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Biomedical subjects

A P Gasecki

Publications and source records attributed to A P Gasecki.

6 recordsLinked to original sources

Sciatic neuropathy associated with persistent sciatic artery.

Persistent sciatic artery is a congenital vascular anomaly of the arterial supply to the lower extremity. Thrombosis, distal embolization, aneurysmal dilatation, and rupture of this vessel with compression of the sciatic nerve have been recorded. Although rare in occurrence, complications of persistent sciatic artery should be included in the differential diagnosis of sciatic neuropathy. We present a case of an acute sciatic neuropathy secondary to pseudoaneurysm formation of a persistent sciatic artery. We demonstrate the diagnostic usefulness of magnetic resonance imaging.

Adult

Leptomeningeal carcinomatosis: a report of 3 cases and review of the literature.

Once thought to be rare, leptomeningeal carcinomatosis from systemic cancer is becoming more common as cancer patients are living longer. Lung, breast and malignant melanoma comprise the majority of solid tumor cases with this condition. The hallmark of the disease and the differential diagnosis are discussed. Only the identification of malignant cells in the cerebrospinal fluid provides as clear-cut diagnosis. Biochemical markers, thus far, cannot substitute for a positive cytology, but may aid in the diagnosis. We report and discuss 3 cases of complete biochemical and radiological assessment and variable degree of aggressiveness of treatment. Better control of the systemic cancer may result in prolongation of life.

Adult

Endarterectomy for symptomatic carotid stenosis. Review of the European and North American Symptomatic Carotid Surgery Trials.

The recent results of two major multicenter trials, ECST (European Carotid Surgery Trialists') and NASCET (North American Symptomatic Carotid Endarterectomy Trial), show benefit of carotid endarterectomy for patients with recent (4-6 months), nondisabling, carotid distribution, cerebral ischemic events (hemispheric and retinal TIA or stroke) and ipsilateral severe (70-99%) carotid stenosis provided that perioperative mortality remains low. ECST, in addition, failed to demonstrate the benefit of surgery for patients with mild stenosis (0-29%). The comparisons between the studies in regards to methodology, measurements, and complications are discussed.

Carotid Stenosis

Correlation of early MRI with CT scan, EEG, and CSF: analyses in a case of biopsy-proven herpes simplex encephalitis.

Herpes simplex encephalitis (HSE) carries a high mortality rate. Therefore, an early diagnosis and institution of acyclovir are essential. We report a case of biopsy-proven HSE with 2 negative cerebrospinal fluid (CSF) analyses and 2 normal CT scans. However, MRI together with EEG were abnormal early in the disease stressing their significant role in any suspected case of HSE. Although brain biopsy remains controversial, CSF herpes simplex antigen detection offers hope in providing an early or retrospective diagnosis while specific antiviral therapy with acyclovir is initiated. Overdependency on routine CSF analysis or head CT scan can result in unnecessary delays in diagnosis and treatment.

Acyclovir