W Müller-Forell

Johannes Gutenberg-Universität Mainz, Mayence, Rheinland-Pfalz, Germany

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Publications (74)116.57 Total impact


  • No preview · Conference Paper · May 2014
  • T. Ibis · J. Gawehn · F. Thoemke · W. Mueller-Forell · M. Dieterich · C. Best

    No preview · Conference Paper · May 2014
  • S. Welschehold · T. Kerz · S. Boor · A. Reuland · W. Mueller-Forell

    No preview · Article · Oct 2013 · Journal of the Neurological Sciences
  • S Welschehold · T Kerz · S Boor · K Reuland · F Thömke · A Reuland · C Beyer · W Wagner · W Müller-Forell · A Giese
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    ABSTRACT: Background and purpose: Computed tomographic-angiography (CT-A) is becoming more accepted in detecting intracranial circulatory arrest in brain death (BD). An international consensus about the use and the parameters of this technique is currently not established. We examined intracranial contrast enhancement in CT-A after clinically confirmed BD, compared the results with electroencephalography (EEG) and Transcranial Doppler Ultrasonography (TCD) findings and developed a commonly applicable CT-A protocol. Methods: Prospective, monocentric study between April 2008 and October 2011. EEG, TCD and CT-A were performed in 63 patients aged between 18 and 88 years (mean, 55 years) who fulfilled clinical criteria of BD. Evaluation of opacification of cerebral vascular territories in CT-A was performed in arterial as well as in venous scanning series by a neuroradiologist and a neurointensivist/neurosurgeon together. Results: CT-A demonstrated a 95% sensitivity in detecting intracranial circulatory arrest when analysing arterial scanning series. We never observed venous blood return in internal cerebral veins. In three cases, BD confirmation by EEG failed because of artefacts. Confirmation of BD by TCD failed in two cases because of absent temporal window. In three cases, TCD demonstrated residual blood flow. Conclusion: CT-A is easily accessible in almost every hospital, offers a high spatio-temporal resolution, is operator independent and inexpensive. The results of CT-A are comparable to other established brain perfusion techniques in BD. An international consensus should be established to ascertain consistent parameters similar to fixed guidelines for other ancillary procedures to determine BD in order to prevent different scanning and evaluation protocols for detecting intracranial circulatory arrest.
    No preview · Article · Jul 2012 · European Journal of Neurology
  • Wibke Müller-Forell · George J Kahaly
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    ABSTRACT: Neuroimaging of Graves' orbitopathy (GO) plays an important role in the differential diagnosis and interdisciplinary management of patients with GO. Orbital imaging is required in unclear or asymmetric proptosis, in suspected optic neuropathy and prior to decompression surgery. Especially computed tomography and magnetic resonance (MR) imaging show the actual objective morphological findings, quantitative MR imaging giving additional information concerning the acuteness or chronicity of the disease. Major morphological diagnostic criteria include a spindle like spreading of the rectus muscles without involvement of the tendon, a compression of the optic nerve in the orbital apex (crowded orbital apex syndrome) and the absence of any space occupying intraorbital process. A longer lasting course of the disease may lead to a corresponding impression of the lamina papyracae, the normally parallel configured medial wall of the orbit, similar to a spontaneous decompression.
    No preview · Article · Jun 2012 · Best Practice & Research: Clinical Endocrinology & Metabolism
  • C Best · J Gawehn · F Thömke · W Müller-Forell · M Dieterich

    No preview · Article · Mar 2012 · Klinische Neurophysiologie
  • H Ridwan · A Kronfeld · J Gawehn · P Stoeter · W Müller-Forell

    No preview · Article · Apr 2011 · RöFo - Fortschritte auf dem Gebiet der R
  • H M Elflein · F Thömke · W Müller-Forell · S Pitz
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    ABSTRACT: To describe clinical features and management of 4 patients suffering from unilateral superior oblique palsies due to MRI-documented trochlear nerve schwannomas. Chart reviews of 4 patients seen at the departments of ophthalmogy and neurology at the University of Mainz. All four patients were male, aged 36 to 72 years at initial presentation. None suffered from neurofibromatosis. The history of double vision prior presentation was 9 months to 13 years, follow-up time was 9 to 156 months. Two patients didn't receive any intervention: one remained stable over the follow-up time of 9 months. In patient #2, fourth nerve palsy was diagnosed 13 years prior to confirmation of a trochlear schwannoma by high-resolution MRI. In the third patient disturbing diplopia and head tilt were sufficiently corrected by strabismus surgery (combined oblique muscle surgery). The fourth patient had received stereotactic radiotherapy of an 8 mm schwannoma. He remained unchanged in the orthoptic measurements for 3,5 years. None of these patients developed any additional symptoms or signs of further cranial nerve or central nervous system involvement. A trochlear nerve schwannoma is a possible cause of an isolated unilateral superior oblique palsy. MRI is a helpful tool for diagnosis and follow-up. Conservative management seems to be justified as patients can remain unchanged over years.
    No preview · Article · Sep 2010 · Strabismus
  • J Gawehn · G Fischer · E Schwandt · W Müller-Forell

    No preview · Article · Mar 2010 · RöFo - Fortschritte auf dem Gebiet der R
  • S Boor · S Welschehold · K Riedel · C Beyer · T Kerz · A Ayyad · A Reuland · W Müller-Forell

    No preview · Article · Mar 2010 · RöFo - Fortschritte auf dem Gebiet der R
  • J Gawehn · G Kutschke · G Vucurevic · W Müller-Forell

    No preview · Article · Mar 2010 · RöFo - Fortschritte auf dem Gebiet der R
  • K Engelhard · W Müller-Forell · C Werner
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    ABSTRACT: The main target of treatment in patients with head trauma is to maintain the physiological parameters within the following normal limits: intracranial pressure (ICP) below 20 mmHg, cerebral perfusion pressure (CPP) between 50 and 70 mmHg, normoxemia (SpO(2) >90%), normocapnia (paCO(2): 35-38 mmHg), normoglycemia (80-130 mg/dl) and normothermia (36.0-37.5 degrees C). Space-occupying intracranial bleeding or edemas must be evacuated immediately. If these interventions do not result in adequate control of ICP and CPP, the next step would be to administer mannitol and barbiturates. Mild hyperventilation, therapeutic hypothermia, or decompressive craniectomy should be used solely in patients with a persistent ICP increase. Infusion of calcium antagonists or glucocorticoids is never indicated in patients with head trauma.
    No preview · Article · Jan 2009 · Der Anaesthesist
  • K. Engelhard · W. Müller-Forell · C. Werner
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    ABSTRACT: Die Basistherapie von Patienten mit schwerem Schädel-Hirn-Trauma (SHT) zielt darauf ab, sämtliche physiologischen Variablen in einem normalen Bereich zu halten. So gelten die folgenden primären Endpunkte: intrakranieller Druck (ICP) unterhalb von 20mmHg, zerebraler Perfusionsdruck (CPP) innerhalb des Bereichs von 50–70mmHg, Normoxämie (SpO2 >90%), Normokapnie (paCO2: 35–38mmHg), Normoglykämie (80–130mg/dl) und Normothermie (36,0–37,5°C). Liegen raumfordernde intrakranielle Blutungen oder Ödeme vor, muss unverzüglich eine chirurgische Entlastung erfolgen. Wenn die genannten Interventionen zu keiner ausreichenden Kontrolle des ICP und des CPP führen, ist die Gabe von Mannitol oder Barbituraten indiziert. Der Anwendung von milder Hyperventilation, therapeutischer Hypothermie und Dekompressionstrepanation sollte nur beim therapierefraktären ICP-Anstieg erfolgen. Die Infusion von Ca++-Antagonisten und Glukokortikoiden ist definitiv nicht gerechtfertigt. The main target of treatment in patients with head trauma is to maintain the physiological parameters within the following normal limits: intracranial pressure (ICP) below 20mmHg, cerebral perfusion pressure (CPP) between 50 and 70mmHg, normoxemia (SpO2 >90%), normocapnia (paCO2: 35–38mmHg), normoglycemia (80–130mg/dl) and normothermia (36.0–37.5°C). Space-occupying intracranial bleeding or edemas must be evacuated immediately. If these interventions do not result in adequate control of ICP and CPP, the next step would be to administer mannitol and barbiturates. Mild hyperventilation, therapeutic hypothermia, or decompressive craniectomy should be used solely in patients with a persistent ICP increase. Infusion of calcium antagonists or glucocorticoids is never indicated in patients with head trauma.
    No preview · Article · Nov 2008 · Der Anaesthesist
  • Wibke Müller-Forell · Kristin Engelhard
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    ABSTRACT: Neuroimaging is essential in the treatment of cerebral nervous system disorders or in patients in the ICU with deterioration of their neurologic function. Leading clinical symptoms are acute neurologic deficits with different stages of hemisymptomatology, primary or progressing loss of consciousness or vigilance deficit, focal or generalized seizures, sometimes combined with an acute respiratory or circulatory insufficiency. The resulting questions can be summarized in those of intracranial space occupying hemorrhage; acute infarction; and signs for reduced cerebral blood flow, cerebrovascular vasospasm, or intracranial mass. Recent evolutions in imaging have contributed to an increase in diagnostic sensitivity and specificity along with reduced side effects. This article illustrates typical and atypical differential diagnoses, with some emphasis on traumatic brain injury.
    No preview · Article · Oct 2007 · Anesthesiology Clinics
  • S v Paczynski · K.P. Braun · W Müller-Forell · C Werner
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    ABSTRACT: The constantly extending indication spectrum of magnetic resonance imaging (MRI) is a challenge for the anaesthesiologist, who is being increasingly more consulted for assistance during the examination. Due to the special technology of MRI the anaesthetic technique differs substantially from that in the operating theatre. In addition to the permanent strong magnetic field the intermittently used high frequency impulses are also a potential danger for the patient. Patients with metal implants (e.g. cardiac pacemaker) are particularly at risk. For the safe treatment of patients during MRI a special MRI compatible anaesthesia equipment is necessary. Unsuitable devices can lead to malfunctioning or to projectile effects (attracting ferromagnetic objects into the magnet) causing injury to the patients. This paper describes the MRI technology and the associated dangers for the patient as well as the characteristics of the anaesthetic techniques.
    No preview · Article · Sep 2007 · Der Anaesthesist
  • S. Paczynski · K.P. Braun · W. Müller-Forell · C. Werner
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    ABSTRACT: Das sich kontinuierlich erweiternde Indikationsspektrum der Magnetresonanztomographie (MRT) ist eine Herausforderung für die Anästhesiologie, die zunehmend für die Betreuung von Patienten während der Untersuchung hinzugezogen wird. Als Folge der speziellen Technik der MRT unterscheidet sich die anästhesiologische Tätigkeit dort erheblich von der im Operationssaal. Neben dem permanenten starken Magnetfeld bergen auch die intermittierend angewendeten Hochfrequenzimpulse ein mögliches Gefahrenpotenzial. Besonders gefährdet sind Patienten mit Metallimplantaten (z. B. Herzschrittmacher). Zur sicheren Versorgung der Patienten im MRT ist eine spezielle, MRT-kompatible Anästhesieausstattung nötig. Ungeeignete Geräte können neben Fehlfunktionen auch durch Projektileffekte (Hereinziehen ferromagnetischer Teile in den Magneten) zu Verletzungen von Patienten führen. Die aktuelle MRT-Technik, die damit verbundenen Gefahren für den Patienten und die Besonderheiten der anästhesiologischen Tätigkeit werden zusammenfassend dargestellt.
    No preview · Article · Aug 2007 · Der Anaesthesist
  • W Müller-Forell · P Urban
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    ABSTRACT: Isolated cortical vein thrombosis is only rarely diagnosed, although it presents with typical signs on imaging, presented in the paper. We report on five patients with this diagnosis, who all presented with focal sensomotoric seizures. Imaging with CT and MRI was the leading method. All patients were treated with oral anticoagulation and showed full recovery.
    No preview · Article · Apr 2007 · Der Radiologe
  • M Nedelmann · W Müller-Forell · M Kaps

    No preview · Article · Jan 2007 · Aktuelle Neurologie
  • W. Müller-Forell · P Urban
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    ABSTRACT: Im klinischen Alltag wird die isolierte oberflächliche Venenthrombose (OVT) selten diagnostiziert, obwohl sich typische bildgebende Befunde finden. Wir berichten von 5 Patienten, die alle wegen fokaler sensomotorischer Anfälle zur Aufnahme kamen. Dabei war die bildgebende Diagnostik mit CT und MRT wegweisend. Nach der Diagnosestellung erfolgte eine orale Antikoagulation, die in allen Fällen zu einer kompletten Beschwerdefreiheit führte.
    No preview · Article · Jan 2007 · Der Radiologe
  • Peter P Urban · W Müller-Forell
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    ABSTRACT: Isolated cortical vein thrombosis is only rarely diagnosed, although it may commonly be overlooked. We report on four patients with this diagnosis who all presented with focal sensorimotor seizures. The diagnosis was made by a typical CT and MRI-pattern, which is described in detail. The prognosis was excellent in all patients and the treatment options are discussed.
    No preview · Article · Jan 2006 · Journal of Neurology

Publication Stats

744 Citations
116.57 Total Impact Points

Institutions

  • 1989-2014
    • Johannes Gutenberg-Universität Mainz
      • • Department of Neurobiology
      • • Klinik für Anästhesiologie
      • • Institute of Neuroradiology
      • • Klinik und Poliklinik für Neurologie
      • • III. Department of Medicine
      • • Department of Neurosurgery
      Mayence, Rheinland-Pfalz, Germany
  • 2013
    • Universitätsklinikum Freiburg
      • Institute of Neuropathology
      Freiburg an der Elbe, Lower Saxony, Germany