Brain Edema. Cerebello Pontine Angle Tumors.: Pathophysiology and Therapy - Diagnosis and Surgery. (Advances in Neurosurgery)

This volume contains the papers presented at the 24th Annual Meeting of the Deutsche Gesellschaft fur Neurochirurgie, held in Mainz, Western Germany, on April 30 - May 3, 1973. Deliberate choice was made of two crucial still hotly debated subjects which, for ages, have meant a source of constant worry, and nights without sleep to every neurosurgeon. Just as long as our special field exists, there have been the problems of how to control brain edema and ·of how to reduce lethality and the secondary lesions in surgery of cerebello-pontine angle tumors. Concerning the first subject, new pathological, pathophysiological and chemical aspects, the mechanisms of brain edema formation and resolution are presented in the hope for better understanding. Furthermore, the relationship between brain edema, intracranial pressure, cerebral blood flow and metabolism are discussed. Finally, the therapeutical consequences as well as the results of experimental and clinical work are presented, and a comparison of effects between different methods (hypertonic solutions, diuretics, steroids, controlled hyperventilation, hyperbaric oxygen) is given. Concerning the second main subject, any important contributions to the early diagnosis of cerebello-pontine angle tumors have been included. Nevertheless, it is of utmost interest for the neurosurgeon to know which approach he is to prefer for the different stages of tumor size and to be familiar with the trans­ labyrinthine approach or the posterior craniotomy, as well as with the importance of the use of the microscope in neurosurgery, the preservation of the facial nerve and, in certain cases, its repair. Front Matter....Pages I-XVI Front Matter....Pages XVII-XVII Pathophysiology of Brain Edema: Pathological Aspects....Pages 1-4 Pathophysiology of Cerebral Edema: Chemical Aspects....Pages 5-18 Capillary Lesions and Hemorrhages in Brain Edema....Pages 19-23 Blood Brain Barrier and Scintigraphy....Pages 24-27 Biochemical Disturbances in Experimental Brain Edema....Pages 28-33 Alterations of Metabolism in Brain Edema Following Head Injury....Pages 34-41 Consequences of Cerebral Edema and Increased Intracranial Pressure....Pages 42-51 Intracranial Pressure Measurements in Clinical Practice....Pages 52-56 Nature and Significance of the CUSHING Reflex....Pages 57-61 Ventricular Fluid Pressure in Children with Severe Brain Injuries....Pages 62-67 Intracranial Pressure, Hemodynamics and Metabolic Disorders in Patients with Severe Head Injury....Pages 68-72 Front Matter....Pages 73-73 Hypertonic Solutions and Diuretics in the Treatment of Brain Edema....Pages 75-80 The Influence of High and Low Dosages of Mannitol 25% in the Therapy of Cerebral Edema....Pages 81-91 Steroids in the Treatment of Brain Edema....Pages 92-105 Electroencephalographical Findings During Therapy of Brain Edema with Dexamethasone....Pages 106-113 Influence of Ventilation and Hyperventilation on Brain Edema and Intracranial Pressure....Pages 114-127 Artificial Ventilation in Cerebral Edema — A Critical Analysis of Manometric and Gazometric Conditions....Pages 128-140 The Influence of Ventilatory Changes on CSF Lactate and CSF L/P-Ratio in Brain Injury....Pages 141-145 Treatment of Cerebral Acidosis in Posttraumatic and Postoperative Cerebral Edema Influence on CBF, EEG, and Clinical Status....Pages 146-150 Effect of Hyperbaric Oxygen on Intracranial Pressure in Brain Edema....Pages 151-157 Front Matter....Pages 73-73 Effect of Hyperbaric Oxygenation (HO) in Severe Injuries and in Marked Blood Flow Disturbances of the Human Brain....Pages 158-163 Front Matter....Pages 165-165 The Effects of Hypercarbia on Cerebral Blood Flow and Carbohydrate Metabolism in Deep Normovolemic Arterial Hypotension....Pages 167-175 Regional Cerebral Blood Flow and Regional Cerebrovascular Reactivity Following Local Brain Injury....Pages 176-183 Cerebrovascular Autoregulation After Acute Brain Injury with Particular Reference to Changes in Intra-Ventricular Pressure....Pages 184-185 Desintegration of Polysynaptic Vegetative Control of the Mesencephalic Reticular Formation After Brain Edema in Animal Experiments....Pages 186-194 The Influence of Hypercapnia and Hypoxia on Intracranial Pressure and on CSF Electrolyte Concentrations....Pages 195-198 Dissociation of rCBF from Perfusion Pressure in Early State of Cerebral Death (Abstract)....Pages 199-199 Front Matter....Pages 201-201 Microtopography of the Cerebellopontine Angle and Early Otologic Diagnosis of Cerebellopontine Angle Tumors (Abstract)....Pages 203-203 Neuroradiological Diagnosis of Cerebellopontine Angle Tumors....Pages 204-207 Anomalies of the Arteries of the Caudal Brain Stem and the Cerebellopontine Angle....Pages 208-211 The Diagonal Distribution of Spontaneous Nystagmus in Cerebellopontine Angle Tumors....Pages 212-216 The Value of Petrous Bone Exposures in STENVERS’ Position and of Brain Scanning in the Diagnosis of Tumors of the Cerebellopontine Angle Region....Pages 217-224 The Diagnostic Value of Brain Scan in Cerebello-Pontine Angle Tumors....Pages 225-226 Radio-Isotope Cisternography for the Diagnosis of Cerebello-Pontine Angle Tumors....Pages 227-229 Duroliopaque Cisternography in Cerebello-Pontine Angle Tumors (Abstract)....Pages 230-230 The Use of Vertebral Angiography in the Differential Diagnosis of Cerebello-Pontine Angle Lesions....Pages 231-236 Front Matter....Pages 237-237 Experiences and Results with the Translabyrinthine Approach and Related Techniques (Abstract)....Pages 239-239 Experiences and Results with Posterior Approaches (Abstract)....Pages 240-241 Surgical Reconstruction of Intracranial Lesions of Cranial Nerves....Pages 242-247 Advances in Surgery for Acoustic Neurinoma (A Synopsis)....Pages 248-249 Front Matter....Pages 237-237 Microsurgical Experience in Surgery of Acoustic Neurinomas (Abstract)....Pages 250-250 Experiences in Microsurgery of Acoustic Neurinomas (Abstract)....Pages 251-251 Critical Observations Concerning the Diagnosis and Clinical Features in 100 Cases of Tumors in the Cerebellopontine Region....Pages 252-259 Operations and Results in 102 Tumors of the Cerebellopontine Angle....Pages 260-261 Preservation of the Facial Nerve in Acoustic Neurinoma Surgery (Abstract)....Pages 262-262 Crossed Cranial Nerve Anastomosis for Re-Innervation of Muscles Supplied by the Facial Nerve....Pages 263-263 Facial Paralysis Secondary to Skull Fractures New Approaches in Management (Abstract)....Pages 264-264 Cerebello-Pontine Angle Arterio-Venous Malformations (Abstract)....Pages 265-265 Cerebellopontine Angle Meningiomas....Pages 266-274 Intra- and Postoperative Complications in Cerebello-Pontine Angle Tumors and Their Relation to the Patients’ Position, Type of Ventilation and Cranial Nerve Lesion....Pages 275-283 Front Matter....Pages 285-285 Determination of the Size of the Third Ventricle Following Subarachnoid Hemorrhage by Echoencephalography....Pages 287-294 Experience with Ultrasonic B-Scan, Assessing the Ventricular System in Children and Adults....Pages 295-298 Comparative Study of Computerized and A-Mode Midline Echoencephalography....Pages 299-306 Scintigraphic Findings with Cerebrovascular Lesions....Pages 307-309 Surgical Treatment of a Carotid-Cavernous-Fistula Without Interruption of the Carotid Circulation....Pages 310-314 The Therapy of Extracranial Arteriovenous Malformations of the Carotid-Vertebral Circulation....Pages 315-321 Clinical, Morphological and Pathogenetic Consideration on the So-Called “Temporal Lobe Agenesis Syndrome”....Pages 322-326 The Bilateral Orbita-Round-About-Osteotomy and -Swivelling in Morbus CROUZON....Pages 327-332 Retrolabyrinthine Section of the Posterior Root of the Fifth Nerve (Abstract)....Pages 333-334 Supraspinal Pain Control by Dorsal Column Stimulation: A Possible Neuronal Interaction at the Level of Mesencephalic Reticular Formation....Pages 335-338 Front Matter....Pages 285-285 Osseous Instability in Cranio-Vertebral Dysplasia (Abstract)....Pages 339-339 Lumbal Dermal Sinus with Lateral Sinus Opening (Abstract)....Pages 340-340 Hematomyelia with Paraplegia Following Coarctation of the Aorta....Pages 341-342 Spontaneous Subarachnoid Hemorrhage Due to Spinal Vascular Malformations....Pages 343-349 Front Matter....Pages 351-351 Presidential Remarks....Pages 353-353 In Memory of the 100th Birthday of O tfrid F oerster ....Pages 354-356 To the 75th Birthday of W ilhelm T önnis ....Pages 357-358 To the 70th Birthday of A rist S tender ....Pages 359-360 Bestowing of the O tfrid F oerster -Medal Upon H ugo K rayenbühl ....Pages 361-362 Otfrid-Foerster Memoral Lecture....Pages 363-382 Back Matter....Pages 383-388