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Biomedical subjects

E W Radü

Publications and source records attributed to E W Radü.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Perimesencephalic subarachnoid hemorrhage: clinical and computer tomography aspects].

AIM: The blood distribution on CCT and the prognosis of patients with nonaneurysmal subarachnoidal haemorrhage were retrospectively studied and compared to a patient group with aneurysmal haemorrhage. METHODS: The blood distribution on CCT (72 h after bleeding episode) of 26 patients with nonaneurysmal subarachnoidal haemorrhage confirmed by two normal cerebral angiograms was compared to the blood distribution of 76 patients with aneurysmal haemorrhage. The clinical condition of these patients was further analysed, 4-60 months after the bleeding episode. RESULTS: In 62% of patients with nonaneurysmal haemorrhage the blood distribution was perimesencephalic. The aneurysmal blood distribution pattern was more extended and only one patient showed a perimesencephalic pattern. 80% of the patients without aneurysms in angiography had no limitations in daily functional capacity. CONCLUSION: The perimesencephalic pattern is frequently found in patients with nonaneurysmal subarachnoidal haemorrhage, the prognosis of these patients is excellent. Rarely is the perimesencephalic haemorrhage caused by a ruptured aneurysm. It needs thorough angiographic evaluation.

Adult↗
PubMed1994

Central nervous system lupus: concomitant occurrence of myelopathy and cognitive dysfunction.

Reported are two cases of patients with central nervous system systemic lupus erythematosus (SLE) with clinical features of a myelopathy confirmed by magnetic resonance imaging (MRI). In one case, further evaluation including Single Photon Emission Computerized Tomography (SPECT) and neuropsychological testing, indicated higher cortical deficits which improved after treatment with monthly pulse intravenous cyclophosphamide. Subsequent cessation of cyclophosphamide was associated with further progression of the neurological disease in this patient.

Adult↗
PubMed1993

[Local therapeutic fibrinolysis in ischemic cerebrovascular insults: initial findings in 6 patients].

Local therapeutic fibrinolysis is considered an efficient and established treatment for peripheral arterial occlusive disease. The introduction of newer fibrinolytics along with the development of interventional catheterization techniques have extended its use to previously untreated events such as cerebrovascular occlusions. Between 1989-1991 six patients with basilar and/or middle cerebral artery thrombosis were treated at the University Hospital, Basel, by superselective local intraarterial infusion of 400,000 U/h urokinase for 1-2 hours. Two of four patients with basilar artery occlusion showed complete remission one year after the intervention. The third showed no neurological improvement despite angiographic recanalization, and 48 h later suffered a fatal brainstem haemorrhage, while the fourth did not recover from coma and succumbed. Both patients with occlusion of the middle cerebral artery showed complete recanalization, but one had complete and the other partial neurological remission. Signs of slight systemic fibrinolysis were present but never attained the intensity of systemic therapeutic fibrinolysis as the antiplasmin and fibrinogen values showed. In summary, local therapeutic fibrinolysis contributes to the reduction of mortality and to remission of symptoms in occlusions of basilar artery, and offers some advantage in occlusions of the middle cerebral artery. A definite benefit from the latter will be proved only through large-scale randomized trials. The indication for local therapeutic fibrinolysis for thromboses of cerebral arteries requires a careful benefit-risk evaluation, an experienced angiography team and a special infrastructure for computed tomography and digital subtraction angiography.

Adult↗
PubMed1993

[Intracranial lymphoma. Radiologic findings in 40 patients].

We analysed the radiologically findings of 40 patients with histologically confirmed cerebral lymphoma but without AIDS in a retrospective study; 31 of these had primary cerebral lymphoma without any other manifestation of the disease. All patients had CT, 24 had angiography and in five patients MRT had been performed in addition. CT showed a solitary lesion in 60%, of these 62% had scalloped margins and 38% were nodular, 34% were isodense and 57% were hyperdense. Following contrast injection, there was increased density in 97% of the lesions. The most frequent localisation was in the region of the basal ganglia and the corpus callosum (33%), in the frontal lobes (30%) and in the temporal lobes (20%). Angiographically, 63% showed evidence of a space-occupying lesion, there were vascular irregularities in 33% and tumour contrast in 21%; in 25% of the patients angiography was normal. Early venous filling was not found in any case. T1 weighted sequences during MRT of 5 patients showed the tumour to be isointense or slightly hypointense. T2 weighted images showed the tumour to be hyperintense or with mixed signal intensities.

Adolescent↗
PubMed1993

[Radiologic assessment of suspected orbital fracture].

In suspicion of orbital fractures plain X-ray of the skull in half axial view are recommended. To be sure of this diagnosis one need to do examinations in high resolution computed tomography, axial and coronal view, in order to demonstrate the total extension of the fracture and lesions of the soft tissue of the orbit and of the surrounded areas. Magnetic resonance tomography is helpful in demonstrating fat and muscles around or in the fractures. There is no need to do other projections of plain skull X-rays except there is no computed tomography available.

Frontal Bone↗
PubMed1993

Treatment of multiple sclerosis with 15 +/- deoxyspergualin. Design of a controlled study with close MRI-monitoring.

The rationale and design of a prospective randomized double blind study of 15 +/- Deoxyspergualin in the treatment of Multiple Sclerosis are presented. The study was started in autumn 1992 and will include more than 200 patients who will be randomized either to DSG low dose or DSG high dose or placebo. Average number of contrast enhancing lesions in monthly cranial MRIs during the first six months of treatment and change in EDSS at the end of the two-year study period will be the main efficacy parameters.

Adolescent↗
PubMed1992

Aspirin as a risk factor for hemorrhage in patients with head injuries.

The role of aspirin as a risk factor in the occurrence of intracranial bleeding following head injury was investigated. Chronic subdural hematoma appears to be a suitable model for the evaluation of risk factors in the development of hemorrhage. The most common risk factors found in our study were, apart from age, chronic alcohol abuse (28%), consumption of cumarin-derivates (21%), aspirin (13%), and heparin (5%). A patient undergoing aspirin treatment must be considered at risk of development of chronic subdural hematoma. Aspirin should not be prescribed to patients with post-traumatic headaches.

Adult↗
PubMed1992

Lipoma of the cauda equina selectively involving lower sacral roots. Case report.

A 44-year-old male patient suffering from sexual and voiding dysfunction did not exhibit any sensorimotor deficit except for a lax anal sphincter with loss of the bulbocavernosus reflex (BCR). The absence of both the electrically induced BCR and cortical evoked responses to stimulation of the dorsal penile nerve as well as partial denervation of the pelvic floor musculature suggested damage to the lower sacral roots. The site of the lesion as indicated by electrophysiological findings was confirmed by computerized tomography and magnetic resonance imaging. The operation revealed a lipoma involving a few cauda fibers which produced a distension in the region of the conus medullaris.

Adult↗
PubMed1991

[The diagnosis of Cushing's syndrome. Results of diagnostic assessment of 20 patients with Cushing's syndrome of variable etiology (1979-1989)].

In the light of 20 cases of Cushing's syndrome the currently used diagnostic strategies are presented. For initial screening the classical dexamethasone suppression test using 1 mg dexamethasone p.o. and 24-hour urinary extraction of free cortisol were used, and diagnosis was confirmed using the 2 mg dexamethasone suppression test for two days. All three tests had a sensitivity of 100% in these 20 patients. Etiological evaluation was performed using basal ACTH plasma concentration measurement and the more recently available stimulation tests using corticotropin-releasing factor (CRF): in cases with suspected pituitary-hypothalamic etiology, selective catheterisation of the sinus petrous inferior with simultaneous blood sampling for measurement of plasma ACTH concentration was performed. Detailed etiological diagnosis is important in Cushing's syndrome since therapeutic measures differ widely: the etiologies in the 20 patients with Cushing's syndrome were: central Cushing's disease (microadenoma in 11, pituitary carcinoma in 1), adrenal carcinoma (3), adrenal adenoma (1), adrenal hyperplasia (1), ectopic ACTH production (2) and alcohol-induced Cushing's syndrome (1). The stepwise procedure in screening and diagnosis of the various etiologies of Cushing's syndrome are presented and the results of the 20 patients compared with the literature.

Adrenal Cortex Function Tests↗
PubMed1991

Sex and side differences of cerebral arterial caliber.

The diameter of 261 middle cerebral and 225 anterior cerebral arteries was measured on half axial antero-posterior (ap) view, and the diameter of 217 internal carotid arteries on side view angiograms. Mean diameter was significantly larger by 9.3%, 8.8% and 9.7% respectively in males than in females. In the females the vessels of the left hemisphere were wider but not significantly so than those of the right hemisphere, and the contrary was true for the males. In both sexes the side difference was reversed in the eighth decennium. There was no correlation of vessel diameter with age except for a statistically significant increase by 7.8% of right middle cerebral artery diameter in males from the fifth to the sixth decennium.

Adolescent↗
PubMed1989

[Multiple sclerosis: correlation between clinically suspected locations and ascertained lesions in MRI].

The neurological symptoms of patients with multiple sclerosis are located to four brain areas and are compared with the demonstrated Magnetic Resonance Imaging (MRI) lesions. Areas mostly involved are the centrum semiovale, the periventricular space, the cerebellum and the brain stem. There is a good correlation of the different clinical locations and the MRI lesions in general. Only in the cerebrum lesions are more frequent than expected. In individual patients correlations are difficult to achieve especially in the cerebellum and the spinal cord. Repeated, complete studies of the brain and the spinal cord with contrast medium are necessary to improve the results.

Brain↗
PubMed1989

[Acetazolamide stimulation test in the preoperative assessment of cerebrovascular reserve capacity in unilateral carotid obstruction].

Using the 16-detector 133Xe-NaCl technique (Novo Cerebrograph) quantitative measurements of regional cerebral blood flow (rCBF) were performed in 13 patients with unilateral carotid obstruction before and after stimulation with 1 g acetazolamide. In all patients resting studies showed no significant difference in hemispheric perfusion and a 47% flow increase after acetazolamide on the side with normal carotid artery. On the obstructed side in 8 patients the hemispheric flow increased equally indicating a sufficient and adequate intracerebral collateral circulation and capacity. In 5 patients a significant redistribution of brain flow occurred with diminished increase on the occluded side. This flow pattern indicates an inadequate vasodilator response and insufficient collateral capacity. The rCBF stimulation test identifies patients with a restricted collateral capacity and these patients could benefit from a surgical treatment.

Acetazolamide↗
PubMed1989

[Is bacterial osteomyelitis of the spine spondylitis or spondylodiscitis?].

This is a retrospective study of 43 patients with pyogenic vertebral osteomyelitis. Results obtained with several diagnostic methods, including myelography and CT are described and the usefulness of the different methods is assessed. The frequency of occurrence of the pathogenic bacteria, the focal localization, and the interval between early symptoms and diagnosis are determined. Involvement of intervertebral disc and adjacent vertebrae indicates the development of spondylodiscitis. There are several reasons to characterize the vertebral osteomyelitis as spondylodiscitis too.

Bacterial Infections↗
PubMed1988

[Cerebral circulation at rest and following CO2 stimulation in patients with unilateral carotid obstruction].

Using the 16-detector 133Xe-NaCl-technique (Novo Cerebrograph) quantitative measurements of regional cerebral blood flow (rCBF) were performed in 14 patients with unilateral carotis obstruction before and during stimulation with 3% CO2 inhalation. In all patients resting studies did not show any significant differences in hemispheric perfusion. In 11 patients the hemispheric blood flow increased significantly (by more than 6%) during CO2 inhalation on the side without carotis obstruction. The following results were found after 3% CO2-stimulation over the hemisphere with the obstructed carotid artery: 1) rCBF increased significantly on both sides (n = 6) indicating the sufficiency of cerebral collateral circulation; 2) a side-to-side significant difference (n = 4) with the lower perfusion on the pathological side, indicating a decreased or suspended reserve capacity; and 3) bilateral loss of cerebrovascular reactivity (n = 4) as indicator of insufficiency of cerebral collateral circulation. Asymmetry in rCBF or missing cerebrovascular reserve are indications for surgical treatment of the carotis obstruction.

Administration, Inhalation↗
PubMed1985

[Ultrasonic blood flow measurement in stenoses and occlusions of the internal carotid artery].

Blood flow in the common carotid artery as measured by means of the QFM system of Furuhata in 100 patients with angiographically proven obstructive or occlusive lesions of the internal carotid or middle cerebral artery, was compared with the normal blood flow range in healthy persons of 41 to 70 years of age. Findings were considered to be pathological in 72% of the patient pool. This figure was based on one or more of the standard-value criteria, namely, unilateral flow, bilateral flow, and percentage of the difference between both sides. Pathological findings were thus obtained in 100 per cent of the bilateral and in 90 per cent of the unilateral occlusions, in 53 per cent of the bilateral and in 52 per cent of the unilateral stenoses of the internal carotid artery. In occlusions of the internal carotid artery, no significant correlation between blood flow in the common carotid artery and the presence of an ophthalmic collateral extending beyond the carotid siphon could be established. However, there was a correlation with the diameter of the external carotid artery as well as to the sum total of the cross-sectional areas of its main branches. There was no significant correlation between common carotid blood flow and linear luminar narrowing in stenoses of the internal carotid artery if contralateral pathology was disregarded. Compared with normal flow (7,6 +/- 1,4 ml/sec), the mean flow was reduced in all unilateral stenoses of more than 30 per cent, whereas it was increased in stenoses of less than 30 per cent associated with a contralateral stenosis, and in stenoses of less than 70 per cent associated with a contralateral occlusion of the internal carotid artery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗