Compared to I-MIBG SPECT/CT, F-DOPA PET/CT provides accurate tumor extent in patients with extra-adrenal paraganglioma.

Aim: The aim of this study was to compare the accuracy of I-MIBG SPECT/CT with that of F-DOPA PET/CT for staging extra-adrenal paragangliomas (PGLs) using both functional and anatomical images (i.e., combined cross-sectional imaging) as the reference standards.

Image registration of MR and CT images using a frameless fiducial marker system.

A new system of fiducial stereotactic markers that can easily be adapted to various imaging modalities without losing image registration was developed and tested. Utilizing MR and CT imaging the accuracy of the new system was evaluated with phantom studies and preliminary patient studies. The markers are clearly visible without artifacts on both imaging modalities.

Effect of amiloride and emopamil on intracranial pressure.

The authors sought to determine whether amiloride or emopamil could reduce intracranial pressure in experimental brain edema of the rat. For this purpose the rats functionally nephrectomized and brain edema of the cytotoxic type induced by infusion of 100 ml aqua bidest/kg body weight. After the end of the infusion 10 or 20 ml mM amiloride/kg body weight or 50 microliters mM (s)-emopamil/kg body weight in 10 ml 150 mM NaCl/kg body weight or 10 ml isotonic saline/kg body weight were injected followed by continued recording of intracranial pressure (ICP) and systemic arterial pressure for at least 3 hours.

Effect of torasemide on intracranial pressure, mean systemic arterial pressure, and cerebral perfusion pressure in experimental brain edema of the rat.

Torasemide, a puridine-3-sulfonylurea derivative, is a lipophilic diuretic compound. It interacts with the Na+2Cl-K+ carrier and at higher concentrations with the chloride channels. The lipophilic nature of torasemide may determine its access to glial and neuronal cells across the blood brain barrier.

Effect of torasemide on intracranial pressure, mean systemic arterial pressure and cerebral perfusion pressure in experimental brain edema of the rat.

The study was performed to establish whether a lipophilic loop diuretic, torasemide could modify intracranial pressure and cytotoxic brain edema. Brain edema was induced by water intoxication in nephrectomized rats. Following intravenous injection of 100 mg torasemide/kg body weight at 50, 60, 70, 90 and 120 min, a significant decrease of intracranial pressure was observed.

[Problems in diagnosis and therapy of extensive intramedullary tumors (illustrated by a case report)].

The case is presented of a patient with intramedullary ependymoma extending from C 1 to D 5, treated by a three-stage surgical procedure. A historical review is provided, followed by a discussion of the difficulties of diagnosis, especially at an early stage, and of the surgical management.

Photodynamic treatment of malignant brain tumors.

30 patients with primary or recurrent malignant brain tumors (9 primary, 18 recurrent malignant gliomas, 1 malignant meningioma, 2 melanomas) were treated altogether 37 times by photodynamic therapy (PDT) whether after intravenous, intraarterial or direct intratumoral sensitisation by hematoporphyrin (HPD) after conventional surgical removal of the tumor mass. The light was produced by an Argon pumped dye laser at doses varying from 40-220 J/cm2. A single dose of radiation of 4 Gy was administered to 18 patients immediately after PDT.

[Neurosurgical therapy of epilepsy].

We are witnessing a renaissance of the surgical treatment of epilepsy, with renewed interest in the classic procedures and development of new ones such as selective amygdalohippocampectomy. Surgery is being increasingly used in the treatment of medically intractable seizures. Exact presurgical evaluation, with definition of the focus, is of the utmost importance and good results are largely dependent on case selection for surgical therapy.

[Tractotomy and partial nucleotomy as a form of therapy in refractory pain of the trigeminal nerve and cancer pain in the head and neck area].

Persistent trigeminal neuralgia, herpes zoster neuralgia of the first division of the trigeminal nerve and pain caused by cancer situated in the head and neck pose frustrating problems for patients and physicians. Tractotomy and/or partial vertical nucleotomy of the subnucleus caudalis nervi trigemini offers a logical approach to the treatment of such pain, since these structures contain fibres of the Vth nerve, as well as the somatosensory fibres of the VIIth, IXth and Xth nerve. Tactile and some thermal sensitivity of the face is preserved and anaesthesia dolorosa and keratitis neuroparalytica is avoided.

Effect of gammahydroxybutyrate on intracranial pressure, mean systemic arterial pressure and cerebral perfusion pressure in experimentally induced brain oedema of the rat.

In the treatment of raised intracranial pressure (ICP) an agent is needed which can similarly reduce ICP and protect the brain without reducing systematic arterial pressure and cerebral perfusion pressure. Gammahydroxybutyrate (GHB) decreases cerebral metabolic requirement of oxygen (CMRO2) and glucose utilization rate. The effect of GHB on ICP, systemic arterial pressure and cerebral perfusion pressure in the experimentally induced brain oedema of the rat was examined.

[Depressed fracture of the calvaria].

This study is based on 147 depressed fractures of the calvaria. 60% of the diagnosed and treated cases were compound depressed fractures. Of the 147 patients 12 developed intracerebral, epidural and subdural hematomas.

Effect of gammahydroxybutyrate on intracranial pressure, mean systemic arterial pressure and cerebral perfusion pressure in experimentally induced brain oedema of the rat.

The effect of gammahydroxybutyrate (GHB) on ICP, systemic arterial pressure and cerebral perfusion pressure in the experimentally induced brain oedema of the rat was examined. 400 mg/kg GHB reduced significantly ICP (11.74 +/- 1.

[Space-occupying, traumatically-induced hemorrhage of the posterior cranial fossa].

A total of 4,408 patients were treated for head injuries from 1980 to 1986 at the University Hospital of Innsbruck in Austria. Nine of them (0.2%) showed a traumatic, space-occupying hematoma in the posterior fossa.

[Lumbar disk hernia in children and adolescents].

Of 3,946 patients with lumbar disc herniation, who were operated on from 1980 to 1987 at the Clinic of Neurosurgery of the University of Innsbruck, 11 consecutive patients (0.27%) were younger than 19 years. In 9 patients (82%) there was radicular pain; in 90% the straight-leg raising test was positive, in 36% there was clear relation trauma to the onset of symptoms.

Rupture of a giant aneurysm of the inferior wall of the internal carotid artery after saphenous vein interposition graft to the middle cerebral artery.

A patient with a giant aneurysm of the inferior wall of internal carotid artery presented with progressive vision failure with optic nerve atrophy on the left eye. She underwent exploration of the aneurysm, which was found impossible to clip. Clamping of the common carotid artery was not tolerated there being inadequate collateral circulation.

Steroid-induced complete remission in a case of primary cerebral non-Hodgkin's lymphoma.

A case of a primary non-Hodgkin's lymphoma of the CNS is reported in which a complete and stable disappearance of an enhancing mass lesion on the CT scan after treatment with dexamethasone was followed by the occurrence of a high-grade malignant lymphoma in the opposite hemisphere 18 months later. The long-lasting and stable remission suggests a direct oncolytic effect of corticosteroids on lymphoma cells. Furthermore, this case illustrates the usefulness of repeated CT examinations in patients with CNS lymphoma and steroid treatment.

Effect of furosemide, bumetanide and mannitol on intracranial pressure in experimental brain edema of the rat.

Loop diuretics interfere with NaCl-KCl cotransport, which operates not only in the kidney but as well in a variety of nonepithelial cells including neuronal and glial cells. In these cells loop diuretics are able to reduce cellular volume. The present study has been performed to establish, whether furosemide or bumetanide directly modify intracranial pressure in cytotoxic brain edema.

[Hydrocephalus following spontaneous subarachnoid hemorrhage].

In the period 1980-1985 221 patients presenting with subarachnoid haemorrhage were operated on at the Department of Neurosurgery of the University of Innsbruck. 26 patients (11.7%) of them required a ventriculoatrial or ventriculoperitoneal shunt.

[Simultaneous occurrence of brain tumors and aneurysms].

Three patients with different types of intracranial tumour--glioma, meningioma and pituitary adenoma--and associated aneurysms are described. The aetiology of aneurysm formation in the presence of tumours is discussed and a review of the literature given.

Tractotomy and partial vertical nucleotomy--for treatment of special forms of trigeminal neuralgia and cancer pain of face and neck.

The therapy of face and neck pain has often been elusive. We attempted to improve the condition of these patients and tried to influence 1. pain of trigeminal neuralgia, where other forms of therapy had failed, 2.

[Epidermoid in the 4th ventricle].

A case of pearly tumor (cholesteatoma or epidermoid cyst) of the IV. ventricle in a patient aged 64 years is reported. The patient had been treated one year earlier for lumbar herniated nucleus pulposus.

Subarachnoid metastases from a prolactinoma.

A 37-year-old man developed a left frontal metastasis from a prolactin-secreting pituitary tumour, which had been operated on nine years before. The metastatic tumour was totally excised. One and a half years later he was found to have multiple left temporal and parietal subarachnoid metastases.