Biomedical subjects

D Pelz

Publications and source records attributed to D Pelz.

24 records · Page 2Linked to original sources

PubMed1985

Oblique positioning for intravenous digital subtraction angiography images of the neck and head.

Oblique intravenous digital subtraction arteriography (IV-DSA) images of the neck were centered high to include the carotid bifurcations and siphons on one view in 80 consecutive patients being investigated for cerebral vascular atherosclerosis. Using a 27 cm image intensifier, these two important areas for atherosclerotic involvement were seen together on 68.1% of the images. In 25.6% of the images, the centering was too low to include the siphons on the film due to incorrect interpretation of facial anatomy on the oblique scout view. Careful attention to anatomic detail will allow correct centering in most patients. This will allow the bifurcations and siphons to be seen in profile together, thereby decreasing the number of film runs needed and the contrast volume given.

Arteriosclerosis↗

PubMed1984

CT demonstration of hemiatrophy and fatty replacement of the tongue.

We report a patient in whom computed tomography was used to demonstrate denervation, hemiatrophy and fatty replacement of the tongue, secondary to lower motor neuron involvement of the hypoglossal nerve by a meningioma. This unusual finding has only been described once before.

Adipose Tissue↗

PubMedDate not supplied

Major cerebral arterial and venous disease in osteopetrosis.

Two patients with osteopetrosis were studied in whom severe stenosis of one or both internal carotid arteries was demonstrated. One patient had autosomal dominant osteopetrosis and the other patient had the autosomal recessive form of the disease. In one patient, probable occlusion of one internal jugular vein and retrograde thrombosis of the contributing dural venous sinuses was present. Venous drainage of parts of the brain occurred through dilated emissary and scalp veins. It appears that major extracranial vessels may be impinged upon by dysplastic bone in osteopetrosis, although this is the first report of such an occurrence. A posterior fossa aneurysm was present in one case, and may have been related to abnormal intracranial hemodynamics.

Bone and Bones↗

PubMedDate not supplied

Angiographic follow-up of large cerebral AVMs incompletely embolized with isobutyl-2-cyanoacrylate.

This study evaluated the long-term angiographic results in large cerebral arteriovenous malformations (AVMs) partially embolized with isobutyl-2-cyanoacrylate. Preembolization, immediate postembolization, and long-term follow-up angiograms were performed in 30 large, partially embolized brain AVMs. Particular attention was paid to the relative size of the residual AVM nidus and the embolized arterial feeders, to recruitment of new feeders, to the size of residual draining veins, and to the speed of arteriovenous shunt. Nine cases with less than 50% AVM nidus obliteration showed no significant morphologic changes. In 18 cases with 50-75% obliteration of the AVM nidus, 11 (61.1%) showed no significant changes, six (33.3%) showed enlargement of the AVM nidus, and one (5.5%) evolved to complete angiographic obliteration. In three cases with 75-99% AVM nidus obliteration, one remained unchanged, one showed an increase in the size of the AVM nidus, and one evolved to complete obliteration. Evaluation by plain film, CT, and cerebral angiography of the isobutyl-2-cyanoacrylate deposits showed that when the polymer was positioned predominantly in arterial feeders there was invariably reconstitution of the AVM nidus through leptomeningeal, deep medullary, and/or dural collaterals. This phenomenon did not occur when the isobutyl-2-cyanoacrylate was deposited mainly in the AVM nidus.

Arteriovenous Malformations↗

PubMedDate not supplied

Clinical trial of Iohexol vs. Conray 60 for cerebral angiography.

Iohexol, a new nonionic contrast agent, and Conray 60 were compared in a double-blind clinical trial of 60 patients for safety, imaging effectiveness, and patient discomfort in cerebral angiography. There was no significant difference between the two agents in physiologic changes, film quality, or incidence of adverse effects in the 60 patients. One patient in the iohexol group suffered a cardiac arrest, which was clinically due to septic shock and was probably the result of inadvertent contamination of the iohexol used for test injections in this case. Bacterial growth can be supported in iohexol under certain circumstances, due to the lack of preservatives in this contrast material. The patients in the iohexol group experienced significantly less discomfort than the Conray 60 group. Iohexol is a safe, effective contrast agent when handled properly and causes less discomfort to patients than Conray 60.

Adult↗

PubMedDate not supplied

Preembolization superselective angiography: role in the treatment of brain arteriovenous malformations with isobutyl-2 cyanoacrylate.

Transfemoral and intraoperative embolization of arteriovenous malformations (AVMs) of the brain with isobutyl-2 cyanoacrylate may achieve complete and permanent occlusion of the AVMs. The preembolization superselective angiogram is an important source of information to decrease potential technical or clinical complications while seeking that goal. The information obtained from the angiogram of each individual feeder may be classified as anatomical, dynamic, and functional. This angiogram is performed either through a calibrated-leak balloon glued to a Silastic tubing, which is capable of negotiating cortical arterial curves, or through a short catheter directly placed into a feeder at surgery. In 64 patients, 175 preembolization superselective angiograms were obtained. Of those, 105 were obtained using the transfemoral technique, and 70 were obtained by direct catheterization after a craniotomy. Complications occurred in eight patients with only one permanent injury. Transient neurologic deficit occurred in five patients. One patient developed a permanent left monoplegia and one patient a subarachnoid hemorrhage without permanent neurologic deficit. In one patient, a delayed intracerebral hemorrhage produced a right hemiplegia and aphasia. The patient fully recovered in 6 months.

Bucrylate↗