Clinical Neuroscience

[Experiences at the Heidelberg Psychiatric Hospital]

SIMKÓ Alfréd

JUNE 01, 1959

Clinical Neuroscience - 1959;12(06)

[The author reports on his experiences at the Heidelberg Psychiatric Hospital.]

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Clinical Neuroscience

[Clinical and neurosurgical significance of cerebral herniations associated with intracranial space narrowing]

HULLAY József

[The author describes the different types of brain herniations, their symptoms and their significance, based on literature and his own observations. With regard to the neurosurgical tasks, he concludes that the resolution of certain types of herniation, primarily herniations of the hippocampus and tonsils, should be considered a neurosurgical task, to be performed separately from the removal of the space narrowing, but simultaneously with the space narrowing procedure, and based on his experience, he recommends the routine suctioning of the herniated hippocampus and cerebellar tonsils simultaneously with the resolution of the space narrowing.]

Clinical Neuroscience

[Neuropathological changes associated with internal carotid artery occlusion]

GALLAI Margit

[The author reported 9 cases of unilateral and 1 case of bilateral internal carotid artery occlusion, one of embolic origin, seven of sclerotic and two of sclerotic thrombangitis obliterans. On the basis of these studies, he believes that, in addition to internal carotid artery occlusion, the presence of concomitant general vascular disease contributes significantly to the clinical signs, the formation and location of necrosis. In particular, the patency of the circle of Willis, its developmental abnormalities and pathological changes are relevant. The obstruction of the basal collateral circulation facilitates the continued spread of thrombus into the media and anterior trunk in fresh carotid occlusion. Continuous spreading found only in association with fresh occlusion suggests that this fresh thrombus in and distal to the circ. art. of Willis, like emboli, may later recanalize leaving behind locally organized thrombus fragments. From the fragmenting fresh thrombus, microemboli may enter the peripheral small vessels, causing patchy ischaemic lesions. In 10 cases, 11 internal carotid arteries were occluded. The media area on the same side was damaged in all cases. In 3 cases in which compensation by circ. art. Willisii was anatomically unobstructed, only microscopically. In all cases of anterior area softening, the distal trunk of the a. cer. ant. was always completely or partially occluded from the a. communicans ant. Adequate blood supply to the a. cer. post. area is ensured by the basilar system even when it arises from the carotid artery by a thicker branch. If, however, the posterior trunk is occluded distal to the circle of Willis, the whole area of supply is damaged. Despite internal carotid artery occlusion, the hemispheric artery remained macroscopically intact in two cases where anatomically intact basal and pial collateral circulation was possible.]

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Comparison of direct costs of percutaneous full-endoscopic interlaminar lumbar discectomy and microdiscectomy: Results from Turkey

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Microdiscectomy (MD) is a stan­dard technique for the surgical treatment of lumbar disc herniation (LDH). Uniportal percutaneous full-endoscopic in­terlaminar lumbar discectomy (PELD) is another surgical op­tion that has become popular owing to reports of shorter hos­pitalization and earlier functional recovery. There are very few articles analyzing the total costs of these two techniques. The purpose of this study was to compare total hospital costs among microdiscectomy (MD) and uniportal percutaneous full-endoscopic interlaminar lumbar discectomy (PELD). Forty patients aged between 22-70 years who underwent PELD or MD with different anesthesia techniques were divided into four groups: (i) PELD-local anesthesia (PELD-Local) (n=10), (ii) PELD-general anesthesia (PELD-General) (n=10), (iii) MD-spinal anesthesia (MD-Spinal) (n=10), (iv) MD-general anesthesia (MD-General) (n=10). Health care costs were defined as the sum of direct costs. Data were then analyzed based on anesthetic modality to produce a direct cost evaluation. Direct costs were compared statistically between MD and PELD groups. The sum of total costs was $1,249.50 in the PELD-Local group, $1,741.50 in the PELD-General group, $2,015.60 in the MD-Spinal group, and $2,348.70 in the MD-General group. The sum of total costs was higher in the MD-Spinal and MD-General groups than in the PELD-Local and PELD-General groups. The costs of surgical operation, surgical equipment, anesthesia (anesthetist’s costs), hospital stay, anesthetic drugs and materials, laboratory wor­kup, nur­sing care, and postoperative me­dication diffe­red significantly among the two main groups (PELD-MD) (p<0.01). This study demonstrated that PELD is less costly than MD.

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[The Comprehensive Aphasia Test in Hungarian]

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Atypical presentation of late-onset Sandhoff disease: a case report

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[Assessing Nurses’ Knowledge of Surgical Wound Care, Complications and Knowledge of Bandages]

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