The results of surgical treatment of 86 craniopharyngioma patients are followed up in the postoperative and later periods. Under the indication of progressive impairment of vision by direct pressure on optical structures the direct tumour operation was carried out in 50 cases. The postoperative lethality of 32%, the total lethality within one year of 36% and within 5 years of 44% correspond to the world level and show an increasing improvement in the last few years. The relative independency of the postoperative lethality rate of the degree of radicality speaks for a correct appraisal of the operability limit which is given by the vicinity of the diencephalic structures. With the indication of prevailing cerebral compression and the formation of hydrocephalus by a blocking of the foramen of Monro a spinal-fluid draining operation instead of a tumour operation was carried out in 33 cases. The results of bilateral Torkildsen drainage are compared with those obtained with valve draining. It appears that the bilateral placing of a Cordis-Hakim valve is the best method, especially because no functional impairment due to a possible increase in rachialbumin need be expected.
Mesh-terms: Adolescent; Adult; Berlin; Brain Neoplasms :: complications; Brain Neoplasms :: mortality; Brain Neoplasms :: surgery; Child; Child, Preschool; Cranial Nerve Neoplasms :: surgery; Craniopharyngioma :: complications; Craniopharyngioma :: mortality; Craniopharyngioma :: surgery; Female; Germany, East; Humans; Male; Middle Aged; Optic Chiasm :: surgery; Palliative Care; Postoperative Complications;
Other papers by authors:
P Wright,
M Birkett,
S R David,
K Meehan,
I Ferchland,
K J Alaka,
J C Saunders,
J Krueger,
P Bradley,
L San,
M Bernardo,
M Reinstein,
A Breier
Lilly Research Centre, Eli Lilly Company, Surrey, UK.
OBJECTIVE: The authors evaluated the comparative efficacy and safety of intramuscular olanzapine, intramuscular haloperidol, and intramuscular placebo for the treatment of acute agitation in schizophrenia. METHOD: Hospitalized patients with schizophrenia received one to three injections of intramuscular olanzapine, 10 mg, intramuscular haloperidol, 7.5 mg, or intramuscular placebo over a 24-hour period. Agitation was measured with the excited component of the Positive and Negative Syndrome Scale and two additional scales. RESULTS: According to scores on the excited component of the Positive and Negative Syndrome Scale, both intramuscular olanzapine and intramuscular haloperidol reduced agitation significantly more than intramuscular placebo 2 and 24 hours following the first injection. Intramuscular olanzapine reduced agitation significantly more than intramuscular haloperidol 15, 30, and 45 minutes following the first injection. No patients treated with intramuscular olanzapine experienced acute dystonia, compared with 7% of those who were treated with intramuscular haloperidol. No significant QT(c) interval changes were observed in any patients. CONCLUSIONS: Intramuscular olanzapine represents a rapid, effective, and safe treatment for acute agitation in schizophrenia.