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Biomedical subjects

D R Enzmann

Publications and source records attributed to D R Enzmann.

At least 127 records · Page 7Linked to original sources
PubMed1980

CT of central nervous system infections in immunocompromised patients.

The computed tomographic (CT) scan appearance of parenchymal central nervous system (CNS) infection in 12 immunosuppressed patients was unlike that of the usual bacterial abscess in immunologically intact hosts. The lesions were poorly circumscribed and of low density. Contrast enhancement was minimal and did not assume a "ring" configuration. These CT scan findings heralded a poor prognosis. Compared to the neuropathologic findings, the CT scan generally underestimated the extent of involvement. Three other compromised patients were better able to localize the infection. This successful defense was manifested on their CT scans as the more typical "ring" pattern of contrast enhancement. Patients with this CT scan appearance of their CNS infection had a better prognosis.

Adult↗
PubMed1980

Sonography of ventricular size and germinal matrix hemorrhage in premature infants.

Using the anterior fontanelle as an acoustic window, high resolution gray scale sonography brain scans with mobile apparatus were obtained in 35 premature infants. The sonographic technique provided accurate assessment of ventricular size and detected the subependymal germinal matrix and intraventricular hemorrhages. Ventricular size measurements correlated closely with computed tomography (CT) determinations (r = 0.83--0.92) in 29 infants. Sonography imaged the hemorrhages as areas of increased echogenicity with mass effect located characteristically in the region of the caudate nucleus. The size of the hemorrhages could be grossly estimated, but the full extent of hemorrhages was better delineated by CT. Sonography seemed superior in detecting small hemorrhages that were isodense with surrounding brain on CT. Despite its advantages of benignancy, accuracy, ease of examination, and cost, our sonography technique had limitations. False-negative sonograms occurred when the hemorrhage was located only in the posterior aspects of the ventricular system. Small hemorrhages in the caudate could be missed by either CT or sonography because of sampling error. Recognition of other disease processes was limited with sonography. The sonographic brain scan is a good initial test for high risk premature infants suspected of having subependymal germinal matrix and intraventricular hemorrhages. If the sonogram is negative or not typical for subependymal germinal matrix and intraventricular hemorrhages, CT is indicated.

Cerebral Hemorrhage↗
PubMed1980

Third ventricular choroid plexus arteriovenous malformation simulating a colloid cyst. Case report.

A case of a cystic encapsulated arteriovenous malformation arising from the tela choroidea of the third ventricle is reported. Although the appearance of this lesion on computerized tomography scan suggested a colloid cyst by its location, it was atypical because of the non-homogeneity both before and after contrast infusion. The increased density on the unenhanced scan was due to hemosiderin pigment in the capsule wall caused by old hemorrhage. The diagnosis in this case was made by histological examination.

Brain Diseases↗
PubMed1980

Operative treatment of a giant cerebral artery aneurysm with hypothermia and circulatory arrest: report of a case.

A patient with a giant left middle cerebral artery aneurysm is presented. Because of previous operations and dense adhesions of the dominant frontal and temporal lobes to the aneurysm sac, we elected to obliterate the aneurysm by endaneurysmorrhaphy with the patient under hypothermia and cardiac arrest. Elective cardiac arrest has become a relatively safe, controllable procedure and may be of significant value in the treatment of difficult neurosurgical problems.

Adult↗
PubMed1979

Support and bolusing device for scanning small objects.

A versatile bolusing device made of polystyrene is described for scanning small objects in currently available "air gap" computed tomography scanners. The device, consisting of three concentric rings fitted inside one another, allows for artifact-free and reproducible imaging.

Animals↗
PubMed1979

Computed tomography in primary reticulum cell sarcoma of the brain.

The CT findings in 16 patients with histologically proved primary central nervous system (CNS) reticulum cell sarcoma (RCS) showed this malignancy to have predilection for the basal ganglia and thalamus, the periventricular white matter, the corpus callosum, and the vermis cerebelli. In 43% of patients with untreated tumor it presented as multifocal lesions; in each of these patients the basal ganglia were involved in conjuction with another site. In the other 57% of patients with untreated tumor presenting as solitary lesions the basal ganglia, the corpus callosum, and the frontal lobe were sites of predilection. Such solitary lesions may be indistinguishable from other tumors. Contrast enhancement of RCS was characteristically homogeneous with rare lucency, even in very large lesions.

Adolescent↗
PubMed1979

Metrizamide and radionuclide cisternography in communicating hydrocephalus.

Simultaneous 111In-DPTA and metrizamide CT cisternography correlated closely in the qualitative imaging of cerebrospinal fluid (CSF) dynamics in 9 normal patients and in 11 patients thought to have communicating hydrocephalus. CSF clearance of both tracers was similar; significant absorption occurred in the spinal dural sac. Although delayed elevated serum iodine levels correlated highly with abnormal persistent ventricular penetration (detection at 48 hours), these levels cannot be used to predict abnormal ventricular stasis. The pattern of ventricular and cortical sulcus enlargement on the plain CT scan did not indicate whether the dynamic metrizamide cisternogram would be normal or abnormal.

Cisterna Magna↗
PubMed1979

Experimental brain abscess evolution: computed tomographic and neuropathologic correlation.

Brain abscess evolution was studied in dogs by correlating the CT appearance with the neuropathologic findings. The abscess, produced by direct inoculation, progressed from an area of cerebritis to a well encapsulated abscess over 14 days. Ring enhancement was seen in the cerebritis stage prior to capsule formation. The ring reached its maximum size at this stage and correlated best with the area of cerebritis surrounding the developing necrotic center; the rim of this ring increased in thickness, resulting in progressive diminution of the central lucent area on scans delayed up to 60 min. The diameter of the ring decreased as cerebritis receded. Once the capsule had formed, the central lucent area was similar and no longer filled in on delayed scans.

Animals↗
PubMed1979

Cerebral infarction and migraine: clinical and radiologic correlations.

Cerebral infarction was documented by arteriography and serial computed cranial tomography (CT) in four young adults (ages 16 to 32 years) with migraine. In one case, posterior cerebral artery occlusion produced a deep parietotemporal infarct. The other three cases all had frontotemporal infarcts (one hemorrhagic) in the territory of the middle cerebral artery, without major arterial occlusion. Two infarcts produced lasting neurologic deficits; one was associated with mild, transitory symptoms, and one was asymtomatic. Laboratory investigations in two cases revealed no hematologic or cardiovascular predisposition to cerebrovascular disease. Cerebral infarction, as revealed by CT, may be more prevalent in "complicated" migraine than is generally appreciated. Such lesions may or may not develop in chronologic and anatomic relationship to the headache, and may involve either large or small arteries. The prognosis for functional recovery, based on this limited sample, seems favorable.

Adolescent↗
PubMed1979

Appearance of Graves' disease on orbital computed tomography.

Extraocular muscle enlargement was symmetrical in 70% and asymmetrical in 30% of patients with Graves' ophthalmopathy. True unilateral muscle involvement occurred in 6%. Computed tomography (CT) showed bilateral orbital involvement in 50% of patients presenting clinically with unilateral eye signs. In patients without a clinically apparent ophthalmopathy, CT demonstrated muscle enlargement in 40%. The medial and inferior rectus muscles were the most frequently and most severely involved. Orbital radiation therapy can result in a decrease in size of involved muscles.

Graves Disease↗
PubMed1978

Enlargement of subarachnoid spaces and lateral ventricles in pediatric patients undergoing chemotherapy.

This retrospective study investigated the possible adverse effects of cancer therapy on the brain. Cranial computed tomographic scans of 76 patients with non-central nervous system malignancies and 25 patients with leukemia had enlarged lateral ventricles and/or cortical sulci in 19% and 40%, respectively. Leukemic patients, especially those with meningeal involvement, had the most frequent and most severe abnormalities.

Adolescent↗
PubMed1978

Computed tomography in leptomeningeal spread of tumor.

Computed tomography proved insensitive to leptomeningeal spread of hematologic malignancies including leukemia, lymphoma, and malignant histiocytosis. In only 3% of patients did it directly demonstrate leptomeningeal tumor. In comparison, the detection rate of leptomeningeal tumor secondary to carcinoma was 44% and for melanoma, 100%. Intracranial subarachnoid seeding from primary brain gliomas was detected in each instance. The simultaneous presence of parenchymal metastases with leptomeningeal carcinomatosis occurred in 18% of patients with nonhematologic malignancies. Computed tomography evidence of communicating hydrocephalus, previously thought to be a major factor in clinical symptomatology, occurred in only 11% of patients.

Adult↗
PubMed1978

Malignant melanoma metastatic to the central nervous system.

The CT appearance of metastatic malignant melanoma is varied, but it can show features suggesting the correct diagnosis. Intracerebral hemorrhage alone, associated with an adjacent tumor nodule or mixed diffusely with a tumor, occurred in 10 of 33 patients. Identification of a tumor nodule is important, since it may be the site of recurrent hemorrhage if not removed completely at surgery. Unusual presentations such as meningeal carcinomatosis and lesions simulating primary gliomas also occurred.

Adult↗
PubMed1978

Computed tomography in the follow-up of medulloblastomas and ependymomas.

The course of 36 patients with medulloblastoma and ependymoma was evaluated prospectively by clinical examination, radionuclide (RN) studies and computed tomography (CT). Seventeen of the 36 patients (47%) had tumor recurrence. Twelve (41%) of the 29 patients with medulloblastoma had recurrent tumors of which 7 of 12 (58%) were at the primary site and 2 of 12 (17%) were within the ventricles while 10 of 12 (83%) were in the subarachnoid space. Five of the 7 patients with ependymoma had recurrent tumors. In 4 of the 5 patients tumor recurred at the primary site while subarachnoid seeding occurred in 2 of 5 patients (40%) and intraventricular metastases were found in 4 of 5 patients (80%). Progressive ventricular enlargement often accompanied subarachnoid seeding, presumably secondary to obstruction of cerebrospinal fluid (CSF) flow in the subarachnoid pathways. CT and RN scans were frequently complementary in detecting tumor recurrence.

Brain Neoplasms↗
PubMed1978

Computed tomographic brain scanning in patients with lymphoma.

A retrospective study of 118 lymphoma patients revealed the computed tomographic brain scan to be sensitive to involvement of the orbit and the brain parenchyma by lymphoma. Brain parenchymal lymphoma was seen only in diffuse histiocytic lymphoma; dural infiltration was less readily detected. Leptomeningeal lymphoma could not be directly demonstrated by the CT scan, even with the use of intravenous contrast medium. Serial CT scans contributed to patient care by differentiating the sometimes confusing nonlymphomatous brain lesions.

Adolescent↗
PubMed1978

Computed tomography of herpes simplex encephalitis.

On the initial computed tomographic (CT) scan in 10 of 13 patients with herpes simplex encephalitis (HSE), the most characteristic finding was a unilateral, low-density lesion in the medial temporal lobe and/or insular cortex. This lesion was seen in all patients as the disease progressed. When associated with hemorrhage and streaked contrast enhancement this lesion added specificity to the CT scan, but this situation occurred in only 3 patients. Early in the course of HSE, focal CT findings localized the temporal lobe of greatest involvement in 12 patients; 1 had a normal initial CT scan.

Adolescent↗