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Biomedical subjects

C B Wilson

Publications and source records attributed to C B Wilson.

787 records · Page 44Linked to original sources
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Primary central nervous system tumors: advances in knowledge and treatment.

The ability to diagnose, monitor, and treat CNS tumors has been improved by new imaging techniques such as positron emission tomography (PET) scanning and functional MR imaging, stereotactic surgery, delivery of radiotherapy with brachytherapy and radiosurgery, and novel methods for delivering chemotherapy. These innovations combined with the new information about tumor pathogenesis and behavior revealed by molecular research give hope that more specific treatments for malignant CNS tumors will be developed in the future.

Cell Transformation, Neoplastic↗
PubMedDate not supplied

Multiple dural arteriovenous fistulas of the cranium and spine.

Dural arteriovenous fistulas are acquired lesions that usually involve the dura around the cavernous sinus. The transverse, sigmoid, and superior sagittal sinuses may be affected occasionally. With the exception of bilateral cavernous sinus dural arteriovenous fistulas, the simultaneous occurrence of dural arteriovenous fistulas at two locations is rare. Among 105 patients evaluated for dural arteriovenous fistulas, we identified seven patients with fistulas at two sites. The age of the patients ranged from 27 to 74 years. Presentation was related to hemorrhage in three patients, loss of vision in four, and a bruit and headaches in one. Patients were treated with combined surgical and endovascular techniques. All treated lesions were completely closed with no mortality or permanent morbidity. The presence of multiple fistulas must be considered in patients being evaluated for dural arteriovenous fistulas. Patients with multiple fistulas usually present with life-threatening hemorrhages or acute neurologic decline; the risk factor for hemorrhages, including those related to venous outflow obstruction, is high in patients with multiple dural arteriovenous fistulas.

Adult↗
PubMedDate not supplied

Treatment of dural fistulas involving the deep cerebral venous system.

Eight patients with dural arteriovenous fistulas involving the deep cerebral venous system were treated by a combination of preoperative embolization, intraoperative embolization, and/or surgical excision. All eight patients were men 30-71 years old (mean age, 48.5). The presenting symptoms were hemorrhage in four patients (two subarachnoid, one intraventricular, and one parenchymal), stroke in two patients, and severe chronic headaches in two patients. Four patients were treated and cured by preoperative embolization of external carotid feeding vessels followed by direct intraoperative placement of liquid adhesives into the fistula site. Two patients underwent preoperative embolization followed by surgical interruption of feeding vessels to the fistula. Both patients had persistent fistulas and were subsequently treated by intraoperative embolization with liquid adhesives. One patient was cured and the second had 95% reduction in fistula size. The remaining two patients had surgical excision of the fistula, one in combination with preoperative embolization. Both were completely cured. Two patients developed hydrocephalus after placement of liquid adhesive into the involved vein of Galen and were successfully treated with placement of ventriculoperitoneal shunts. Follow-up periods ranged from 7 to 21 months (mean, 14). We found that patients with dural arteriovenous fistulas could be treated effectively through a combination of neuroradiologic and surgical intervention.

Adult↗
PubMedDate not supplied

Gd-DTPA-enhanced MR imaging of pituitary adenomas.

Eleven previously nonoperated patients with suspected pituitary microadenomas were scanned on a 1.5-T GE system before and after administration of IV gadolinium-DTPA (0.1 mmol/kg). Six patients had Cushing disease, four had hyperprolactinemia, and one had acromegaly. Surgical confirmation was available in all cases, and these findings were correlated with results of CT and venous sampling, when available. The normal pituitary gland, infundibulum, and cavernous sinuses enhance immediately after the administration of gadolinium-DTPA, allowing contrast between the enhancing normal glandular tissue and low-intensity microadenomas. Contrast-enhanced MR detected a lesion not seen on the unenhanced images in two patients with Cushing disease and in one patient with hyperprolactinemia. Tumor delineation was improved with gadolinium administration in two additional cases. In six patients, administration of gadolinium did not significantly alter the precontrast interpretation. Adenomas were found at surgery in all 11 patients. The tumor was correctly localized on MR in four of the six patients with Cushing disease, resulting in an accuracy of 66.7%. In another patient, although a focal lesion was detected on MR, location of the adenoma at surgery was discrepant with the MR findings and was therefore considered a false-positive study. In the single false-negative examination, both pre- and postcontrast MR failed to detect a surgically confirmed microadenoma suspected on both contrast-enhanced CT and venous sampling. Correct localization of the adenoma was achieved in all of the five non-Cushing patients, yielding an accuracy of 100%. Immediate T1-weighted coronal scans were most useful in detecting intrasellar disease. Delayed scans obtained 30 min after injection did not improve the differentiation of pituitary gland from microadenoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Acromegaly↗
PubMedDate not supplied

Modified procarbazine, CCNU, and vincristine (PCV 3) combination chemotherapy in the treatment of malignant brain tumors.

Fifty-eight patients harboring recurrent malignant brain tumors were evaluated. CCNU (110 mg/m2) was administered on Day 1, procarbazine (60 mg/m2) was administered daily for 14 days beginning on Day 8, and vincristine (1.4 mg/m2) was administered on Days 8 and 29 of each 6-week cycle of therapy. Therapy was continued until tumor progression was documented. Before each course, a neurologic examination was performed and radionuclide and computerized tomographic scans were obtained. Response and progression were defined as improvement or deterioration, respectively, in at least two of the three tests. Of the 46 patients harboring recurrent malignant gliomas, 12 (26%) responded to therapy, 18 (39%) had tumor progression, and 16 (35%) had disease stability. Nineteen of the 46 patients were not previously treated with another form of chemotherapy: eight (42%) responded to therapy, eight (42%) had disease stability, and only three (16%) had early tumor progression. The median time to tumor progression was 26 weeks for patients responding to therapy or having disease stability. Approximately 30% of the patients were alive without evidence of tumor progression at 1 year. Evaluated by time to tumor progression and rate of tumor response or stabilization, this combination was similar to the BCNU-5-fluorouracil combination used for patients harboring recurrent malignant glioma.

Brain Neoplasms↗