[Resumption of professional work after cerebral aneurysm surgery]. / Powrót zdolnosci do podjecia pracy zawodowej po przebytej operacji tetniaków mózgu.

The influence of various factors upon the resumption of professional work was examined in the group of 87 patients, who had undergone an operation of single cerebral aneurysms. Professional activity was resumed by 59.9% members of the examined group. The age and the level of education or professional training were found to be the most influential factor. The location of aneurysms and sex of patients was found to have no influence. The fact that greater percent of those living in the country resumed their professional activities than those living in towns or cities can be explained by greater difficulty in to suffering was a quite frequent factor which can be overcome due to proper information given to the patients, thereby the greater number of patients can resume their professional career.

[Theories of intracranial aneurysm etiology]. / Teorie powstawania tetniaków wewnatrzczaszkowych.

The main theories of the origin of intracranial aneurysms as the most common vascular malformations are presented. Three main theories maintain that they are either the congenital, acquire or both of those defects. The presence of aneurysms in the bifurcations of the arteries with the loss of the muscle layer and the coexistence with other vascular malformations of the arteries and their rareness in children give the evidence of the acquire origin. The present theories join this two positions and take into consideration also the hemodynamic and inflammation as well as degeneration, atheromatosis, toxic and traumatic factors.

[Biological and clinical significance of acute phase proteins with particular emphasis on the role of C-reactive protein]. / Biologiczne i kliniczne znaczenie bialek ostrej fazy ze szczególnym uwzglednieniem roli bialka C-reaktywnego.

The acute phase response is a non-specific, early phenomenon, in which the concentration of a number of plasma proteins is increased following most forms of tissue injury, bacterial infection, inflammation, malignant neoplasia and surgical procedures. These plasma proteins are collectively termed acute-phase proteins. Their most important role is to restore the homeostasis of human organism. C-reactive protein (CRP) regarding his dynamic reaction, is one of the best non-specific biochemical indicators of most disorders. The multiple quantitative measurement of CRP is usefull in the diagnosis, differentiation, the assessment of treatment effectiveness and patient's prognosis, additionally to other clinical parameters.

[Management in cases of multiple cerebral aneurysms]. / Postepowanie w przypadkach mnogich tetniaków mózgu.

In the management of multiple intracranial aneurysms one has to face some problems, which do not occur in cases with single ones. The majority of neurosurgeons nowadays trend to operate on all detected aneurysms. Some controversy still exists concerning operating strategy--to operate all aneurysms simultaneously or in stages. Those who advocate the late way of treatment have to recognise which one of aneurysms was the cause of haemorrhage and must be operated first. This is one of the main factors influencing the results of treatment of multiple cerebral aneurysms.

[Spontaneous intracerebral hematomas]. / Spontaniczne krwiaki sródmózgowe.

The choice of treatment in spontaneous intracerebral haematomas has always been controversial. As indications to surgery should be regarded: location and size of haematoma, shifting of midline structures and deterioration of consciousness. The results of treatment are worsened by deep location of haematoma, especially in thalamus and brain stem region, very big size, primary serious condition, very advanced age of the patient and some metabolic diseases like liver dysfunction. It is difficult to establish fixed rules of treatment of spontaneous intracerebral haematomas and the decision depends mainly on the experience of the surgeon.

[Spontaneous intracerebral hematomas in the material of the Department of Neurosurgery of Medical Academy in Lublin]. / Krwiaki sródmózgowe w materiale Kliniki Neurochirurgii AM w Lublinie.

Between 1972 and 1991, 170 patients with spontaneous nontraumatic intracerebral haematomas were treated in the Neurosurgical Department of Medical Academy in Lublin. In 89 (52.5%) patients, the haematomas were caused by ruptured aneurysms; in 14 (8%), by angiomas; 67 (39.5%) haematomas had other etiology. Within the latter group of patients, 27% suffered from hypertension. Hypertension was also found in 15% of the patients with aneurysms and in 7% of the ones with angiomas. 34% of the haematomas were localized in the temporal lobe, 28%-in the frontal lobe, 3%-in parital lobe, 2%-in occipital lobe, 23% of haematomas were multi-lobal, 8% were found in deep brain structures, and in 2% haematomas were found in cerebellum. 128 patients underwent operative treatment, with a mortality rate of 26%, while 42 patients were treated conservatively, with a mortality rate of 19%. Basing on this material, the authors discuss indications for operative treatment of the haematomas.

[Direct effects of the intrathecal administration of normal saline for the brain expansion after the removal of subdural hematoma]. / Bezposrednie skutki dokanalowego podawania fizjologicznego roztworu soli w celu rozprezenia mózgu po usunieciu krwiaka podtwardówkowego.

In a group of 360 patients the effects were studied of various management methods in case of lacking expansion of the brain after removal of chronic subdural haematoma on the therapeutic results. It was found that intrathecal infusion of normal saline was an effective procedure, with small frequency of transient complications, and was followed by a considerably lower number of re-operations than after external or internal drainage of haematoma cavity.

[A case of multiple vascular malformations of brain and liver]. / Przypadek mnogich malformacji naczyniowych mózgu i watroby.

In a woman aged 45 years after a generalized epileptic seizure CT and MRI demonstrated a lesion of the type of vascular malformation of the brain diagnosed as a haemangioma by angiography which demonstrated also presence of an aneurysm of the left pericallosal artery. Abdominal ultrasonography and tomography found also hepatic haemangioma. Both cerebral vascular lesions were managed successfully in one-step operation. The hypotheses for explaining the coexistence of haemangiomas and aneurysms are discussed.

[Spontaneous acute subdural hematoma]. / Spontaniczny ostry krwiak podtwardówkowy.

A rare case of spontaneous acute subdural haematoma is reported. Causes of non-traumatic subdural haematomas are discussed stressing the necessity of rapid surgical intervention.

[Vasoactive neuropeptides CGRP (calcitonin gene-related peptide) and vasospasm during subarachnoid hemorrhage from ruptured intracranial aneurysm]. / Naczynioaktywne neuropeptydy CGRP (calcitonin gene-related peptide) i VIP (vasoactive intestinal polypeptide) a skurcz naczyniowy w przebiegu krwawienia podpajeczynówkowego z peknietego tetniaka wewnatrzczaszkowego.

The authors discuss the role of active neuropeptides Calcitonin Gene-Related Peptide (CGRP) and Vasoactive Intestinal Polypeptide (VIP) in the arterial spasm caused by haemorrhage from ruptured intracranial aneurysm. These substances act as vasodilators on brain vessels. Between the first and the second week after subarachnoid haemorrhage their concentration in the periarterial nerve fibres of the big vessels is significantly low. According to the experiments, the erythrocytes are this component of the blood which causes the decrease of the number of nerve fibres containing CGRP and VIP. The clinical tests of CGRP and VIP in the treatment of the vascular spasm after subarachnoid haemorrhage are being continued.

[Familial occurrence of intracranial aneurysms]. / Rodzinne wystepowanie tetniaków wewnatrzczaszkowych.

Four cases of intracranial aneurysms are reported found in two families. They accounted for 1% of all patients with these aneurysms treated in that time period. The aetiology of the aneurysms, the most frequent locations in familial cases and the risk of occurrence of asymptomatic aneurysms in such families are discussed.

[Aneurysm of the azygos anterior cerebral artery]. / Tetniak tetnicy przedniej mózgu nieparzystej.

A case of aneurysm associated with the anterior cerebral artery is described. The authors stress diagnostic difficulties in such cases and discuss the coexistence of vascular anomalies and cerebral aneurysms.

[Brain abscesses of unknown etiology]. / Ropnie mózgu nieznanego pochodzenia.

On the basis of literature data and own material of 18 cases of cerebral abscesses of unknown origin the authors discuss their incidence, most frequent locations, diagnostic difficulties and results of surgical treatment in relation to remaining groups of cerebral abscesses of known aetiology.

[Evaluation of cerebral blood flow in postoperative increased intracranial pressure]. / Ocena mózgowego przeplywu krwi w pooperacyjnych zwykach cisnienia wewnatrzczaszkowego.

In 20 patients with expanding intracranial lesions the intracranial pressure, cerebral blood flow, mean arterial blood pressure were determined and the cerebral perfusing pressure and cerebral vascular resistance were calculated before the operation and after removal of the expanding lesion. In 7 cases rises of the intracranial pressure occurred after the operation. In 5 of them they were associated with increased cerebral blood flow and decreased vascular cerebral resistance which was an evidence of their vasogenous mechanism. In 2 cases increased intracranial pressure was associated with raised cerebral vascular resistance suggesting oedema as the cause. The value of the investigations is discussed which give the results on which the choice of a proper management can be based in cases of increased intracranial pressure.

[Relation between cerebral blood flow and the changes in perfusion pressure in patients with brain compression processes]. / Zaleznosc przeplywu mózgowego krwi od zmian cisnienia perfuzyjnego u chorych ze sprawami uciskowymi mózgu.

In 20 patients with expanding intracranial lesions the cerebral blood flow was determined by the method of Kety-Schmidt in an own modification with an original device--N2O-meter, with simultaneous continuous measurement of the intraventricular pressure and arterial blood pressure. This made possible determination of the cerebral perfusion pressure and of the effect of its fluctuations on the cerebral blood flow. Lowering of the cerebral blood flow below the normal value occurred when the perfusion pressure fell below 60 mm Hg, but its further fall, even to 20 mm Hg, caused no proportional decrease of the cerebral blood flow.