected via a microcatheter into the distal M1 segment (n = 7), the inferior MCA trunk (n = 3), or into MCA branches (n = 10).
Objective: In light of the competition between microneurosurgery and alternative methods such as stereotactic radiosurgery, we tested the hypothesis that changes in the cerebral circulation after microneurosurgery are common among patients without evidence of cerebrovascular or neoplastic disease.
Methods: Blood flow velocities (BFVs) were recorded with transcranial Doppler ultrasonography, before surgery and every other day after surgery, for a group of 50 patients who underwent transsylvian selective amygdalohippocampectomies for treatment of hippocampal sclerosis. Hexamethylpropylene amine oxime-single-photon emission computed tomographic testing, including acetazolamide testing of cerebrovascular reactivity, was performed during the second postoperative week for 20 of the 50 patients.