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Biomedical subjects

A E Rosenbaum

Publications and source records attributed to A E Rosenbaum.

At least 19 recordsLinked to original sources
PubMed1998

Predictive signs of discogenic lumbar pain on magnetic resonance imaging with discography correlation.

STUDY DESIGN: The correlation between discogenic lumbar pain and disc morphology was investigated by using magnetic resonance imaging and discography. OBJECTIVES: To assess the various pathologic parameters seen on magnetic resonance imaging in patients with discogenic lumbar pain and to correlate them with observations on discography. SUMMARY OF BACKGROUND DATA: Although numerous previous studies on the subject have been performed, the correlations between various pathologic findings on magnetic resonance imaging and pain reproduction by provoked discography have not been explained fully. METHODS: One hundred and one lumbar discs in 39 patients were studied with magnetic resonance imaging and pain provocation discography. When pain reproduction under discography was concordant, various pathologic parameters on magnetic resonance imaging were analyzed by three statistical parameters to determine the associated magnetic resonance imaging findings. RESULTS: Radial tears commonly are demonstrated on magnetic resonance imaging in discs with concordant pain on discography. The presence of these tears is not a reliable predictor of a painful disc on discography. Although a high-intensity zone on T2-weighted images is a relatively reliable predictor of pain, the statistical values were lower than those in previous studies. Massive degeneration and severe disc height loss were rare in this population. These findings were good predictors of pain on disc injection. CONCLUSIONS: Although the lumbar intervertebral discs with posterior combined anular tears are likely to produce pain, the validity of these signs for predicting discogenic lumbar pain is limited.

Adult↗
PubMed1998

Giant cervical epidural veins after craniectomy for head trauma.

Markedly dilated cervical epidural veins and right upper extremity weakness developed in a 43-year-old man 4 months after contralateral craniectomy for head trauma. After cranioplasty, his symptoms improved markedly and the size of the veins returned to normal. These findings suggest that enlarged cervical epidural veins may occur without an underlying vascular lesion and that upper extremity weakness may occasionally be attributable to spinal cord venous stasis.

Adult↗
PubMed1997

Smaller format, laser camera-generated images: acceptability and cost savings.

RATIONALE AND OBJECTIVES: To evaluate the use of laser-generated smaller images in neuroradiologic practice. MATERIALS AND METHODS: Computed tomographic (CT) scans of the heads of five subjects were obtained at bone and brain windows in three formats: 12:1 (12 images on a 35 x 43-cm film), 15:1 and 20:1. Two laser-camera systems were used. Images were measured, physically separated, and reconstructed as a 35 x 43-cm ensemble; they were presented randomly to seven radiologists who assessed image size and interpretability. Observer preference was also noted. One camera system was evaluated for contrast and spatial resolution by a medical physicist. RESULTS: These were negligible differences in image area between the 15:1 and 20:1 formats. No discernible differences in quality were found among the three formats. The 12:1 images were preferred by the radiologists, but the 20:1 images were deemed acceptable. Annualized cost savings of 46.7%, or $46,650, were projected for adoption of the 20:1 image format for neuroradiologic CT and magnetic resonance imaging. CONCLUSION: No major differences were detected in image area between the 15:1 and the 20:1 image formats or in image quality among the three formats. Use of a smaller image format may result in substantial cost savings.

Cost-Benefit Analysis↗
PubMed1997

Magnetic resonance imaging of cerebrospinal fluid leak and tamponade effect of blood patch in postdural puncture headache.

This prospective study examined the efficacy of magnetic resonance imaging (MRI) in visualizing cerebrospinal fluid (CSF) leak in patients with postdural puncture headache (PDPH) and determining the spread of the blood patch in the epidural space and the extent of tamponade on the thecal sac. After obtaining institutional review board approval, five patients with symptomatic PDPH after 3 days of failed conservative treatment were included in this study. MRI using proton density (PD) and T2-weighted imaging was performed on all patients and CSF flow studies were done on one patient. All patients received 20 mL of blood in the epidural space. They remained supine for 45 min, and repeat MRI studies were performed. Extent of the spread of blood in the epidural space was measured. A visual analog scale of 0-10 was used to evaluate the headache. All patients had severe postural headache with nausea/vomiting. Preblood patch MRI showed extrathecal CSF and hemosiderosis indicating the site of dural puncture in four patients. The postprocedure MRI demonstrated the blood patch as a large extradural collection with anterior displacement of the thecal sac, the mean spread being 4.6 intervertebral spaces. The tamponade effect of the blood patch was observed on PD, T2-weighted, and CSF flow images. All patients experienced immediate resolution of their symptoms. This study suggests that using MRI, the site of the CSF leak, the tamponade effect of the blood patch, and its spread in the epidural space can be documented.

Adult↗
PubMed1997

The long-term effects of pregnancy and bromocriptine treatment on prolactinomas--the value of radiologic studies.

OBJECTIVE: To evaluate the long-term effects of pregnancy and bromocriptine treatment on prolactin-secreting pituitary tumors in women undergoing infertility treatment for prolactinomas. METHODS: The records of 17 patients with prolactinomas were reviewed. Data regarding age, prepregnancy baseline and postpartum serum prolactin levels, and radiologic studies including CT or MRI were assessed. 16 patients were treated with bromocriptine before achieving pregnancy. Bromocriptine therapy was resumed after delivery for the duration of 1 to 14 years. RESULTS: 45% of pregnancies did not affect the size of prolactinomas, 27% of pregnancies showed a decrease in size of prolactinomas or radiologic evidence of resolution of the tumor and 27% of pregnancies demonstrated radiologic increase in the size of prolactinomas. CONCLUSIONS: It is safe for patients with prolactinomas to achieve pregnancy following bromocriptine treatment. Pregnancy may lead to a slight decrease in the size of prolactinomas, increase in size, no change, and in some cases, complete resolution. There were no visual field changes during the pregnancies. Pregnancy and long-term bromocriptine treatment may be helpful in reduction of the size of the tumor.

Adult↗
PubMed1996

Intrinsic cervical spinal cord deformation on MRI: "the distorted 'H' sign".

Extrinsic and intrinsic pathologic processes involving the spinal cord can affect its gross morphologic appearance. Contour-related abnormalities of the spinal cord can be determined by both noninvasive and invasive imaging techniques. Detailing internal dysmorphism of the spinal cord is more difficult to determine because the internal architecture of the cord is not usually visualized. Now magnetic resonance (MR) imaging can readily demonstrate the central "H" configuration of the normal spinal gray matter on axial T2* gradient-recall echo pulse sequences; thus, it should also be capable of demonstrating distortions of it. We initially reviewed 55 abnormal cervical spine 1.5-T MR imaging studies. Of 37 large lesions, 31 deformed the "H" whereas 18 small lesions did not. To compare potential differences in visualization of the "H" by MR scanners of different field strengths (1.5-0.5 T), a total of 125 additional patients were reviewed at different State University of New York (SUNY) sites. Visualization of the "H" varied from 51.4% at 1.5 T to 18.4% at 0.5 T. As resolution of the spinal cord increases on MR imaging, it becomes possible to more accurately map the altered cord "interior," which may have a detectable clinical (neurologic) counterpart.

Cervical Vertebrae↗
PubMed1994

Anti-Ro(SS-A) autoantibodies in central nervous system disease associated with Sjögren's syndrome (CNS-SS): clinical, neuroimaging, and angiographic correlates.

OBJECTIVE: To examine in Sjögren's syndrome (SS) the interrelationship between the presence of the anti-Ro(SS-A) antibody response and (1) concomitant presence and type (ie, focal or nonfocal) of CNS disease (CNS-SS), (2) cross-sectional brain MRI or CT, and (3) abnormal cerebral angiography. METHODS: Neurologic, neuroimaging, and angiographic features of CNS-SS patients were correlated with the presence of precipitating anti-Ro(SS-A) autoantibodies detected by gel double-immunodiffusion or quantitative ELISA, which detects antibodies directed against the 60-kd peptide. Statistical analyses were performed using Fisher's exact test (two-tailed) with Haldane's adjustment and odds ratio with Cornfield 95% confidence intervals. RESULTS: Precipitating antibodies against the Ro(SS-A) antigen, determined by gel double-immunodiffusion, were present in an increased frequency in CNS-SS patients with (1) documented clinical CNS disease, (2) focal clinical CNS manifestations and serious complications, (3) large regions of increased signal intensity, consistent with ischemia/infarcts on brain MRI scans or regions of decreased attenuation consistent with infarcts on CT, and (4) abnormal cerebral angiograms consistent with small-vessel angiitis. Finally, the anti-Ro(SS-A) antibody response in CNS was directed against the 60-kd peptide specificity, determined by ELISA. CONCLUSIONS: Clinical, neuroimaging (cerebral CT), and angiographic observation suggest that a subset of anti-Ro(SS-A) antibody-positive, in contrast with -negative, CNS-SS patients have more serious and extensive CNS disease, some with frank cerebral angiopathy. Anti-Ro(SS-A) antibodies are postulated to play a role in mediating or potentiating vascular injury in CNS-SS.

Autoantibodies↗
PubMed1991

The effect of computed tomographic scan orientation on information loss in the three-dimensional reconstruction of tripod zygomatic fractures.

Fractures modeled in the dried skull indicate that the initial plane of computed tomography (CT) section contributes to the accuracy of three-dimensional (3D) images generated from two-dimensional (2D) CT data. The authors retrospectively analyzed seven clinical cases of tripod zygomatic fractures that were imaged with both axial and coronal CT scan orientations. Ten observers evaluated paired 3D CT images, one generated from 2D CT data in the axial plane and the other generated from coronal 2D CT data, for each of the seven cases of tripod fractures. A G-E 9800 CT scanner with the 3D98 Quick processing system were used for the 3D reconstructions. The axial scan orientation resulted in 3D reconstructions that had significantly less information loss in the display of the tripod fractures than did those based on coronal CT data (P less than .025).

Humans↗
PubMed1991

Neuroradiology.

Explore the source record for details and available documents.

Brain Diseases↗
PubMed1991

Magnetic resonance imaging and anatomy of the spine.

This article deals with the detailed anatomy of the spine most pertinent to magnetic resonance (MR) imaging. The cervical and lumbar regions, the pediatric spine, and the intervertebral discs are emphasized. High resolution MR images of cadaver spines obtained from a 1.5 tesla imager were compared with cryomicrotome sections. This correlative study provided meaningful anatomic information for accurately interpreting and better understanding MR images of living patients.

Cervical Vertebrae↗
PubMed1989

Three-dimensional surface rendering of nasal anatomy from computed tomographic data.

This article investigates the potential of using three-dimensional surface-rendered computed tomographic reconstructions for demonstrating normal and pathologic intranasal anatomy. Three-dimensional surface renderings of the intranasal structures were generated in 38 patients from coronal high-resolution computed tomographic images. Because of the complex anatomy, three-dimensional images were believed to be useful for surgical planning. There may be a correlation between the appearance of the uncinate process and severity of inflammatory sinus disease.

Humans↗
PubMed1989

Lumbar myelography with iohexol in outpatients: prospective multicenter evaluation of safety.

A multicenter open, noncomparative evaluation of the safety of iohexol was prospectively conducted in 81 adult outpatients undergoing screen-film lumbar myelography. Iohexol (180 milligrams of iodine per milliliter) was administered via a lumbar route at a dose of 8-17 mL. Computed tomography (CT) was performed after myelography. The safety of iohexol was assessed by monitoring adverse reactions and neurologic status and by measuring vital signs and serum laboratory values. The most frequent adverse reaction was headache (16 of 81 patients [19.7%]). Twelve patients complained of a headache on the day of the myelographic procedure, and four patients reported a headache 24 hours after the procedure. Nausea or vomiting occurred in four of 81 patients (4.9%) only on the day myelography was performed. No other neurologic abnormalities were found. Iohexol produced myelographic and CT studies of good to excellent quality in all patients. This study indicates that iohexol can be employed safely in lumbar myelography of adult outpatients.

Adult↗
PubMed1989

Microphysiological recordings at CT gantry site during stereotactic thalamotomy.

Neural unit recording was performed during CT-guided stereotactic thalamotomy in 2 patients referred for severe cerebellar ataxia and dysmetric movements. Periodic CT scanning was performed during the recording in order to verify probe location and trajectory. Our experience with electrophysiological recordings at the CT gantry site demonstrates the feasibility of acquiring satisfactory neural unit recordings in spite of the high-voltage environment.

Brain↗
PubMed1989

Intraoperative CT-guided serial microbiopsy of brain lesions and concomitant use of CT air and angiographic studies.

The value of step-by-step confirmation of the location of the brain biopsy probe is demonstrated, using serial CT scanning to confirm the exact source of the sample tissue. Concomitant use of CT angiography and a CT air study makes possible the biopsy of small areas and of areas near major cerebral vessels, as well as of lesions near critical areas like the optic chiasma, basal ganglia, midbrain, and other complex lesions. The pathologist on-line examination of the CT-confirmed serial samples enables the surgeon to obtain the most informative tissue for the ultimate histopathological diagnosis. Our experience with the technique is illustrated by examples of its application in some complex cases.

Biopsy↗
PubMed1988

Mu-opiate receptors measured by positron emission tomography are increased in temporal lobe epilepsy.

Neurochemical studies in animal models of epilepsy have demonstrated the importance of multiple neurotransmitters and their receptors in mediating seizures. The role of opiate receptors and endogenous opioid peptides in seizure mechanisms is well developed and is the basis for measuring opiate receptors in patients with epilepsy. Patients with complex partial seizures due to unilateral temporal seizure foci were studied by positron emission tomography using 11C-carfentanil to measure mu-opiate receptors and 18F-fluoro-deoxy-D-glucose to measure glucose utilization. Opiate receptor binding is greater in the temporal neocortex on the side of the electrical focus than on the opposite side. Modeling studies indicate that the increase in binding is due to an increase in affinity or the number of unoccupied receptors. No significant asymmetry of 11C-carfentanil binding was detected in the amygdala or hippocampus. Glucose utilization correlated inversely with 11C-carfentanil binding in the temporal neocortex. Increased opiate receptors in the temporal neocortex may represent a tonic anticonvulsant system that limits the spread of electrical activity from other temporal lobe structures.

Adolescent↗
PubMed1988

Pseudopseudohypoparathyroidism with spinal cord compression.

We describe a patient with pseudopseudohypoparathyroidism who had an osseous tubercle on the anterolateral margin of the foramen magnum causing compression of the spinal cord. This patient had no evidence for any endocrinopathies and had no other spinal canal anomalies. We suggest that the morphologic phenotype found in patients with pseudopseudohypoparathyroidism, also known as Albright's hereditary osteodystrophy, has an associated risk for spinal cord compression due to congenital vertebral anomalies. The poor recovery of neurologic function following spinal decompression mandates prompt recognition and therapy of this condition in patients with Albright's hereditary osteodystrophy.

Adolescent↗