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Biomedical subjects

B A Mehta

Publications and source records attributed to B A Mehta.

27 records · Page 2Linked to original sources
PubMed1985

"Reverse" superficial temporal artery-middle cerebral artery bypass.

A new technical variant on the superficial temporal artery-middle cerebral artery anastomosis was performed in a patient with occlusions of both the left internal and external carotid arteries and persistent ischemic symptomatology. Instead of anastomosing the proximal segment of the superficial temporal artery to the middle cerebral artery as is conventionally done, the distal segment of the superficial temporal artery was anastomosed to a cortical branch of the left middle cerebral artery. Reconstituted flow of the left superficial temporal artery via right superficial temporal artery collateral branches proved adequate to relieve the patient's ischemic episodes. "Reverse" superficial temporal artery-middle cerebral artery anastomosis should be considered in those cases where occlusive disease of the external carotid circulation renders conventional bypass procedures ineffective in the treatment of ischemic symptomatology.

Arterial Occlusive Diseases↗
PubMed1985

Primary and secondary histiocytic lymphoma of the brain: CT features.

The authors examined 19 patients with diffuse histiocytic lymphoma of the brain, including 8 with primary disease and 11 with secondary disease. Both primary disease and secondary disease involving the brainstem and deep nuclei exhibited the characteristic CT appearance, consisting of a large, solid, homogeneously enhanced mass with varying amounts of edema. However, most secondary lymphomas outside the brainstem and basal ganglia contained large areas of low attenuation consistent with necrosis. Multifocal lesions were seen only in patients with secondary lymphoma. Systemic chemotherapy for extracranial lymphoma had no effect on the CT appearance of intracranial lesions. The authors suggest that these "unusual" CT patterns are actually typical of a distinct subset of histiocytic lymphomas.

Adolescent↗
PubMedDate not supplied

Persistent trigeminal artery detected with standard MRI.

The trigeminal artery is the most common of the primitive carotid-basilar anastomoses to persist into adulthood. Prior to the introduction of MRI, the diagnosis of persistent trigeminal artery (PTA) could only be made at cerebral angiography. This study compares angiography and standard brain MRI in 11 cases of PTA. Nine of the 11 PTAs were identified with MRI. Axial imaging gave the best definition of the course of the PTA.

Adult↗
PubMedDate not supplied

Hallervorden-Spatz disease with bilateral involvement of globus pallidus and substantia nigra: MR demonstration.

Hallervorden-Spatz disease presents with relentless mental and physical deterioration. Pathologically there is abnormal iron deposition in the globi pallidi, substantia nigra, and red nuclei. A spectrum of abnormal basal ganglia signal intensities have been described on MRI. A pediatric case with low signal intensity in the globi pallidi and substantia nigra is presented.

Child↗
PubMedDate not supplied

Imaging-guided injection techniques with fluoroscopy and CT for spinal pain management.

Local spinal pain and radiculopathy are common conditions that debilitate millions of Americans annually. Most cases are successfully treated conservatively with rest or physical therapy. Chiropractic manipulation or, in some cases, surgery may also be performed. Percutaneous injection has been used for spinal pain management for many years, but many of these procedures have historically been performed without imaging guidance. Recently, however, newer minimally invasive, imaging-guided percutaneous techniques have been added to the list of available treatment options for spinal pain. Imaging-guided techniques with fluoroscopy or computed tomography increase the precision of these procedures and help confirm needle placement. Cervical, thoracic, lumbosacral, and sacroiliac pain can be evaluated and treated safely and effectively with injections of local anesthetics or long-acting steroids into facet joints, sacroiliac joints, selective nerve roots, spondylolytic areas, and the epidural space. Because imaging-guided techniques appear to provide better results and reduce complication rates, they are becoming more popular despite controversy regarding their effectiveness. Controversy will continue to surround these imaging-guided techniques until large, double-blinded studies become available. In the meantime, there is an increased demand for these procedures from referring physicians, and it is important to be able to safely perform them with a minimum of patient discomfort.

Anesthetics, Local↗
PubMedDate not supplied

Angiographic features of gliosarcoma.

Gliosarcoma is a brain neoplasm that is being recognized with increasing frequency. We discuss the radiographic findings in 14 pathologically proven cases. At angiography in nine cases, four showed mixed dural and pial vascular supply to the lesion. Early cortical venous drainage, irregular tumor vessels, and a prominent vascular stain with well-defined tumor margins were seen in the majority of cases. CT showed an irregular enhancing rim surrounding a necrotic center in 14 cases. Most lesions were peripherally located and invaded dura.

Aged↗
PubMedDate not supplied

Cerebral angiography in brainstem revascularization.

Surgical management of patients with vertebrobasilar insufficiency has been developed within the past decade. Cerebral angiography plays a crucial role in identifying potential surgical candidates and in directing the surgical approach. Fifty-two patients underwent brainstem revascularization procedures at Henry Ford Hospital between November 1979 and August 1985. Twelve occipital artery to anterior inferior cerebellar artery bypasses, five occipital artery to posterior inferior cerebellar artery bypasses, four intracranial vertebral endarterectomies, 29 superficial temporal to superior cerebellar artery bypasses, and two superficial temporal to posterior cerebral artery bypasses were performed. The preoperative angiograms in these patients were analyzed to illustrate how angiographic localization of vascular disease directs the surgical approach. We report the results of postoperative angiograms. Technical features of the various surgical procedures, the role of the neuroradiologist, and several features of the angiographic technique used with these patients are described.

Adult↗
PubMedDate not supplied

Fenestration of intracranial arteries with special attention to associated aneurysms and other anomalies.

PURPOSE: To determine the association of intracranial arterial fenestration and aneurysms. METHODS: We retrospectively reviewed 5,190 cerebral angiogram reports and identified 37 patients with arterial fenestrations. RESULTS: These 37 patients had 38 fenestrated arteries: 16 basilar, 10 vertebral, nine middle cerebral, and three anterior cerebral arteries. Seven of these patients had a total of 13 aneurysms, although only one aneurysm was at the site of a fenestration. The remaining aneurysm patients had fenestrations as unassociated findings. Other anomalies detected were two azygous anterior cerebral arteries, on dural arteriovenous shunt of the cavernous sinus, one extracranial arteriovenous fistula, and one developmental venous anomaly (venous angioma). None of the fenestrations were in the vessels directly involved with these associated lesions. The incidence of aneurysm at the fenestration was 7% (one in 16) for basilar artery fenestrations. Considering all fenestrations, the incidence of aneurysm at the site of fenestration was 3%. CONCLUSION: Our data show that the association of a fenestration with an aneurysm at the fenestration site is not different from the typical association of circle of Willis bifurcations with saccular aneurysms.

Adolescent↗