Biomedical subjects

D E Tomaszek

Publications and source records attributed to D E Tomaszek.

8 recordsLinked to original sources

PubMed1985

Cerebellar infarction: analysis of twenty-one cases.

Review of 3000 cranial computed tomography scans performed in the past 7 years at North Carolina Memorial Hospital revealed 21 patients who showed evidence of cerebellar infarction. The presenting symptoms and signs closely resembled benign labyrinthine disease. Five of the patients presented for seemingly unrelated medical problems and had no history suggestive of recent cerebellar insult. Hypertension and cardiovascular disease were common in these patients, and in the majority of instances, the cerebellar deficits were mild and showed progressive resolution. Angiograms demonstrated numerous, often diffuse abnormalities. Computed tomography scanning is mandatory for patients with sudden onset of labyrinthine or cerebellar signs or symptoms. Cerebral angiography is recommended to detect potentially treatable vascular lesions.

Adult↗

PubMed1985

Treatment of cerebrospinal fluid and syringosubarachnoid shunt infection with systemic and intrathecal antibiotics.

We present a case of a patient with two preexisting Silastic syringosubarachnoid shunt catheters who developed Enterobacter meningitis. The infection was treated successfully with systemic and intrathecal antibiotics without removal of the catheters. With careful sequential clinical and laboratory monitoring, even this type of cerebrospinal fluid shunt infection can be eradicated without catheter removal and replacement.

Anti-Bacterial Agents↗

PubMed1984

Contiguous scalp, skull, and epidural Hodgkin's disease.

A patient with Hodgkin's disease of the nodular sclerosing subtype presented with recurrent disease at the site of a previous blunt trauma to the head. The tumor involved the scalp and subjacent skull and epidural space. This particular presentation of Hodgkin's disease is probably unique, and involvement of the skull and cranial cavity by this subtype of Hodgkin's disease is rare.

Adult↗

PubMed1984

Sudden death in a child with an occult hindbrain malformation.

Chiari type I malformation in previously asymptomatic children can contribute to sudden death. We report a case of a 3-year-old child with this syndrome who died 48 hours after an apparently mild head injury. The case illustrates that, in children with abnormal head size or shape, it may be important to obtain skull films after even minimal craniocerebral trauma.

Arnold-Chiari Malformation↗

PubMed1984

Combined subclavian artery and brachial plexus injuries from blunt upper-extremity trauma.

Four cases of blunt upper extremity trauma producing subclavian artery and brachial plexus injuries are presented. In each case the patient was hemodynamically stable and arteriography demonstrated the subclavian lesion. Arterial reconstruction was successfully accomplished in three cases, but no use of the injured limb was regained by any patient. Early arterial repair may still be indicated to allow later above-elbow amputation for the purpose of functional rehabilitation.

Adult↗

PubMed1984

Occult esophageal perforation associated with cervical spine fracture.

A case of surgically confirmed cervical esophageal perforation associated with burst fractures of two cervical vertebral bodies is presented. We also describe a second case in which an incidentally discovered abscess of the cervical region could have been the result of esophageal perforation secondary to spine injury. Both patients had negative positive contrast esophagograms . This complication of cervical spine injury is extremely rare, and diagnosis can be difficult. Cervical esophageal perforation must be considered in the face of unexplained cervical, thoracic, or systemic sepsis and in the presence of an unexplained cervical mass. Severe cervical fracture with or without subluxation seems to constitute the anatomical basis for the entity. The treatment consists of drainage and antibiotics aimed at oral flora. The clinical features, diagnostic tests, and surgical management of this entity are reviewed.

Adult↗

PubMed1983

Unilateral subdural hematoma without midline shift.

Two cases of radiographically isodense subdural hematoma are presented in which absence of displacement of midline cerebral structures was due not to bilateral lesions, but rather to "balancing" of the volumetric effect of a unilateral lesion by preexisting encephalomalacia. Attention to the past medical history and the computed tomography scan which showed evidence of unilateral loss of brain substance led to the proper diagnosis.

Adult↗

PubMed1983

Above-knee amputations in psychiatric inpatients.

Data on 121 primary above-knee amputations and 12 stump revisions performed on a population of nonambulatory elderly psychiatric inpatients showed that the overall morbidity and mortality rates compared favorably with those in previously published reports on other groups of patients who received the same type of amputations, despite the precarious health of the psychiatric patients. By use of spinal anesthesia; meticulous attention to the prevention, early detection, and prompt treatment of wound complications; and identification of patients at high risk, this often desperately needed operation can be performed with good results.

Adult↗