Chronic Subdural Hematoma (CSH) is Still an Important Clinical Problem. Analysis of 700 Consecutive Patients.

Background: Chronic subdural hematoma (CSH) is still an important neurosurgical problem and the number of patients increases despite the progress in early diagnosis of cerebral lesions.

Methodology: We analyzed a group of 700 consecutive patients treated in neurosurgical departments for CSH. Clinical state on admission was evaluated according to the Markwalder scale, all patients had CT studies and were operated using craniotomy or burr holes with closed system drainage techniques.

Vertebroplasty (PVP) is effective in the treatment of painful vertebral hemangiomas.

We assessed the results of percutaneous vertebroplasty treatment of painful vertebral hemangiomas in 110 patients, with a three years follow-up. 110 patients with painful vertebral hemangiomas were treated by percutaneous vertebroplasty. The patients were diagnosed by MRI and observed for 3 years after surgery.

Keyhole Surgery of Pineal Area Tumors - Personal Experience in 22 Patients.

Background: Pineal area tumors are challenging for surgery due to their location. However, the removal of the lesion is critical for further treatment and survival of the patients.

Material And Methods: 22 patients with pineal area tumors were surgically treated via keyhole medial suboccipital craniotomy and supracerebellar midline approach All the patients were operated in the sitting position with the use of operating microscope and microsurgical technique.

Neurogenic Pulmonary Edema in Aneurysmal Subarachnoid Hemorrhage.

Neurogenic pulmonary edema (NPE) is observed in cerebral injuries and has an impact on treatment results, being a predictor of fatal prognosis. In this study we retrospectively reviewed medical records of 250 consecutive patients with aneurysmal subarachnoid hemorrhage (SAH) for the frequency and treatment results of NPE. The following factors were taken under consideration: clinical status, aneurysm location, presence of NPE, intracranial pressure (ICP), and mortality.

Complications of percutaneous vertebroplasty: An analysis of 1100 procedures performed in 616 patients.

Percutaneous vertebroplasty (PVP) is a minimally invasive procedure widely used for the treatment of pain due to vertebral fractures of different origins-osteoporotic, traumatic, or neoplastic. PVP is minimally invasive, but the complications are not rare; however, they are in most cases not significant clinically. The most frequent is cement leakage, which can occur onto veins, paravertebral soft tissue, into the intervertebral disk, or to the spinal canal, affecting foraminal area or epidural space.

Treatment of very large cranial defects with individually shaped polypropylene polyester knitwear prostheses: a series of 11 cases.

Background: Very large cranial defects are not very common in neurosurgical practice and there is not any widely acknowledged standard of their treatment. One of the useful methods in such cases is individual forming of polypropylene-polyester knitwear. Such material was used in the past but before 2008 it was available only as standardized plates.

Treatment of multiple osteoporotic vertebral compression fractures by percutaneous cement augmentation.

Purpose: Vertebral compression fractures cause significant pain and some patients are debilitated by the pain due to the fracture. Conventional surgery carries a high risk and has a poor outcome. Vertebroplasty is a minimally invasive surgical procedure, which in vertebral fractures restores stability and diminishes pain.

Reconstruction of cranial defects with individually formed cranial prostheses made of polypropylene polyester knitwear: an analysis of 48 consecutive patients.

This article presents a new method of cranioplasty in which polypropylene polyester knitwear was used as the filling material. The basis for prosthesis shaping was a three-dimensional model of the defect made according to the patient's CT scans. Previously, such material has never been a subject of computer-aided design and computer-aided manufacturing (CAD/CAM) individual forming.

Early and long-term outcomes of vertebroplasty for single osteoporotic fractures.

Background And Purpose: Percutaneous vertebroplasty (PVP) is a minimally invasive vertebral augmentation procedure for the treatment of recent, osteoporotic vertebral compression fractures. The aim of the study was to determine the early and late outcomes of PVP for osteoporotic vertebral compression fractures.

Material And Methods: We prospectively assessed outcomes of PVP in 200 patients with single, osteoporotic vertebral compression fracture.

Treatment of chronic subdural hematoma by burr holes and closed-system drainage.

This article highlights the treatment of choice of chronic subdural hematoma. The importance, effectiveness, and low complication rate of minimally invasive procedure by burr holes and closed-system drainage is discussed.

Head-injured adult patients with GCS of 3 on admission--who have a chance to survive?

The authors analysed a series of 111 adult patients admitted to the Department of Neurosurgery, Medical University of Lódź directly after trauma with initial GCS of 3 points. 74% of them had intracranial haematoma, mainly subdural, and were treated surgically within the first 3 hours after trauma. 8 patients had no abnormalities on CT scans.

[Cerebral cysticercosis. Case report].

The authors present a case of a long course of disseminated cerebral cysticercosis. Diagnosis of cysticercosis was confirmed by serial magnetic resonance examinations.

Middle cerebral artery aneurysm developing apparently de novo.

The author reports a patient with a fatal subarachnoid and intracerebral hemorrhage from a middle cerebral artery aneurysm, which apparently developed de novo. 18 years before, the patient was operated for an anterior communicating artery aneurysm and, during this procedure, an anterior cerebral artery was ligated. Hemodynamic disturbances due to anterior artery occlusion are suggested as the cause of new aneurysm formation.

Acute subdural haematoma in adults: an analysis of outcome in comatose patients.

The authors analysed a series of 200 adult patients admitted to the Department of Neurosurgery, Medical University of Lódź with a diagnosis of acute subdural haematoma (ASDH). 63% of them were surgically treated within the first 4 hours after head injury, the others were operated on 4 to 16 hours after trauma. All patients had GCS below 10 for the whole time period from trauma to surgery.

[Parkinsonism caused by bilateral subdural haematomas].

The authors present a case of 75-year old man with bilateral chronic subdural haematomas presenting as parkinsonism. Surgical removal haematomas was followed by complete recovery of the patient.

[Usefulness of intracranial pressure measurement by Camino V420 system: preliminary report].

The authors discuss the basis of ICP measurements with Camino V420 system and present the introductory experience of Department of Neurosurgery, Medical Academy of Lódź with it's clinical use. Continuous ICP measurements, lasting from 24h to 15 days were performed in 16 patients. In 13 of them ICP measurements were done in order to establish the dynamics of hydrocephalus and indications for shunt surgery.

Cerebral and cerebellar glial tumors in the same individual.

We report histologically different gliomas occurring simultaneously in both the cerebrum and cerebellum in a 53-year-old woman. One tumor was a cerebellar astrocytoma, and the second was a temporal glioblastoma multiforme. Two months after the removal of both tumors, the third lesion, located in the basal ganglia, was found on a computed tomographic examination, but it was not verified histologically.

Acute head injuries in the elderly. An analysis of 136 consecutive patients.

136 patients older than 70 years, admitted to our neurosurgical ward directly after head trauma, were analysed. 40% of them were admitted with low GCS, below 9 points, and showed a mortality of 85%. 45 patients had intracranial mass lesions--the commonest was subdural haematoma, with a low incidence of epidural haematomas.

[Cranioplasty of extensive defects of the cranial vault bones using a "Codubix" prosthesis].

In the years 1980-1987 in the Neurosurgery Department, Medical Academy in Lódź in 21 patients aged 12 to 59 years covering of cranial vault bone defects over 100 cm2 of area was done using of cranioplasty polypropylene-polyester knitted fabric Codubix. The size of the implanted prostheses was from 100 to 430 cm2. The time from bone defect occurrence to cranioplasty was from 4 weeks to 18 years.

[Usefulness of computerized myelotomography in the diagnosis of discopathy of the cervical spine].

The authors compared the results of preoperative computer-assisted myelography (CAM) with surgical findings in 45 patients with suspected cervical disc disease. In 98% CAM gave full and proper diagnosis confirmed by surgery. Only in one patient, the preoperative diagnosis was extraspinal tumour, and surgery revealed prolapsed nucleus pulposus lying freely on the anterior wall of the dural sac.

[Clinical course and the results of the treatment of unilateral chronic subdural hematoma].

The authors analysed the clinical and surgical results in 131 patients treated for unilateral chronic subdural haematoma. 71% of patients had a history of head trauma, 34% were addicted to alcohol. In 18% of cases the clinical course mimicked cerebral stroke.

Effect of mannitol on intracranial pressure in focal cerebral ischemia. An experimental study in a rat.

The authors studied the effects of mannitol on intracranial pressure (ICP) in experimental focal ischemia in a rat. Stroke was produced by occlusion of middle cerebral artery (MCA). The study revealed that mannitol decreases ICP in ischemic stroke much less then in healthy animals and also a significant rebound effect was seen, especially in the 5th and 7th day after MCA occlusion.

Clinical pattern of chronic subdural haematoma.

To assess the clinical manifestation of chronic subdural haematoma (CSH) the authors retrospectively analysed the files of 131 adult patients treated in the Department of Neurosurgery Medical Academy of Lódź. In 14 patients the illness had a sudden onset, suggesting cerebral stroke. 50% of patients had symptoms of raised ICP, there were no differences between young and older patients.

[Aphasia without alexia after surgical treatment of aneurysm of the right middle cerebral artery--incomplete lateralization of verbal functions?].

The authors present a case of aphatic disorders after surgical treatment of the right middle cerebral artery aneurysm. A prominent dissociation of verbal function was noticed.