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Biomedical subjects

F A Strang

Publications and source records attributed to F A Strang.

8 recordsLinked to original sources

Intracranial haemangioendothelioma mimicking a meningioma.

A 33-year-old man presented with a history of fits and on initial investigation was suspected of having a left frontal parafalcine meningioma. Initial surgical procedure to excise the lesion had to be abandoned owing to the extreme vascularity of the lesion. Histology revealed it to be a haemangioendothelioma. At a second operation the tumour was completely removed. The histology of this rather uncommon tumour is discussed and the literature is reviewed.

Adult↗

Internal carotid artery occlusion in association with Crohn's disease.

A 38-year-old white male with small bowel Crohn's disease presented with an acute right-sided cerebrovascular accident. He died 36 hr later and postmortem revealed thrombosis over the whole length of an otherwise completely normal left internal carotid artery. Histological examination of the artery revealed no abnormalities and in particular no evidence of arteritis. This brings the total number of such cases reported to three, but this is the first with postmortem data. The occurrence of such an event in a young person with normal carotid arteries and no other risk factors would suggest an association with his Crohn's disease, possibly as a result of a coagulation abnormality.

Adult↗

Arnold-Chiari malformation. Review of 71 cases.

The natural history of symptomatic adult Type I Arnold-Chiari malformation (ACM) is variable, and the value of surgery in the management of this disease is difficult to assess. A series of 71 patients in whom a diagnosis of Type I ACM was confirmed at operation is presented, and the progress of the patients following posterior fossa decompression is analyzed. The length of history varied greatly. Pain was the commonest symptom (69% of patients); other symptoms included weakness (56%), numbness (52%), and unsteadiness (40%). The presenting physical signs consisted of a foramen magnum compression syndrome (22%), central cord syndrome (65%), or a cerebellar syndrome (11%). Myelography was performed in 69 patients, and was the most useful investigation. Only 23% of plain radiographs were abnormal. In addition to tonsillar descent, the operative findings included arachnoid adhesions (41%) and syringomyelia (32%). All patients underwent suboccipital craniectomy and C1-3 laminectomy. Respiratory depression was the most frequent postoperative complication (14%), and one patient died from sleep apnea. Early postoperative improvement of both symptoms (82%) and signs (70%) was followed by later relapse in 21% of patients, showing an initial benefit following surgery. None of the patients with a cerebellar syndrome deteriorated, whereas 56% of patients with evidence of foramen magnum compression and 66% of those with a central cord syndrome maintained their initial improvement. The authors conclude that posterior fossa decompression appears to benefit some patients, although a significant proportion might be expected to relapse within 2 to 3 years after operation, depending upon the presenting syndrome.

Adult↗

Electron density and atomic number determination by computed tomography. Part I: Methods and limitations. Part II: A study of colloid cysts.

The feasibility of extracting electron density and effective atomic number from measurements of tissue in vitro and in vivo has previously been reported. The method requires scans to be obtained at two different beam energies. Optimization of these energies at 40 keV and 80 keV could enable a variation of 1 part in 400 of effective atomic number to be detected. The method is subject to certain limitations related to accuracy and sensitivity. The effect of varying the concentrations of certain atoms has been modelled demonstrating the limits below which variation in effective atomic number is unlikely to be detectable at acceptable radiation doses. A series of 12 patients with colloid cysts has been considered. All were treated by bilateral ventriculo-cisternostomy from one to 23 years ago. Nine of these patients, and the colloid cyst of one patient who died before treatment could be instituted, have been subjected to double energy scanning. The results suggest that the high attenuation values observed in colloid cysts are due to increased electron density and not to any increase in high atomic number elements. The cysts do not appear to change in size or content over long periods.

Adult↗

The clinical and surgical feature in 40 patients with primary cerebellar ectopia (adult Chiari malformation).

This paper reports 40 patients with primary cerebellar ectopia investigated in the University of Manchester departments of neurology and neurosurgery over the five years, 1968-1973. A review of the clinical and surgical findings showed that (a) pain of varying type was the most common symptom, (b) four main clinical groups could be recognized--syringomyelia, paraparesis, cerebellar syndrome and 'raised pressure' syndrome and (c) surgical decompression of the posterior fossa and upper cervical spine resulted in improvement in over 70 per cent of patients with a small incidence of post-operative complications. It should be emphasised that primary cerebellar ectopia is not uncommon and is an important syndrome in its own right. It is often not accompanied by syringomyelia and in these patients the diagnosis can be difficult without supine myelography.

Adult↗