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Hypercapnia impact on vascular and neuronal reactivity in patients before and after carotid endarterectomy
Ostrý, Svatopluk ; Stejskal, Lubor (advisor) ; Šonka, Karel (referee) ; Zvěřina, Eduard (referee)
Indications for carotid endarterectomy (CEA) of symptomatic and asymptomatic internal carotid artery (ICA) stenosis were based on numerous randomised studies. The benefit was rated relative to the lowered risk of ipsilateral stroke relapse. There is evidence that rCBF correlates with brain electrical activity (EEG, SEPs). Somatosensory function is represented by evoked neuronal activity in central region. Can the neuronal activity in primary somatosensory cortex be influenced by hypercapnia-induced increased rCBF or CEA in patients with ICA stenosis or is a change such as that permanent? The aim of the present study was to determine whether CEA in unilateral symptomatic stenosis in the extracranial vascular system had a bearing on neuronal activity in the central region of the cerebral cortex. Material and methods The criteria for enrollment in the study were a history of ischaemic insult (TIA, RIND, minor stroke) less than six weeks before admission and unilateral stenosis of the ICA of 70-99 % measured on the DSA with the NASCET method. Patients were divided inti two groups: Group A (28 men and 13 women) with their initial NIHSS ≤ 2. Group B consisted of 12 men and 5 women, starting NIHSS was from 3 to 8. All patients were examined before CEA, on post-operative days 3-7 and 3 months after CEA. SEPs ans...
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The analysis of the risk factors in gamma knife radiosurgery for benign meningiomas
Kollová, Aurélia ; Liščák, Roman (advisor) ; Zvěřina, Eduard (referee) ; Náhlovský, Jiří (referee)
DOCTORAL THESIS ABSTRACT THE ANALYSIS OF THE RISK FACTORS IN GAMMA KNIFE RADIOSURGERY FOR BENIGN MENINGIOMAS MUDr. Aurélia Kollová, MBA Consultant: Assoc. Prof. MUDr. Roman Liščák, Ph.D. Doctoral thesis represents results of the analysis of Gamma Knife radiosurgical treatment of meningiomas, benign intracranial tumors, and the risk factors related to the treatment in 368 patients with 400 meningiomas treated at the Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital in Prague between 1992 and 1999. Detailed analysis of the results of skull base meningiomas was performed, as well as analysis of long-term results. Edema prediction model was created in order to identify patients with higher risk for post treatment complications with its practical clinical implication. The actuarial tumor 5- and 10- years control was 97,9% and 94,7% respectively, what confirms efficiency of radiosurgical treatment, with low temporary and permanent morbidity of 9,6% and 1,3% respectively, which was rarely disabling. Radiosurgery as a minimally invasive technique is a treatment of choice of meningiomas in skull base fulfilling size criteria; as a part of multimodal approach in large meningiomas, in patients, who would not tolerate operative procedure and in elderly. Dissertation thesis consists of six...
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Hemodynamic parameters of the cervical carotid bed of saline in the throes of stenosis of the carotid bulb and the bed capacity of treated recanalization excercise
Gregová, Daniela ; Kalvach, Pavel (advisor) ; Zvěřina, Eduard (referee) ; Beneš, Vladimír (referee) ; Bauer, Jiří (referee)
With the increasing number of patients suffering from some metabolic diseases leading to the development of atherosclerosis there is an urgent need for early diagnosis of the scale. If we think about disability sclerotic cerebral arteries, the optimal method of investigation is duplex ultrasonography, which is relatively inexpensive and friendly for the patient. To assess not only the structure and extent of atherosclerotic plaque, but also to assess the extent of any narrowing of the arteries and to evaluate the hemodynamic impact of structural changes present. It is an ideal candidate for screening in primary or secondary prevention of stroke, as well as for regular checks dispensarized patients. Knowledge of normal hemodynamic conditions in the cervical carotid stream is necessary in the assessment of various pathological conditions. This paper seeks to offer the most comprehensive view on the issue of carotid stenoses ultrasonografisty eyes. For practical reasons we focus on localized stenosis in the carotid bulb, the number is high above the stenosis in other locations.
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The analysis of the risk factors in Gamma knife radiosurgery for benign meningiomas
Kollová, Aurélia ; Liščák, Roman (advisor) ; Náhlovský, Jiří (referee) ; Zvěřina, Eduard (referee)
Doctoral thesis represents results of analysis of stereotactic radiosurgical treatment of meningiomas, benign intracranial tumors, and the risk factors related to the treatment in 368 patients with 400 meningiomas treated at the Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital in Prague between 1992 and 1999. Detailed analysis of the results of skull base meningiomas was performed, as well as analysis of long-term results. An edema prediction model was created in order to identify patients with higher risk for post treatment complications with its practical clinical implication. The actuarial tumor 5 and 10 years control was 97,9% and 94,7% respectively, what confirmes efficiency of radiosurgical treatment, with low permanent morbidity of 6,4% and zero mortality. Radiosurgery as a minimally invasive technique is a treatment of choice of meningiomas in skull base filfilling size criteria; as a part of multimodal approach in large meningiomas, which cannot be excised completely, in patients, who would not tolerate operative procedure and in elderly. Doctoral thesis consists of seven chapters and 4 appendices.The first chapter deals with theoretical background of meningioma as a nosologic entity. Hypotheses and goals of the study are defined in the second chapter. The third chapter...
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Age dependent decrease of cerebro-vascular reactivity and its impact on brain parenchyme integrity
Peisker, Tomáš ; Kalvach, Pavel (advisor) ; Zvěřina, Eduard (referee) ; Hort, Jakub (referee)
Summary: Sufficient vasodilatory and vasoconstrictive reactivity of cerebral arterioles is an important prerequisite for adequate capillary perfusion. To appreciate its capacity during aging and to elucidate its impact on parenchymal integrity we undertook a correlation using ultrasonography and brain MRI. Sixty healthy persons with no stenoses in carotid and vertebral arteries were examined by transcranial doppler ultrasonography (TCD) to assess middle cerebral artery mean flow velocities (MFV) et rest, after 30 sec apnea and after 90 sec hyperventilation. Young persons, N=20, mean age 24,8 (20- 32) were compared with middle aged, N=20, 54,8 (40-63) and elderly, N=20, 76,2 (69-84). A cohort of 40 elderly persons, mean age 68,4 (57-85) were evaluated also by MRI using FLAIR and T2-weighted sequences. Their extent of leukoaraiosis measured by the Fazekas scale was correlated with their vasoregulatory capacity. Results: The steady state mean flow velocity (MFV) in young persons, 71 cm/sec, decreases to 48,1 and to 44,9 cm/sec in the middle and the old aged. The postapnoic vasodilatation in young persons accelerates the MCA blood velocity by 41,7%, while in middle and old age only by 37,9 and 32,7% respectively. The MCA deceleration post hyperventilation by 49,8% in young people decreases to 37,8% and to 29,7%...
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The determination of the end-to-side anastomosis within the neurotization techni ques in thebrachial plexus reconstruction and the influence of the locally appli ed VEGF on the peripheral nerve regeneration
Kaiser, Radek ; Haninec, Pavel (advisor) ; Zvěřina, Eduard (referee) ; Ehler, Edvard (referee)
There is rising importance of the brachial plexus injury firstly due to its increasing incidence as a result of higher survival rate of the patients after polytrauma and due to the higher success rate of the surgical treatment. Recently, the obstetric brachial plexus palsy is the area of interest of many articles. The indication criterion is one of the most important problems to be solved as well as increasing awareness about the possibility of the surgical treatment. Many of injured elements of the brachial plexus are reconstructed by a donor nerve transfered onto the recipient nerve, i.e. by neurotization. This method can have better outcome than the suturing of the proximal parts of the plexus especially due to its main advantage - suturing as close to the muscle as possible. It is still not clear which donor nerve is better to use for neurotization of specific recipients due to the lack of large randomized clinical trials. End-to-side anatomosis (ETS) was re-discovered at the beginning of 90's at the same time when the Oberlin method (OT) was firstly described in the literaure. These techniques are applicable only in the Erb's palsy with functional lower part of the plexus. The basis of the effect of ETS anastomosis is the collateral sprouting of the axons which is one of the most important...
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Biological behaviour of beta2-microglobulin in liquor in clinically defined nosological units
Svatoňová, Jana ; Adam, Pavel (advisor) ; Matěj, Radoslav (referee) ; Zvěřina, Eduard (referee)
MUDr. Jana Svatoňová Autoreport for Dissertation Work Biological behaviour of beta2-microglobulin in liquor in clinically defined nosological units 1 Charles University in Prague 1st Faculty of Medicine Autoreport for Dissertation Work BIOLOGICAL BEHAVIOUR OF BETA2-MICROGLOBULIN IN LIQUOR IN CLINICALLY DEFINED NOSOLOGICAL UNITS MUDr. Jana Svatoňová 2014 MUDr. Jana Svatoňová Autoreport for Dissertation Work Biological behaviour of beta2-microglobulin in liquor in clinically defined nosological units 2 Contents Contents ............................................................................................... 2 1. Introduction .................................................................................. 3 2. Objective of this work .................................................................... 8 3. Material and methodology .............................................................. 9 4. Results .........................................................................................10 5. Discussion....................................................................................11 6. Conclusion ...................................................................................12 7. Literature: ....................................................................................12 8. The...
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Optimalised indications for microsurgical and endovascular treatment of intracranial aneurysms.
Štekláčová, Anna ; Beneš, Vladimír (advisor) ; Přibáň, Vladimír (referee) ; Zvěřina, Eduard (referee)
Univerzita Karlova v Praze 1. lékařská fakulta Autoreferát disertační práce Optimalizace indikací chirurgického a endovaskulárního ošetření intrakraniálních aneurysmat Anna Štekláčová 2018 2 Doktorské studijní programy v biomedicíně Univerzita Karlova v Praze a Akademie věd České republiky Obor: Neurovědy Předseda oborové rady: Prof. MUDr. Karel Šonka, DrSc. Školicí pracoviště: Neurochirurgická a neuroonkologická klinika 1. LF UK a ÚVN, Praha Školitel: Prof. MUDr. Vladimír Beneš, DrSc. Disertační práce bude nejméně pět pracovních dnů před konáním obhajoby zveřejněna k nahlížení veřejnosti v tištěné podobě na Oddělení pro vědeckou činnost a zahraniční styky Děkanátu 1. lékařské fakulty. 3 Obsah Abstrakt - Česky ..................................................................................... 4 Abstract - English ................................................................................... 5 Úvod........................................................................................................ 6 Hypotézy a cíle studie............................................................................. 6 Materiál a metody ................................................................................... 7 Výsledky...
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Biological behaviour of beta2-microglobulin in liquor in clinically defined nosological units
Svatoňová, Jana ; Adam, Pavel (advisor) ; Matěj, Radoslav (referee) ; Zvěřina, Eduard (referee)
MUDr. Jana Svatoňová Autoreport for Dissertation Work Biological behaviour of beta2-microglobulin in liquor in clinically defined nosological units 1 Charles University in Prague 1st Faculty of Medicine Autoreport for Dissertation Work BIOLOGICAL BEHAVIOUR OF BETA2-MICROGLOBULIN IN LIQUOR IN CLINICALLY DEFINED NOSOLOGICAL UNITS MUDr. Jana Svatoňová 2014 MUDr. Jana Svatoňová Autoreport for Dissertation Work Biological behaviour of beta2-microglobulin in liquor in clinically defined nosological units 2 Contents Contents ............................................................................................... 2 1. Introduction .................................................................................. 3 2. Objective of this work .................................................................... 8 3. Material and methodology .............................................................. 9 4. Results .........................................................................................10 5. Discussion....................................................................................11 6. Conclusion ...................................................................................12 7. Literature: ....................................................................................12 8. The...
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