[An animal model of surgical, external cardiac denervation. Studies of the autonomic control of heart rate]. / Tiermodell der operativen, externen kardialen Denervierung Untersuchungen zur neurovegetativen Herzfrequenzsteuerung.

A great role is played in clinical practice by monitoring of vegetative functions, such as heart and respiratory rates. Mean values, rhythms, and interaction of both control variables in the form of respiratory sinus arrhythmia may provide plenty of information, primarily when computerised, and may enable conclusions to be drawn as to neuro-circulatory tonus. The model described in this paper has been devised for the purpose of producing information on types of changes in neurovegetative control in response to functional systemic effects from pharmaceuticals or from substantial, locally delimited lesions of nerve structures. External cardiac denervation is applied for stepwise discontinuation of sympathetic, parasympathetic, spinal, and medullary control systems up to the stage of cerebral death, resulting in cardiac "automatism". Data may thus be derived on the Bainbridge reflex, and correlations may be established with in vitro experiments on chronotropic control of the heart. The results presented in this paper may be of relevance to situations in intensive medical care or to cases with lesions to the central nervous system up to irreversible loss of brain function, when heart rate data recorded from monitoring of the central nervous system or of vegetative functions must be interpreted in all their variability with high reliability and accuracy for differential diagnosis and prognostication.

[Spontaneous spinal epidural hematomas]. / Zur Problematik der spontanen spinalen Epiduralhämatome.

Until now, reports have been given on 249 spontaneous spinal epidural haematomas. Two own cases are included in the submitted analysis. In approximately 78 per cent, the disease begins with pain and radicular disturbances according to the lactation of the haematoma, in 18 per cent with a primary to the location of the haematoma, in 18 per cent with a primary transverse syndrome. The incidence peak is seen around the 60th year of liefe. Men are taken ill more frequently than women, the ratio being 5:3. At the age of 10 to 50 years, the ratio is 3:1. In one third of the patients, no cause of the disease can be detected. One quarter of the patients were given anticoagulants. The prognosis depends on the interval between the first symptoms and the transverse lesion of the cord with paraplegia as well as the time of the operation. For the myelon region (C 1-L 1), the remission rate obtained by an operation within 24 hours after formation of the transverse syndrome is bad in about 34 per cent, for the caudal region (L 2-S 1) it is better in approximately 57 per cent. It the operation is carried out within eight hours, the remission rate is about 84 per cent. In most cases, the disease is diagnosed with a delay and the patients are referred for a surgical treatment too late.

[Cerebral mycotic aneurysms after abortion endometritis]. / Zerebrale mykotische Aneurysmen nach Abortendometritis.

The genesis of abortion endometritis appears to be sufficiently clarified when the aneurysm was successfully demonstrated and the vascular bulgings were located at the typical sites of predilection of Forbus' malformation aneurysms. The demonstrated case shows that this conception is not generally valid and that surprising aspects can be derived from pathological-anatomic findings. A 43-year-old female patient had her third subarachnoid haemorrhage on the second day of admission before a neurosurgical operation could be performed and died of the consequences of this haemorrhage. The histological examination spoke for an embolic-mycotic aneurysm genesis in the presence of abortion endometritis. In the literature, the majority of cerebral mycotic aneurysms are described as a consequence of endometritis, only 20 per cent are due to other inflammatory basic diseases. If cerebral vessels are invaded by bacteria, wall structure, tissue reaction and clinical manifestation are dependent upon the virulence of the pathogens an the defense power of the patient. In case of clinically manifest infectious processes and subarachnoid haemorrhage are coinciding, an inflammatory affection of cerebral vessels should be included in the scope of differential-diagnostic considerations. The establishment of correlations becomes more difficult in case of an apparently inconspicuous interval of several months. That neglected symptoms of an (extracerebral) infection can be in direct connection with cerebral aneurysms haemorrhages is shown by the description of a case with cerebral mycotic aneurysms after endometritis not having been described in the literature until now.

[Clinical and instrumental diagnostics in injuries of the cervical spine (author's transl)]. / Klinische und instrumentelle Diagnostik beim Halswirbelsäulentrauma.

In connection with the mechanical genesis of the accident and extended X-ray examination the analysis of the clinical course gives information about site and prognosis of the injury. The indication for a surgical intervention is decisively influenced by discography and myelography.