Biomedical subjects
Publications and source records attributed to A Servo.
Convulsions and fracture of the neck of the femur following myelography with Conray and Dimer X are reported in two patients with a gross post-tuberculous gibbus deformity of the thoracic spine. The possible causes of the increased risk associated with myelography of the patients with gibbus are discussed.
We have taken myelograms of six patients with grave post-tuberculous thoracic gibbus of the spine and gross deformity of the thoracic cage. Two of these patients suffered violent convulsions and fracture of the neck of the femur. In one patient the myelogram was taken with Conray Meglumine and in another with Dimer X. We suggest that a grave deformity of the thoracic cage is a relative contraindication for lumbar myelography with these water-soluble contrast media. We assume that the reduced tissue oxygenation in these patients results in a lower threshold for convulsions.
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A case is reported with occlusion and stenosis of the internal carotid arteries in association with basal telangiectasia. Fifteen years after postoperative irradiation for an optic glioma, radiological signs typical of the moyamoya syndrome were observed. Radiation therapy is discussed as the cause of the vascular damage in this case.
Oil myelograms were performed on 62 patients with cervical spondylosis and signs of cervical root compression; 185 abnormal roots were seen. A filling defect of greater than or equal to 50% of the thickness of the lateral oil column usually coincided with clinical symptoms from the same root (42/52); 23 such patients were operated on, and 18 had their symptoms relieved. Of 133 roots with less severe abnormalities, only 53 were presumed to be the cause of the clinical symptoms or signs; 16 such patients were operated on, and 7 of them benefited from the operation.
An emergency myelography was performed on 51 patients with acute cauda equina syndrome. Altogether 23 total obstructions for various causes were found; as well as 13 disc herniations, 2 spinal stenoses and 13 patients with minimal findings in water-soluble myelography. A scheme was developed to analyse the cause of the obstruction and the level of the obstruction in disc herniation cases. The scheme seems to function fairly well, although we have had three errors in the diagnoses of 23 obstructions.
A case is reported with congenital absence of the left internal carotid artery associated with an aneurysm on the contralateral carotid syphon. Eight similar cases are reviewed in brief. The possibility of hemodynamic abnormality as the cause of the aneurysm is discussed.
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BACKGROUND AND PURPOSE: We assumed that patients with surgically treated aneurysmal subarachnoid hemorrhage (SAH) might have more lesions than those revealed by CT that could be visible on MR images. METHODS: We conducted a retrospective study of a series of 147 patients with aneurysmal SAH who were treated surgically within 3 days of the onset of SAH. One hundred four patients (mean age, 48.8 years) underwent MR imaging studies 2.1 to 5.6 years (mean, 3.3 years) postoperatively. RESULTS: Eighty-four (81%) patients presented a total of 152 areas of increased signal intensity on T2-weighted images, consistent with infarction; 48% of the patients had lesions in the frontal lobes. CT performed 3 months postoperatively revealed hypodense areas on the scans of only 57% of the patients and showed lesions in the frontal lobes of only 16% of the patients. CONCLUSION: Patients who undergo early surgery for aneurysmal SAH have more lesions than are revealed by CT. The difference is remarkable, especially in the frontal lobes.