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Biomedical subjects

A M Burke

Publications and source records attributed to A M Burke.

10 recordsLinked to original sources
PubMed1991

Non-neoplastic pineal cysts.

We identified 53 patients with non-neoplastic cysts of the pineal gland. In contrast to patients with pineal neoplasms, pineal cysts are usually asymptomatic. They infrequently obstruct the aqueduct to cause hydrocephalus or compress the tectum to produce the neuro-ophthalmologic signs of dorsal midbrain dysfunction. Obstructive hydrocephalus was present in only five patients (9.4%); three of them showed clinical signs of Parinaud's syndrome. CT and MRI typically reveal a cystic mass that averages 1.6 cm in anteroposterior (A-P) diameter with calcification at the periphery and faint rim-like contrast enhancement. Sagittal MRI is the most useful diagnostic test because it shows the anatomic relationship of the cyst to the aqueduct. The mass may compress the tectum and distort the proximal aqueduct; occasionally a large cyst may occlude the aqueduct. All patients with obstructive hydrocephalus had cysts greater than 2.0 cm in A-P diameter. Nine patients had suboccipital craniotomy. In all of them, the cysts contained clear fluid and were easily removed. We advocate conservative management with clinical observation of these benign lesions that may be developmental variants of normal pineal gland.

Adolescent↗
PubMed1991

Sedation for paediatric computerized tomography--a double-blind assessment of rectal midazolam.

This double-blind study investigated the rectal administration of midazolam as an alternative to general anaesthesia for elective computerized tomography (CT) of the brain. Thirty children were randomly allocated to receive either midazolam 0.3 mg kg-1 (Group 1) or midazolam 0.6 mg kg-1 (Group 2) by the rectal route. Sedation was obtained in 13 children in Group 1 and 12 in Group 2 but this was only satisfactory for scanning in seven children in Group 1 and eight in Group 2. We concluded that although the technique produced sedation, it did not reliably produce satisfactory conditions for CT scanning.

Administration, Rectal↗
PubMed1987

Regional variation in cerebral perfusion during acute hypertension.

Regional cerebral blood flow (rCBF) was measured in rats to define the autoregulatory response at different levels of hypertension. Mean arterial blood pressure (MABP) was raised with IV metaraminol. rCBF was measured using 14C-iodoantipyrine. Autoregulation was intact in normotensive animals and those with MABP of 152 to 158 mm Hg. At higher pressures, autoregulation was abnormal and heterogeneous. Hyperperfusion was most prominent in cerebellum, parietal gray matter, thalamus, striatum, and pons. These anatomic sites are recognized sites of hypertensive hemorrhage in humans.

Animals↗
PubMedDate not supplied

Changes in cerebral blood flow and recovery from acute stroke.

We prospectively studied 14 patients with acute cerebral infarctions using serial 133Xenon inhalation cerebral determination (133Xe-rCBF), scored neurological examinations, and neuropsychological testing. All patients underwent the same battery of tests at 3 days, 1 week, 2 weeks, and 4 weeks after cerebral infarction to determine the prognostic value of early rCBF studies and the chronological relationship of changes in rCBF to clinical status. Baseline rCBF within 3 days of symptoms of acute stroke did not correlate with clinical neurological outcome (r = -0.17, p less than 0.30; r = -0.18, p less than 0.28, for the two indices of rCBF used). Among the 11 patients demonstrating neurological recovery, 7 improved at 1 week, significantly before increases in rCBF (p less than 0.05). We conclude that early baseline rCBF does not predict clinical outcome in patients with acute cerebral infarctions and that return of neurological function precedes rather than follows increases in rCBF.

Aged↗