Beschreibung
This volume contains the papers presented at the 24th Annual Meeting of the Deutsche Gesellschaft fur Neurochirurgie, held in Mainz, Western Germany, on April 30 - May 3, 1973. Deliberate choice was made of two crucial still hotly debated subjects which, for ages, have meant a source of constant worry, and nights without sleep to every neurosurgeon. Just as long as our special field exists, there have been the problems of how to control brain edema and ·of how to reduce lethality and the secondary lesions in surgery of cerebello-pontine angle tumors. Concerning the first subject, new pathological, pathophysiological and chemical aspects, the mechanisms of brain edema formation and resolution are presented in the hope for better understanding. Furthermore, the relationship between brain edema, intracranial pressure, cerebral blood flow and metabolism are discussed. Finally, the therapeutical consequences as well as the results of experimental and clinical work are presented, and a comparison of effects between different methods (hypertonic solutions, diuretics, steroids, controlled hyperventilation, hyperbaric oxygen) is given. Concerning the second main subject, any important contributions to the early diagnosis of cerebello-pontine angle tumors have been included. Nevertheless, it is of utmost interest for the neurosurgeon to know which approach he is to prefer for the different stages of tumor size and to be familiar with the trans labyrinthine approach or the posterior craniotomy, as well as with the importance of the use of the microscope in neurosurgery, the preservation of the facial nerve and, in certain cases, its repair.
Autorenportrait
InhaltsangabeI. Pathophysiology of Brain Edema.- Pathophysiology of Brain Edema: Pathological Aspects.- Pathophysiology of Cerebral Edema: Chemical Aspects.- Capillary Lesions and Hemorrhages in Brain Edema.- Blood Brain Barrier and Scintigraphy.- Biochemical Disturbances in Experimental Brain Edema.- Alterations of Metabolism in Brain Edema Following Head Injury.- Consequences of Cerebral Edema and Increased Intracranial Pressure.- Intracranial Pressure Measurements in Clinical Practice.- Nature and Significance of the CUSHING Reflex.- Ventricular Fluid Pressure in Children with Severe Brain Injuries.- Intracranial Pressure, Hemodynamics and Metabolic Disorders in Patients with Severe Head Injury.- II. Clinical Therapy of Brain Edema.- Hypertonic Solutions and Diuretics in the Treatment of Brain Edema.- The Influence of High and Low Dosages of Mannitol 25% in the Therapy of Cerebral Edema. Comparative Study with Monitoring of Intraventricular Pressure.- Steroids in the Treatment of Brain Edema.- Electroencephalographical Findings During Therapy of Brain Edema with Dexamethasone.- Influence of Ventilation and Hyperventilation on Brain Edema and Intracranial Pressure.- Artificial Ventilation in Cerebral Edema. - A Critical Analysis of Manometric and Gazometric Conditions.- The Influence of Ventilatory Changes on CSF Lactate and CSF L/P-Ratio in Brain Injury.- Treatment of Cerebral Acidosis in Posttraumatic and Postoperative Cerebral Edema. - Influence on CBF, EEG, and Clinical Status.- Effect of Hyperbaric Oxygen on Intracranial Pressure in Brain Edema.- Effect of Hyperbaric Oxygenation (HO) in Severe Injuries and in Marked Blood Flow Disturbances of the Human Brain.- III. Intracranial Pressure, Cerebral Blood Flow and Metabolism.- The Effects of Hypercarbia on Cerebral Blood Flow and Carbohydrate Metabolism in Deep Normovolemic Arterial Hypotension.- Regional Cerebral Blood Flow and Regional Cerebrovascular Reactivity Following Local Brain Injury.- Cerebrovascular Autoregulation After Acute Brain Injury with Particular Reference to Changes in Intra-Ventricular Pressure.- Desintegration of Polysynaptic Vegetative Control of the Mesencephalic Reticular Formation After Brain Edema in Animal Experiments.- The Influence of Hypercapnia and Hypoxia on Intracranial Pressure and on CSF Electrolyte Concentrations.- Dissociation of rCBF from Perfusion Pressure in Early State of Cerebral Death (Abstract).- IV. Diagnosis of Cerebello-Pontine Angle Tumors.- Microtopography of the Cerebellopontine Angle and Early Otologic Diagnosis of Cerebellopontine Angle Tumors (Abstract).- Neuroradiological Diagnosis of Cerebellopontine Angle Tumors.- Anomalies of the Arteries of the Caudal Brain Stem and the Cerebellopontine Angle.- The Diagonal Distribution of Spontaneous Nystagmus.- The Value of Petrous Bone Exposures in Stenvers' Position and of Brain Scanning in the Diagnosis of Tumors of the Cerebellopontine Angle Region.- The Diagnostic Value of Brain Scan in Cerebello-Pontine Angle Tumors.- Radio-Isotope Cisternography for the Diagnosis of Cerebello-Pontine Angle Tumors.- Duroliopaque Cisternography in Cerebello-Pontine Angle Tumors (Abstract).- The Use of Vertebral Angiography in the Differential Diagnosis of Cerebello-Pontine Angle Lesions.- V. Surgery of Cerebello-Pontine Angle Tumors.- Experiences and Results with the Translabyrinthine Approach and Related Techniques (Abstract).- Experiences and Results with Posterior Approaches (Abstract).- Surgical Reconstruction of Intracranial Lesions of Cranial Nerves.- Advances in Surgery for Acoustic Neurinoma (A Synopsis).- Microsurgical Experience in Surgery of Acoustic Neurinomas (Abstract).- Experiences in Microsurgery of Acoustic Neurinomas (Abstract).- Critical Observations Concerning the Diagnosis and Clinical Features in 100 Cases of Tumors in the Cerebellopontine Region.- Operations and Results in 102 Tumors of the Cerebellopontine Angle.- Preservation of the Facial Nerve in Acoustic Neurinoma Surgery (Abs
