[Spasm in angiographic image and the development of the symptoms of ischemic stroke in patients after subarachnoid hemorrhage from supratentorial ruptured aneurysm]. / Skurcz w obrazie angiograficznym a wystepowanie objawów udaru niedokrwiennego mózgu u chorych po krwawieniu podpajeczynówkowym z peknietego tetniaka w obszarze nadnamiotowym.

The results of angiographic examinations are presented in relation to the development of ischaemic stroke in 219 patients. In the selection of the patients cases were ruled out with coexistent intracranial haematomas, and the patients treated surgically were ruled out in whom the course of the operation suggested a possible influence of additional factors which might have changed the condition of the patient independently of the main disease. Depending on the results of angiography three groups of patients were isolated with different likelihood of ischaemic stroke development: patients without vasospasm or with segmental vasospasm-stroke developed in 15%-9% of cases; patients with unilateral or bilateral diffuse vasospasm of low or medium intensity-stroke in 34%; patients with high-grade diffuse intensity-stroke in 73% of cases. The frequency of stroke in these groups is analysed in relation to the condition of the patient at the time of angiographic examination.

[Many-year survival after surgical treatment of glioblastoma multiforme. Report of 2 cases]. / Kilkunastoletnie przezycie po operacji glejaka wielopostaciowego mózu; opis dwóch przypadków.

Two female patients are described with survival over 13 years after operation for glioblastoma multiforme. The first patient was 42-year-old at the time of partial removal of the tumour situated in deep parts of the temporal lobe. After the operation she was not given any radiotherapy. CT done 13 years after the operation failed to show tumour presence. The patient is leading a self-dependent life (80 points in Karnofski scale). The other female patient was 28-year-old at the time of nearly complete removal (macroscopic) of right temporal lobe tumour. She received cobalt radiotherapy. CT 9 years after the operation showed no tumour. The present state of the patient was evaluated at 90 points Karnofsky scale. In no case cytostatics were given. These cases demonstrate an exceptionally long survival after operation for malignant glioma. The cause of this long survival is not known.

[Location of cerebral aneurysms and arteriospasm after subarachnoid hemorrhage]. / Umiejscowienie tetniaków a skurcz tetnic u chorych po krwawieniu podpajeczynówkowym.

On the basis of an analysis of 314 patients with aneurysms situated supratentorially the authors tried to establish a possible correlation between the location of the aneurysm and the frequency, intensity and extent of this spasm. Similarly as in the reports of other authors it was not possible to find a correlation between the location of the aneurysm and arteriospasm. Only the group of 28 patients with multiple aneurysms showed the highest percent of most intense and most extensive arteriospasm, which was particularly evident within the first three days after haemorrhage. In the period from the 4th to the 6th days after the last subarachnoid haemorrhage the lowest proportion of angiograms with arteriospasm was noted in patients with aneurysms of the anterior communicating artery. In this group diffuse bilateral arteriospasm was significantly more frequent than in the remaining groups.

Ruptured intracranial aneurysm associated with spontaneous occlusion of internal carotid artery. Experience with 5 cases.

Out of 921 patients diagnosed and treated for intracranial aneurysm in 5 cases (0.5%) the co-existence of ruptured aneurysm and occlusion of the internal carotid artery was found. 4 patients were treated surgically--aneurysm clipping--without serious post-operative complications and 6 months follow-up showed satisfactory results. In 4 of 5 cases the aneurysm was located on the anterior communicating artery (ACA); this fact may support the hypothesis concerning a possible role of enhanced blood flow in aneurysm formation and rupture. In cases with good collateral blood flow extra-/intracranial bypass before aneurysm occlusion seems not to be necessary. The risk of operation in those patients is not as high, as might be expected.

[Spasm of the cerebral arteries in angiographic studies in relation to the duration of bleeding from the aneurysm]. / Skurcz tetnic mózgowych w badaniach angiograficznych w zaleznosci od czasu krwawienia z tetniaka.

The purpose of the study was determination of the incidence of arteriospasm in the brain in relation to the time after the last bleeding to the time of angiography. The authors analysed 209 cases of bleeding in which one-time angiography of the carotid arteries was done. In 45% of cases arteriospasm was found. The lowest incidence of arteriospasm was observed 1-3 days after the last bleeding, and highest on days 7-9 after this bleeding.

[The risk of complications of cerebral angiography in patients with cerebral aneurysms in relation to the time of its use]. / Ryzyko angiografii mózgowej u chorych z tetniakami naczyn mózgowych w zaleznosci od terminu jej wykonania.

The authors analysed the effect of cerebral angiography on the condition of the patients after haemorrhage from an intracranial aneurysm. The studied material comprised 242 patients in whom cerebral angiography was carried out at various times after the haemorrhage by the method of direct percutaneous needle insertion into the carotid artery. Complications of angiography included: worsening of the general condition or neurological condition during the angiography and within 24 hours after it. Such complications were found in 14 patients (5.8%). In only 3 cases they appeared during the angiography. No cases of repeated haemorrhage from the aneurysm were observed. The greatest risk of complications was after 7-9 days from the haemorrhage which was connected with the greatest intensity of arteriospasm at that time. All carotid angiographies were done using a contrast medium hypersmolar and hypertonic in relation to the blood and cerebrospinal fluid (Uropolinum-Polfa 60%).

[Conservative treatment of selected cases of chronic paracerebral hematoma]. / Leczenie zachowawcze w wybranych przypadkach przewleklych krwiaków przymózgowych.

The authors report an analysis of the course of 16 cases treated conservatively for paracerebral haematomas. The diagnosis was based on angiographic findings of computerized tomography (CT). Haematoma resorption was confirmed by CT. The follow-up was from 3 months to 6 years. The patients were in a general good condition without or with only transient signs of focal central nervous system damage, the thickness of the haematomas was never over 15 mm. In all cases the haematomas were resorbed, 15 patients feel well and lead an active life, in one case signs of organic brain injury developed connected with dilatation of the ventricular system and cortico-subcortical atrophy. In the light of the observed material and a literature review criteria are suggested which could indicate expected good effects of conservative treatment in such cases.

[Rheographic studies in the diagnosis of vertebrobasilar syndromes]. / Badania reograficzne w diagnostyce zespolow kregowo-podstawnych.

The authors report the results of investigations of 33 healthy subjects and 33 patients with manifestations of intracranial circulatory disturbances in the vascularization area of the vertebrobasilar system. Type II rheography was used. All curves from the vertebral, vertebromastoid and frontomastoid leads were averaged. No significance of asymmetry between the right and left sides was demonstrated in attempts at differentiation between patients and controls. Mosaicisim of changes of curves during head turning was observed in 15% of controls and 55% of patients.

[Value of rheographic studies in the diagnosis of epileptogenic foci in temporal lobe epilepsy]. / Wartosc badan reograficznych w diagnostyce ogniska padaczkorodnego w padaczce skroniowej.

Using a type II Siemens rheograph 100 patients with temporal lobe epilepsy aged 18--36 years were investigated. In each case rheographic investigation was done in sitting and lying position, at rest and after hyperventilation in both these positions. The shape of the descending arm of the main wave of the averaged rheoencephalographic curve was analysed in detail. In 89 cases unilateral presence of h1 wave was found, which was absent in the rheograms of healthy subjects, and h2 wave was present also. The shape of the remaining rheographic curves in this population was not different from the records obtained in healthy subjects. In 92 patients EEG investigations demonstrated focal changes were found, in 8 bilateral changes were present, prevalent on one side. In 85 cases h waves were present on the side of the epileptogenic focus, and in 4 cases it was present contralaterally but only in patients with bilateral EEG changes. The results of these investigations point to differences in the haemodynamic conditions in the temporal lobes in healthy subjects and in most patients with temporal lobe epilepsy on the side of the epileptogenic focus. Rheographic investigations was found to be useful for determination of the side of the epileptogenic focus.

[Analysis of the rheoencephalographic curves from the temporal areas in healthy subjects aged 18-22 and obtained by means of type II rheography]. / Analiza krzywych reoencefalograficznych z okolic skroniowych u ludzi zdrowych w wieku 18--28 lat, wykonana przy pomocy reografii typ II.

Using Siemens type II rheograph 100 subjects aged 18 to 28 years were investigated analysing averaged rheoencephalographic curves from 50 repetitions by means of a Neuro-Averager apparatus made by Biomedica, and Anops 10 Biological Computer. The trigger for averaging was the QRS complex in ECG of the investigated subject. The records were obtained in sitting and lying positions. All curves were divided into the following types: U waves, U--W waves and W waves; positive and negative curves were also separated. The segment between the peak of the main wave and the beginning of the dicrotic wave was subjected to a particularly careful analysis. Because of its shape and accessory waves occurring there they were divided into alpha and beta waves. In the group of W waves L waves were separated. In sitting position 70% of the waves belonged to group W and positive waves were observed in 98% of this group. In lying position W waves accounted for 61% and positive waves for 12%. The shape of REG wave reflects the haemodynamic conditions in a given area and is changed, similarly as these conditions, with a change in the position of the subject.