Intraoperative C-arm fluoroscopy-based 3D navigation for intraventricular endoscopic intervention.

The authors present the technique of retained ventricular catheter removal by means of fluoroscopy-guided neuronavigation. A disconnected free-floating intraventricular catheter is an unusual shunt complication, and in case of shunt infection it should be removed immediately. The operative procedure described here is the first such imaging technique and original approach to retained ventricular catheter endoscopic surgery. The real-time fluoroscopy-guided neuroendoscopy seems to make 3D intraoperative navigation possible.

[Intracranial pressure in cases of non-traumatic cerebral hematoma-- personal observations and review of the literature]. / Cisnienie wewnatrzczaszkowe w przypadkach nieurazowych krwiaków sródmózgowych--obserwacje wlasne i analiza pismiennictwa.

The analysis of intracranial pressure records in 95 cases of non-traumatic intracerebral haematoma is presented. In 74 cases continuous recording was done. No correlation was found between the values of this pressure and consciousness disturbances. Three types of pressure change patterns were demonstrated: type A - low or normal values unchanging in 43 cases, type B - high initial values with normalization during conservative treatment, type C - very high initial values which decreased after operation in only some patients.

[Our method of management of the cases of intracranial hematoma--late results of the treatment]. / Wlasna metoda postepowania w przypadku nieurazowego krwiaka sródmózgowego--odlegle wyniki leczenia.

An original method of qualification for surgical treatment of patients with non-traumatic intracerebral haematoma is described. The qualification is based on the main elements of the intracranial volume compensation: 1. function of midline structures (F), 2. intracranial pressure features (I), 3. midline structure shift (S). The FIS method was applied in 134 patients; 83 of them were treated surgically and 51 were treated conservatively. The control group comprised 60 patients treated surgically or conservatively with qualification based on other criteria. The use of the FIS method in the preliminary management of patients with non-traumatic intracerebral haematoma made possible a great increase of the survival rate and improvement of the late results of treatment.

[Changes in the intracranial pressure in relation to body posture and their use in the treatment of patients after cranio-cerebral injuries]. / Zmiany cisnienia wewnatrzczaszkowego zalezne od ulozenia ciala i ich zastosowanie w leczeniu chorych po urazach czaszkowo-mózgowych.

The determination of the best body position in patients after cranio-cerebral injuries was the main subject of the undertaken studies. This optimal body position should ensure the intracranial pressure drop on condition that the cerebral blood flow and cerebral elasticity are not disturbed. To accomplish this task a biophysical model of the positional changes of the cerebro-spinal fluid pressure was elaborated. I took the activity of the gravitation and adhesive forces as well as contraction phenomenon into consideration, while preparing the model. The verification of the biophysical model was carried out by clinical examination of 15 patients, which confirmed its correctness. The positional changes of the intracranial pressure and cerebral perfusion pressure as well as cerebral elasticity were analyzed in 11 patients after cranio-cerebral injuries. I disclosed the intracranial pressure normalization and cerebral blood flow improvement by elevation of the body to the position of 30 degrees. Moreover, it appears that the shift of the cerebral midline structures causes an essential diminution of the positional intracranial pressure drop by the body elevation. The retrospective studies in 157 patients after cranio-cerebral injuries permitted me to compare the results of the classical treatment and the positioning one. I have ascertained that the applying of the trunk and head elevation to the position of 30 degrees improves the results of the medical treatment.

[Brain abscess complicated by suppurative meningitis in a patient with cyanotic heart defect. A case report]. / Ropien mózgu powiklany ropnym zapaleniem opon mózgowo-rdzeniowych u chorego z sinicza wada serca. Opis przypadku.

A case is reported of occipital lobe abscess complicated with purulent meningitis in a boy aged 16 years with Fallot's syndrome. The authors stress the necessity of taking into consideration the possibility of this complication in cases of congenital heart diseases and describe diagnostic difficulties due to scant signs of the abscess despite its large size.