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Biomedical subjects

C Manelfe

Publications and source records attributed to C Manelfe.

At least 37 records · Page 2Linked to original sources
PubMed1986

Angiographic architecture of intracranial vascular malformations and fistulas--pretherapeutic aspects.

The authors describe the angio-architecture of intracranial vascular malformations. Several patterns can be identified thanks to the intracranial superselective angiograms that can now be performed. Schematically, the following features can be seen: direct arterial supply, indirect arterial supply, flow-related arterial ectasia (aneurysm), dysplastic aneurysm, direct arteriovenous fistula, intralesional arterial ectasia (aneurysm), intralesional venous ectasia (aneurysm), venous ectasia. Each of these elementary arrangements are illustrated and their clinical significance outlined whenever possible. Finally, the dural AVM drainage into the cortical venous system serves as an almost experimental model for the appreciation of the role played by the venous congestive phenomenon in brain AVM symptoms.

Arteriovenous Fistula↗
PubMed1986

Endovascular treatment of cerebral arteriovenous malformations.

The authors report their experience with the endovascular approach of AVMs. Although the follow-up is short, the approach to the lesion and the morbidity related to the technique is low. 41 patients are reviewed. The most important feature of this series is that only 17 patients had previously bled. 27 had seizures and the remaining intractable headaches or progressive deficits. Only 4 patients were operated on following embolization. Clinical results are good, although few "anatomic" cures have been obtained by embolization alone (5 cases). However, the morbidity was moderately important (19%) per patient, 2/3 of which were totally regressive within a month. One death occurred during the procedure for a young male with a non-surgical posterior fossa brain AVM which had bled two times prior to the endovascular treatment. Topographic presentation of our results is the following: Pure cortical (13 cases), cortico-ventricular (17 cases), deep-seated (without vein of Galen) (2 patient), Posterior fossa (3 cases).

Embolization, Therapeutic↗
PubMed1985

Role of computed tomography in vertebrobasilar ischemia.

Precise delineation of vertebrobasilar ischemia by computed tomography (CT) appears difficult due to the numerous variations in distribution of the posterior fossa arterial supply. While pontine and upper brainstem infarctions can be readily demonstrated, medullary infarction remains beyond the scope of present CT scanners. CT findings in cases of basilar artery occlusion include bilateral pontine infarction or extensive brainstem ischemia, associated with cerebellar and posterior cerebral vascular damage. Demonstration of basilar artery occlusion using routine CT is only rarely achieved. In cerebellar ischemia, CT, in conjunction with clinical syndromes, helps in the recognition of the arterial territory involved. CT provides useful guidelines for the treatment of cerebellar stroke, leading to surgery in cases of massive cerebellar infarction.

Cerebellum↗
PubMed1984

The accessory middle cerebral artery (AMCA). Diagnostic and therapeutic consequences.

The existence of the accessory middle cerebral artery (AMCA) is a rare anatomical variation with an estimated incidence of 0.31%. The embryological development of this artery is unknown. Three anatomical subtypes are described: in the type 1 variety the AMCA arises from the internal carotid artery; in the type 2, the AMCA originates from the proximal part of the anterior cerebral artery; in type 3, the AMCA arises from the distal part of the anterior cerebral artery. The use of endovascular techniques to treat cerebral vascular malformations requires knowledge of the anatomical subtype of AMCA and the brain regions it supplies (cortex, basal ganglia).

Adult↗
PubMed1983

[Digital subtraction angiography in ischemic cerebrovascular accidents].

Recent advances in computer and radiological technology have permitted reassessment of intravenous angiography in the evaluation of cerebrovascular disorders. Although digital subtraction angiography is a relatively new technique, it has rapidly gained a widespread acceptance. It has extended the use of angiography to outpatients and to people in whom conventional angiography is contraindicated. This reliable, safe, and relatively noninvasive technique offers the user two benefits: real-time subtraction and enhanced image quality. The system allows angiographic evaluation of the extracranial and intracranial vessels by means of intravenous injection of contrast material. Extracranial studies clearly demonstrate stenoses and occlusions of the major cervicocephalic arteries. Intracranial studies usually detect major cerebrovascular occlusions and provide insight into the collateral flow patterns. Intravenous digital subtraction angiography permits accurate assessment of cervicocephalic vessels after surgical repair. Although intravenous digital subtraction angiography obviates the need for conventional angiography in many cases, movements from the patients, or superimposition of vascular structures can substantially degrade the quality of the images. Digital subtraction angiography with intra-arterial injection of contrast medium will be contemplated in patients with poor intravenous digital subtraction angiography studies prior to surgery.

Cerebral Angiography↗
PubMed1982

[Haemorrhages of the posterior fossa in full-term newborns (author's transl)].

Four cases of non-traumatic haemorrhage of the posterior fossa in full-term newborns are reported and compared with the 30 cases already published. Computerized tomography is the only method that permits both a diagnostic and a therapeutic approach. Surgery is indicated in the presence of brain stem compression but should be carefully discussed in cases of intracerebellar haemorrhage with secondary extension to the posterior fossa. Early hydrocephalus is common and requires shunting in about 25% of the cases

Cerebellar Diseases↗
PubMed1982

Cerebrospinal fluid rhinorrhea: evaluation with metrizamide cisternography.

Metrizamide computed tomographic cisternography was used to examine 27 patients (19 males and eight females, 14-59 years old) clinically suspected of having cerebrospinal fluid fistulae with rhinorrhea. Twenty-one fistulae were traumatic and six were spontaneous. Five to 6 ml of metrizamide (or lopamidol, two cases) were injected by lumbar puncture at a concentration of 185-200 mg I/ml for direct coronal and axial computed tomographic sections of the skull base. Cerebrospinal fluid rhinorrhea was present at the time of examination in 12 of 27 cases. Results were evaluated according to three criteria: (1) metrizamide passage through the bony and dural defect; (2) demonstrable site of the fracture and/or bony defect; and (3) metrizamide visualized within a paranasal sinus, nasal cavity, or cotton pledget. The examination was considered positive when criterion 1 alone was present and when 2 and 3 were associated. In 15 of 27 cases, cisternography was positive, with the exact site of cerebrospinal fluid leakage demonstrated in 10 patients. In six cases, the results were not definitive; only one of the criteria (2 or 3) was fulfilled. In six cases, cisternography was normal. Seventeen patients underwent surgery. The site of cerebrospinal fistulae was ethmoidal in nine cases, frontoethmoidal in seven, sphenoidal in two, and sphenoethmoidal in one. The relative value of metrizamide computed tomographic cisternography compared with other diagnostic studies, polytomography, positive or negative contrast studies, and radionuclides, is discussed. Diagnostic pitfalls include artifacts and partial volume effect.

Adolescent↗
PubMed1981

Relative value of computed tomography and hypocycloidal tomography in the diagnosis of pituitary microadenoma. A radio-surgical correlative study.

The relative value of a second generation CT scanner and complex motion polytomography are compared in 36 patients undergoing transsphenoidal surgery due to clinical and biological evidence of pituitary hypersecretion. CT findings of focal glandular hypodensity in 17 patients and upward convexity of the sellar contents in 15 patients suggested the presence of a pituitary microadenoma. Complex motion tomographic findings suggesting a microadenoma were found in 21 of 32 cases and included bulging of the sellar floor or localized thinning of the lamina dura. Selective transsphenoidal adenomectomy was performed on 34 of the 36 patients and the preoperative location based on CT scanning data was positively correlated with surgical results in 75% of the cases. When there is a strong clinical suspicion of pituitary hypersecretion both CT and polytomography may suggest the existence and location of a microadenoma. CT should be the radiographic technique of choice since it produces accurate information as to the size and density of the pituitary gland.

Adenoma↗