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  • Hogrefe Publishing Group  (20)
  • 2010-2014  (20)
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  • Hogrefe Publishing Group  (20)
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  • 2010-2014  (20)
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  • 1
    Online Resource
    Online Resource
    Spinale Tumoren - Teil 1: Extradurale Tumoren. Epidemiologie, klinische Aspekte und Therapie
    Hogrefe Publishing Group ; 2011
    In:  Praxis Vol. 100, No. 14 ( 2011-07-01), p. 839-848
    Details
    In: Praxis, Hogrefe Publishing Group, Vol. 100, No. 14 ( 2011-07-01), p. 839-848
    Abstract: Spinal tumors are classified according to their location in extradural, intradural-extramedullary, and intradural-intramedullary tumors. The most frequent extradural tumors are metastases. Primary spinal tumors are rare and predominantly benign. Independent of their origin, spinal tumors manifest themselves with progressive local or radicular pain and neurological deficits. A preferably early diagnosis and subsequent therapy is important to improve the prognosis. The treatment of choice for most of these tumors is the complete surgical resection. In particular with the occurence of neurological deficits a fast surgical intervention is indicated, since the prognosis depends on duration and severity of the preoperative existing deficits. Below, clinical presentation and relevant treatment options of spinal extradural tumors are discussed.
    Type of Medium: Online Resource
    ISSN: 1661-8157 , 1661-8165
    URL: Article
    DOI: 10.1024/1661-8157/a000591
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2011
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  • 2
    Online Resource
    Online Resource
    Behandlungsstrategien für zerebrale kavernomatöse Malformationen
    Hogrefe Publishing Group ; 2014
    In:  Praxis Vol. 103, No. 24 ( 2014-11-01), p. 1447-1463
    Details
    In: Praxis, Hogrefe Publishing Group, Vol. 103, No. 24 ( 2014-11-01), p. 1447-1463
    Abstract: Cerebral cavernomatous malformations (CCM) are a subgroup of low-pressure cerebral vascular malformation. They have an estimated prevalence of 0,1–4% of the population and account for 8–15% of all cerebral vascular malformations. Depending on their size and localization (supratentorial or infratentorial, brain stem), CCM may present with focal bleedings with or without neurological deficits, as epileptic seizures, or are diagnosed incidentally by MRI performed for unspecific symptoms (e.g. headache, vertigo), especially in younger patients (mostly in 2nd or 3rd decade). The decision-making in patients with CCM can be classified into four categories: surgical or conservative treatment of symptomatic or incidental lesions. The decision regarding the optimal therapy in the individual patient must be made in the knowledge of the natural history (risk for bleeding or epilepsy) on the one hand, and the surgical possibilities (accessibility of the lesion) including their estimated outcome on the other hand. Therefore, careful patient selection and appropriate experience of the centre is warranted in the management of CCM.
    Type of Medium: Online Resource
    ISSN: 1661-8157 , 1661-8165
    URL: Article
    DOI: 10.1024/1661-8157/a001854
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2014
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  • 3
    Online Resource
    Online Resource
    Karpaltunnelsyndrom – moderne Diagnostik und Management
    Hogrefe Publishing Group ; 2010
    In:  Praxis Vol. 99, No. 3 ( 2010-02-01), p. 163-173
    Details
    In: Praxis, Hogrefe Publishing Group, Vol. 99, No. 3 ( 2010-02-01), p. 163-173
    Abstract: The carpal tunnel syndrome is the most common entrapment neuropathy (about 3% of the adults are affected). It is characterized by pain and paresthesia along the distribution of the median nerve. Thenar muscle atrophy with corresponding muscle weakness is a late manifestation of advanced disease. Electrophysiological tests are helpful in suggesting the diagnosis. An imaging with a magnetic resonance tomography may be used in the diagnosis of atypical cases. Ergonomic manoeuvres, oral steroids and steroidal injections may alleviate symptoms in mild cases. Surgical decompression of the carpal tunnel is the classical treatment of severe cases as well as for those who do not respond to conservative treatment. After surgery patients usually show excellent results. The following article discusses clinical aspects, diagnosis and current therapeutic options.
    Type of Medium: Online Resource
    ISSN: 1661-8157 , 1661-8165
    URL: Article
    DOI: 10.1024/1661-8157/a000020
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2010
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  • 4
    Online Resource
    Online Resource
    Lumbaler Bandscheibenvorfall - Management, klinische Aspekte und aktuelle Empfehlungen
    Hogrefe Publishing Group ; 2011
    In:  Praxis Vol. 100, No. 24 ( 2011-11-01), p. 1475-1485
    Details
    In: Praxis, Hogrefe Publishing Group, Vol. 100, No. 24 ( 2011-11-01), p. 1475-1485
    Abstract: Lumbar disc herniation has a high prevalence and strong social-medical impact. Patients suffer from lower back pain that radiates from the spine. Loss of sensation or paresis adds to the clinical picture. The diagnosis should be confirmed by imaging in patients considered for surgery. High remission rates initially warrant conservative treatment (adequate analgesia and physiotherapy) in many patients. If this treatment does not lead to significant alleviation within 5-8 weeks, surgery should be performed to reduce the risk of chronic nerve affection. Posterior interlaminar fenestration is the intervention primarily conducted for this diagnosis. A relapse in the same region occurs in up to 10% of patients after months through years, which sometimes necessitates a reoperation if symptoms are pertinent.
    Type of Medium: Online Resource
    ISSN: 1661-8157 , 1661-8165
    URL: Article
    DOI: 10.1024/1661-8157/a000733
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2011
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  • 5
    Online Resource
    Online Resource
    Aneurysmatische Subarachnoidalblutung
    Hogrefe Publishing Group ; 2010
    In:  Praxis Vol. 99, No. 12 ( 2010-06-01), p. 715-727
    Details
    In: Praxis, Hogrefe Publishing Group, Vol. 99, No. 12 ( 2010-06-01), p. 715-727
    Abstract: The most characteristic symptom of an aneurysmal subarachnoid haemorrhage (aSAH) is a sudden onset of severe headache, which can be accompanied by meningism, impaired consciousness, and vegetative symptoms. A cerebral CT scan is the initial diagnostic tool of choice if aSAH is suspected. The localisation and morphology of the aneurysm is depicted in a CT-angiography and/or conventional panangiography. Until definitive exclusion of the aneurysm by either microsurgical clipping or endovascular coiling, rebleeding should be avoided implicitly. The postoperative phase, especially in patients with severe aSAH is embossed with the occurrence of disease-specific complications (cerebral vasospasm, intracranial hypertension, seizure disorder, hydrocephalus) and consecutively increased risk for secondary brain injury. Furthermore, many patients present systemic complications such as electrolyte disturbances and cardiac dysfunctions. Early identification and therapy of cerebral and systemic complications are very important in order improve functional outcome.
    Type of Medium: Online Resource
    ISSN: 1661-8157 , 1661-8165
    URL: Article
    DOI: 10.1024/1661-8157/a000160
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2010
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  • 6
    Online Resource
    Online Resource
    Spinale Tumoren - Teil 2: Intradurale Tumoren. Epidemiologie, klinische Aspekte und Therapie
    Hogrefe Publishing Group ; 2011
    In:  Praxis Vol. 100, No. 14 ( 2011-07-01), p. 849-856
    Details
    In: Praxis, Hogrefe Publishing Group, Vol. 100, No. 14 ( 2011-07-01), p. 849-856
    Abstract: Intradural spinal tumors are classified in extra- and intramedullary tumors. The most frequent intradural-extramedullary tumors are meningiomas and neurinomas. Among the intradural-intramedullary tumors the most frequent ones are ependymomas and astrocytomas. Independent of their origin, spinal tumors usually manifest with progressive local or radicular pain and neurological deficits. The treatment of choice for most of these tumors is a complete surgical resection. In tumors with infiltrative growth into the intramedullary area, a marginal tumor tissue has to be left in situ in order to avoid additional neurological deficits. In particular if neurological deficits appear, a fast surgical intervention is indicated, since the prognosis depends on duration and severity of the preoperative existing deficits. Below, clinical presentation and relevant treatment options of spinal intradural tumors are discussed.
    Type of Medium: Online Resource
    ISSN: 1661-8157 , 1661-8165
    URL: Article
    DOI: 10.1024/1661-8157/a000592
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2011
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  • 7
    Online Resource
    Online Resource
    Die adulte Syringomyelie - ein Krankheitsbild mit verschiedenen Ursachen
    Hogrefe Publishing Group ; 2011
    In:  Praxis Vol. 100, No. 12 ( 2011-06-01), p. 715-725
    Details
    In: Praxis, Hogrefe Publishing Group, Vol. 100, No. 12 ( 2011-06-01), p. 715-725
    Abstract: Syringomyelia describes an intra­medullary cyst in the spinal cord. In the adult patient, the pathology mostly results from Chiari-I-malformation or from severe spinal trauma. The clinical picture varies broadly, but symptoms often include pain and progressive neurologic deficits. During the clinical course, muscular atrophy and loss of pain and temperature sensation may develop in the affected region. Today, magnet resonance imaging helps to detect syringomyelia at an early stage. The interdisciplinary therapeutic approach includes an adequate pain treatment and physiotherapy, in selected cases a surgical intervention by an experienced surgeon. If not treated surgically, most symptomatic patients experience progressive neurologic deficits that may lead to severe paragplegia and chronic neuropathic pain.
    Type of Medium: Online Resource
    ISSN: 1661-8157 , 1661-8165
    URL: Article
    DOI: 10.1024/1661-8157/a000564
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2011
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  • 8
    Online Resource
    Online Resource
    Chronisches Subduralhämatom – Beurteilung und Management
    Hogrefe Publishing Group ; 2010
    In:  Praxis Vol. 99, No. 21 ( 2010-10-01), p. 1269-1277
    Details
    In: Praxis, Hogrefe Publishing Group, Vol. 99, No. 21 ( 2010-10-01), p. 1269-1277
    Abstract: Subdural hematomas (SDH) are associated with an increased morbidity and mortality and generally occur as chronic SDH among older patients. The most frequent signs and symptoms – like headache, alteration of consciousness, gait impairment and hemiparesis – are also prevalent among other diseases, which has to be taken into account in the differential diagnosis. In the case of symptomatic patients with focal neurological deficits, a surgical intervention should be considered, whereas in case of asymptomatic patients or patients with only slight headaches, also a conservative treatment with a clinical and radiological follow-up might be a possibility. Also after surgical intervention, the recurrence rate is between 5 and 33%. Therefore, all patients with chronic SDH depict, irrespective of the indication for an oral anticoagulation, a challenge for the treating physicians.
    Type of Medium: Online Resource
    ISSN: 1661-8157 , 1661-8165
    URL: Article
    DOI: 10.1024/1661-8157/a000275
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2010
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  • 9
    Online Resource
    Online Resource
    Tiefe Hirnstimulation - Möglichkeiten und Grenzen
    Hogrefe Publishing Group ; 2011
    In:  Praxis Vol. 100, No. 8 ( 2011-04-01), p. 469-477
    Details
    In: Praxis, Hogrefe Publishing Group, Vol. 100, No. 8 ( 2011-04-01), p. 469-477
    Abstract: Deep brain stimulation (DBS) is meanwhile an established procedure. It has been employed for several neurological diseases with impressive therapeutic responses to some extent. Stimulation of the ventral intermediate nucleus of the thalamus can distinctively improve tremor associated with essential tremor or Parkinson disease. Similarly, stimulation of the subthalamic nucleus or the globus pallidus internus can substantially diminish bradykinesia, rigidity, and tremor. Additionally, by means of a reduced dopaminergic therapy, it can lead to an improvement of the L-Dopa induced dyskinesias in patients with Parkinson disease. In recent years, DBS has also been used for other neurological and psychiatric diseases. Yet, the exact mechanism of action on a neuronal level remains uncertain. Regardless of the underlying disease and the surgical electrode positioning, a meticulous patient selection and correct indication is of paramount importance for the therapeutic success.
    Type of Medium: Online Resource
    ISSN: 1661-8157 , 1661-8165
    URL: Article
    DOI: 10.1024/1661-8157/a000506
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2011
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  • 10
    Online Resource
    Online Resource
    Niedrig-gradige Gliome im Erwachsenenalter
    Hogrefe Publishing Group ; 2014
    In:  Praxis Vol. 103, No. 23 ( 2014-11-01), p. 1385-1396
    Details
    In: Praxis, Hogrefe Publishing Group, Vol. 103, No. 23 ( 2014-11-01), p. 1385-1396
    Abstract: Low-grade gliomas (LGG) are brain tumors with a low or intermediate biological aggressiveness. According to histopathological features, they are further specified as grade I or II by WHO criteria. Diffuse astrocytomas, oligodendrogliomas, and mixed gliomas are the most common LGG. They mainly affect young patients in their 3rd to 5th decade and often manifest with epileptic seizures. A macroscopically complete or near-complete tumor resection that does not induce additional neurological deficits, is recommended as first line therapy in surgically accessible tumors, as a significant benefit for overall survival has been demonstrated. The indication for adjuvant chemo- or radiotherapy must be discussed interdisciplinary in each case. MGMT promotor methylation, LOH 1p/19q, as well as the status of somatic mutations within IDH1/2 gene constitute biomarkers that may predict response to adjuvant therapy and may correlate to overall survival. These and other biomarkers could be of benefit in future managing plans to offer patients with LGG an individually tailored, optimal treatment.
    Type of Medium: Online Resource
    ISSN: 1661-8157 , 1661-8165
    URL: Article
    DOI: 10.1024/1661-8157/a001835
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2014
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