[Nocturnal sleep patterns during treatment of hydrocephalus]. / Zachowanie sie snu nocnego w czasie leczenia wodoglowia.

By polygraphic methods the authors studied the sleep patterns during treatment of patients with subtentorial tumours causing hydrocephalus. Sleep recording was carried out in three stages of treatment: 1) before insertion of ventriculo-atrial valve, (7 investigations), 2) on the 7th day after valve insertion (7 investigations), 3) two months after removal of the posterior fossa tumour (3 investigations). The control group included patients with peripheral nerve injury in whom sleep recording was done before and after surgical treatment. In cases with hydrocephalus and raised CSF pressure before valve insertion the cyclic pattern of sleep was disintegrated, showing long periods of light sleep (phase 1 + 2) interrupted by long periods of alertness, during sleep, mostly with elimination of the remaining sleep components. The decrease of CSF pressure after valve implantation was parallelled by partial normalization of sleep pattern, that is shortening of the light sleep phase and reduction of the number of alertness during sleeping hours, as well as prolongation of the phases of deep sleep and appearance of paradoxical sleep. However, only removal of the tumour from the posterior fossa made possible approximation of sleep elements to those in the control group. Sleep disintegration of varying intensity in patients with hydrocephalus may be reversible, the rate of normalization of sleep depends on the intensity of sleep disturbances in the initial stage of the disease, but return to nearly normal sleep is possible only after removal of the subtentorial tumour.

[Clinico-theoretical aspects of cerebrospinal fluid pressure changes associated with sleep analysis in patients with hydrocephalus caused by posterior fossa tumors]. / Aspekty kliniczno-poznawcze zmian cisnienia plynu mózgowo-rdzeniowego w polaczeniu z badaniami snu u chorych z wodoglowiem spowodowanym guzami tylnej jamy czaszkowej.

In 6 patients treated for hydrocephalus caused by posterior fossa tumours simultaneous continuous measurement of intraventricular cerebrospinal fluid pressure and all-night polygraphic sleep recording were carried out before and after implantation of ventriculoatrial valve. It was observed that in patients with hydrocephalus and raised CSF pressure electrography demonstrated a breakdown of the cyclic sleep pattern with increased duration of light sleep and higher number of awakening episodes, and with reduced amount of deep sleep and nearly complete absence of REM sleep. The degree of sleep disturbances seemed to be correlated with increased value of CSF pressure. In that period discrepancies were observed between the sleep record suggesting waking and the behaviour of the patient who was asleep at that time. With normalization of CSF pressure record (after valve implantation) an improvement of sleep pattern was observed which approached the normal one.

[Results of polygraphic nocturnal sleep recording in patients with supratentorial brain tumors prior to and following surgery]. / Ocena wyników badania poligraficznego snu nocnego u chorych z guzami nadnamiotowymi mózgu w okresie przed i pooperacyjnym.

The purpose of the study was to establish the influence exerted by a supratentorial brain tumour on the EEG correlates of sleep, and to compare the results before and after operation. Five patients were studied (aged 38 to 59 years) who were treated surgically for supratentorial expanding lesions: two cases of meningioma (in left parietal area), two cases of glioma (right parietal area and occipital area) and one case of intracerebral haematoma. The control group comprised 5 patients operated upon for lesions of the peripheral nerves of extremities. In the patients with supratentorial brain tumours and after their removal the following sleep parameters were unchanged: total sleep duration, number of awakening during sleep, latency time of the first REM phase and stage 3 NREM (deep and superficial sleep). The amount of REM sleep increased after tumour removal. REM-sleep density was selectively and permanently disturbed. In presence of tumour REM-sleep density was found in traces only, after tumour removal it increased but showed a permanent high-grade deficit in relation to controls.

[Cerebrospinal fluid pressure measurements in the ventricular system during and after surgery in patients with supratentorial brain tumors]. / Ocena wartosci pomiaru cisnienia plynu mózgowo--rdzeniowego (cpmr) w ukladzie komorowym podczas zabiegu operacyjnego i w okresie pooperacyjnym u chorych z nadnamiotowymi guzami mózgu.

In the light of CSFP measurements by Lundberg's method in 46 patients the authors showed the role of hyperventilation in lowering of intracranial pressure. A considerable efficacy of dexamethasone was demonstrated as well, the use of this drug permitted to achieve stabilization of CSFP during and after the operation. The investigations showed a considerable effectiveness of such drugs as mannitol and furosemide in lowering of CSFP. Pancuronium was found to be superior to suxamethonium for administration during induction of anaesthesia because the former caused no CSFP rise. In polygraphic investigations of nocturnal sleep with parallel recording of CSFP a rise of CSFP was demonstrated during REM phase of sleep.

[Comparison of results of polygraphic sleep studies and cerebrospinal fluid pressure records in patients following removal of supratentorial expanding lesions]. / Porównanie wyników badania poligraficznego snu z zapisem cisnienia plynu mózgowo-rdzeniowego u chorych po usunieciu przyczyny nadnamiotowego ucisku mózgu.

In 4 patients operated upon for supratentorial brain tumors the authors carried out on the 3rd day after the operation polygraphic recording of nocturnal sleep with simultaneous measurements of cerebrospinal fluid pressure in the ventricular system by the method of Lundberg. A comparison of polygraphic records of nocturnal sleep with parallel measurements of intraventricular pressure demonstrated that all REM phases were associated with a rise in intraventricular pressure, while during phases 3 and 4 of sleep (NREM) the intraventricular pressure was always lower. In the remaining sleep phases 1,2 NREM and during episodes of nocturnal awakening no unequivocal consistencies were found.

[Effect of stress on sleep characteristics in humans]. / Wplyw stresu na charakterystyke snu u ludzi

Earlier investigations of Baekeland et al. (1968) showed that stress conditions change the characteristic features of sleep. It was the aim of this work to compare the effect of pre-examination stress and preoperative stress on the characteristic features of sleep. Three groups of 5 individuals each were studied: students, patients and controls aged from 20 to 45 years. In all patients psychological investigations by the test of Cattel were carried out before each polygraphic recording. These investigations confirmed presence of anxiety prior to falling asleep in the groups of students and patients and its effect on the subsequent sleep. The most significant changes during stress were observed in paradoxical sleep (REM). The amount of this sleep is reduced during stress while its intensity increases significantly (phasic REM sleep period). Persistence of disturbances of sleep depends on the duration of stress stimulus. The stress reaction connected with examination was short-lasting and disappeared after passing the examination. In the group of patients the stress reaction was prolonged on the average 33 days after the operation.

[Sleep characteristics during 1st night in laboratory]. / Charakterystyka snu pierwszej nocy w laboratorium

Three goups, each composed of five individuals were investigated: students, patients and controls aged 20--45 years. The characteristic features of the first sleep in the laboratory were compared with the sleep during experimental pre-examination stress in students and preoperative stress in patients. It was found that the first sleep in the laboratory had the same features as the sleep in experimental stress. The process of adaptation to the conditions of sleep in the laboratory during the 2nd and 3rd night was studied. In the case of patients no adaptation was observed during three successive nights.

[Electroencephalographic studies in patients with vertebrobasilar insufficiency]. / Badania elektroencefalograficzne u chorych z niewydolnoscia krazenia w ukladzie tetniczym kregowo-podstawnym

Thirty-seven patients with vertebrobasilar arterial insufficiency were divided into two groups depending on their clinical condition. In the group of patients with more severe clinical manifestations the intensity of EEG changes was correspondingly greater. In this group in 7 patients the EEG background activity was disturbed, in 4 of them focal changes were present in the left temporal area. Of the patients with less severe clinical changes the background activity was disturbed in 1 cases only.

[Rheoencephalographic studies in healthy subjects of various age groups]. / Badania reoencefalograficzne u osób zdrowych w róznym wieku

The purpose of this study was to establish rheoencephalographic value in 90 healthy subjects aged from 20 to 80 years divided into 3 groups. The investigations were done with a two-channel rheographic apparatus produced by Siemens. The so-called rheography II technique was applied. In each subject measurements were done bilaterally in temporal, parietal and central leads. The curves were evaluated in relation to the ECG curve, taking into account the duration in sec. of two parts of the rheographic curve called I and II intervals. The correlation between the size of intervals I and II and the sex, age, side of measurement and area of measurement was subjected to statistical analysis.