Markakis, Evangelos

[["dc.bibliographiccitation.firstpage","378"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","Acta Anaesthesiologica Scandinavica"],["dc.bibliographiccitation.lastpage","382"],["dc.bibliographiccitation.volume","44"],["dc.contributor.author","Mursch, K."],["dc.contributor.author","Buhre, W."],["dc.contributor.author","Behnke-Mursch, J."],["dc.contributor.author","Markakis, E."],["dc.date.accessioned","2018-11-07T09:59:01Z"],["dc.date.available","2018-11-07T09:59:01Z"],["dc.date.issued","2000"],["dc.description.abstract","Background: In neurosurgical procedures within brainstem structures, corticosteroids are routinely administered to prevent oedema and to reduce intraoperative trauma, After replacing the routine administration of dexamethasone (DX) by high-dose methylprednisolone (MP) during surgery for tumours within brainstem structures, a decreased incidence of intraoperative haemodynamic instability events was observed. To test this hypothesis, a retrospective analysis was performed. Methods: Peroperative data of 62 surgical procedures of brainstem tumours were retrospectively analysed with respect to haemodynamic instability requiring changes in surgical strategy and/or emergence medication with vasoactive drugs. Severe changes in haemodynamic parameters were defined as a significant increase or decrease in heart rate and/or mean arterial blood pressure greater than 30% compared to baseline values. From 1988 to 1994, intravenous dexamethasone was given peroperatively in 33 patients. After a bolus of 1 mg kg(-1) body weight (BW) 30 min preoperatively, 0.2 mg kg(-1) were given every 4 h. From 1994 until now, methylprednisolone was administered instead of dexamethasone in 29 patients. After an initial bolus of 30 mg kg(-1) BW immediately before surgery, 5.4 mg kg(-1) h(-1) were given 23 h postoperatively. Results: The results of this retrospective analysis suggest that the number of operations with episodes of bradycardia, arterial hypotension (P<0.05), tachycardia and arterial hypertension (P<0.005) was significantly decreased in the group of patients treated with high-dose methylprednisolone. Conclusion: The retrospective analysis of the clinical data showed that the routine use of high-dose methylprednisolone was associated with a decreased incidence of haemodynamic instability in a selected group of patients undergoing brainstem surgery. This finding has to be proven in prospective double-blind controlled studies. (C) Acta Anaesthesiologica Scandinavica 44 (2000)."],["dc.identifier.doi","10.1034/j.1399-6576.2000.440404.x"],["dc.identifier.isi","000086041400004"],["dc.identifier.pmid","10757568"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/37490"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Munksgaard Int Publ Ltd"],["dc.relation.issn","0001-5172"],["dc.title","Peroperative cardiovascular stability during brainstem surgery. The use of high-dose methylprednisolone compared to dexamethasone - A retrospective analysis"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","128"],["dc.bibliographiccitation.issue","2"],["dc.bibliographiccitation.journal","British Journal of Neurosurgery"],["dc.bibliographiccitation.lastpage","136"],["dc.bibliographiccitation.volume","19"],["dc.contributor.author","Mursch, K."],["dc.contributor.author","Halatsch, M. E."],["dc.contributor.author","Markakis, E."],["dc.contributor.author","Behnke-Mursch, J."],["dc.date.accessioned","2018-11-07T11:10:07Z"],["dc.date.available","2018-11-07T11:10:07Z"],["dc.date.issued","2005"],["dc.description.abstract","Intrinsic brainstem tumours in adults have a poor prognosis and surgical resection is rarely performed. Encouraged by successful operations on children performed in our department, we began a more aggressive strategy of open operations. Between 1986 and 1997, we operated upon 16 consecutive patients over 16 years of age (five female, 11 male, mean age 36.9 years) who were suffering from intrinsic tumours located in the pons and/or medulla oblongata. The extent of first open resection was 80 - 100% in two of the cases and more than 50% in nine cases. The mean survival time after the first occurrence of symptoms was 88.1 ( median 34.5) months, and 39.9 ( median 11) months after the first open operation. The rate of 5-year survival from the first occurrence of symptoms was 37.5% (25% after the first open surgical procedure). Thirteen out of 16 patients died within the follow-up period of at least 6.3 years, two of them within the immediate postoperative period. Eleven patients experienced a postoperative deterioration of symptoms from which only four recovered. Eight patients had from WHO grade II astrocytoma and a similar course as patients with higher-grade gliomas (n=4). Our results indicate that open microneurosurgery for intrinsic brainstem tumours is of questionable benefit for the patient. Although surgery offers the advantages of reliable confirmation of histopathology and may be associated with prolonged survival, neurological deterioration was common and, unlike in paediatric patients, often irreversible."],["dc.identifier.doi","10.1080/02688690500145530"],["dc.identifier.isi","000231478700004"],["dc.identifier.pmid","16120515"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/53148"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Taylor & Francis Ltd"],["dc.relation.issn","0268-8697"],["dc.title","Intrinsic brainstem tumours in adults: results of microneurosurgical treatment of 16 consecutive patients"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","141"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie"],["dc.bibliographiccitation.lastpage","145"],["dc.bibliographiccitation.volume","35"],["dc.contributor.author","Ludwig, H.-C."],["dc.contributor.author","Klingler, M."],["dc.contributor.author","Timmermann, Arnd"],["dc.contributor.author","Weyland, Wolfgang"],["dc.contributor.author","Mursch, K."],["dc.contributor.author","Reparon, C."],["dc.contributor.author","Markakis, E."],["dc.date.accessioned","2018-11-07T08:53:30Z"],["dc.date.available","2018-11-07T08:53:30Z"],["dc.date.issued","2000"],["dc.description.abstract","Objective: Due to the exponential shape of the intracranial volume-pressure relation, simple measurement of epidural, parenchymal or intraventricular intracranial pressure (ICP) in traumatic brain injury (TBI) often fails to early recognize patients with a fulminant development of intracranial hypertension even during recently available methods of tissue PO2 and microdialysis measurements. One approach to this problem could be repetitive intracranial volume provocations to evaluate a trend of the intracranial elastance. Several previously published methods use invasive volume challenge through access to the cerebrospinal fluid (CSF). This pilot study describes changes in intracranial pressure due to variations of airway pressure with BIPAP ventilation maneuvers. Patients and methods: Ten patients with severe TBI were enrolled and completed the study. The inclusion was based on radiologic signs due to TBI in the first CT-scan and the clinical indication for insertion of an ICP monitoring device. Patients with elevated ICP above 20 mm Hg were excluded. The epidural ICP response together with haemodynamic parameters in relation to defined airway pressure changes (Delta P-AW) was detected. The influence of the duration of Delta P-AW was evaluated additionally. Data of central venous pressure (CVP), ICP, mean arterial pressure (MAP), cerebral perfusion pressure (CPP), airway pressure (P-AW) and blood flow velocity of the middle cerebral artery (V-MCA) were analyzed on the basis of differences between the maximum (inspiration) and minimum P-AW values (expiration). Results: Elevations of P-AW in the range of 20 to 35 cm H2O resulted in changes of the ICPmean from 4.1 to 6.0 mm Hg (r = 0.9, p < 0.05). A correlation was estimated for the changes of systolic arterial pressure (P-art) and CPPmean due to P-AW variations which ranged between 4.5 and 11.6 mm Hg (r = 0.99, p < 0.05). Concerning the transcranial doppler measurements the data of changes of the blood flow velocity of the middle cerebral artery (V-MCA) revealed a positive correlation to P-AW with a r = 0.99, p < 0.05. Conclusions: Elevation of the venous outflow resistance and a transient increase in cardiac output have to be considered as mechanisms for transduction of transthoracic pressure changes to intracranial pressure variations. We conclude, that trends of changes in elastance can be derived from intermittent airway pressure variations. This can be useful in easy and on line dynamic monitoring of ICP in traumatic brain injury."],["dc.identifier.doi","10.1055/s-2000-13008"],["dc.identifier.isi","000086021800004"],["dc.identifier.pmid","10768051"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/22424"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Georg Thieme Verlag"],["dc.relation.issn","0939-2661"],["dc.title","The influence of airway pressure changes on intracranial pressure (ICP) and the blood flow velocity in the middle cerebral artery (V-MCA)"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","75"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Epilepsy Research"],["dc.bibliographiccitation.lastpage","82"],["dc.bibliographiccitation.volume","36"],["dc.contributor.author","Steinhoff, Bernhard J."],["dc.contributor.author","Tumani, Hayrettin"],["dc.contributor.author","Otto, Markus"],["dc.contributor.author","Mursch, Kay"],["dc.contributor.author","Wiltfang, Jens"],["dc.contributor.author","Herrendorf, Gregor"],["dc.contributor.author","Bittermann, Hans-Joachim"],["dc.contributor.author","Felgenhauer, Klaus"],["dc.contributor.author","Paulus, Walter"],["dc.contributor.author","Markakis, Evangelos"],["dc.date.accessioned","2017-09-07T11:44:24Z"],["dc.date.available","2017-09-07T11:44:24Z"],["dc.date.issued","2002"],["dc.description.abstract","In the brain, S100 protein and neuron-specific enolase (NSE) are mainly found in glial cells and neurons, respectively. We investigated concentrations of S100 protein and NSE in cisternal cerebrospinal fluid obtained during implantation of foramen ovale electrodes in eight patients with temporal lobe epilepsy (TLE). In addition, the meningeal markers cystatin-C and β-trace as well as total protein were measured. Patients with trigeminal neuralgia (TN) undergoing glycerol rhizotomy served as controls. S100 protein and NSE levels ipsilateral to the site of seizure onset were significantly higher than in TN. Contralateral TLE values were also markedly but not significantly elevated. The meningeal markers cystatin-C and β-trace protein as well as total protein did not differ in TLE and TN. We conclude that interictal temporal lobe dysfunction corresponds with neuronal and glial marker elevations in the extracellular space and that site-specific elevations may predict the site of seizure origin biochemically."],["dc.identifier.doi","10.1016/s0920-1211(99)00026-1"],["dc.identifier.gro","3151649"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/8466"],["dc.language.iso","en"],["dc.notes.status","final"],["dc.notes.submitter","chake"],["dc.relation.issn","0920-1211"],["dc.title","Cisternal S100 protein and neuron-specific enolase are elevated and site-specific markers in intractable temporal lobe epilepsy"],["dc.type","journal_article"],["dc.type.internalPublication","unknown"],["dc.type.peerReviewed","no"],["dspace.entity.type","Publication"]]