Biomedical subjects
Publications and source records attributed to F E Glasauer.
A histologically confirmed case of focal dysplasia of the cerebral cortex is presented. The computerized tomographic, electroencephalographic, pathological, and angiographic findings are discussed with respect to this rare developmental disorder. A review of the literature is presented with a possible etiology for this condition.
A case of a large cisterna magna cyst presented a problem in differential diagnosis. Characteristic changes were shown on plain skull roentgenograms and on radionuclide brain scan. The diagnosis was established on the basis of pneumoencephalography and isotope cisternography. The lesion responded well to surgical management.
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Benign tumours of the spine are infrequent. Among the bony lesions occurring in children and adolescents are osteochondroma, benign osteoblastoma, and aneurysmal bone cyst. Although more than 50% of the osteochondromas are found in patients below 20 years of age, their incidence in the vertebrae is very low. In contrast, benign osteoblastoma and aneurysmal bone cyst are rare lesions, but occur relatively commonly in the spine. A case report of each of these bony lesions is presented. The symptomatology, the characteristic radiological and pathological appearance, and the appropriate treatment of these benign lesions of the spine are described.
An unusual type of dermoid cyst is reported in 10 African infants. In these cases a soft, cystic mass located over the anterior fontanel was noted shortly after birth and gradually enlarged. The cyst had no intracranial extension and was easily excised intact. The clinical and x-ray findings of the cyst are described and compared with the usual dermoids. The histology and the contents of the cyst are detailed and some peculiarities of this lesion pointed out.
Five patients surgically treated for unusual intracranial foreign bodies are presented. They include representative cases of the three most commonly encountered types of these injuries: industrial accidents, suicidal attempts and the result of criminal assault. Immediate radiological examination is mandatory because the deceptively small entrance wound is usually in no way commensurate with the large size of the foreign body the presence of which is frequently not suspected. The surgical removal of these foreign bodies requires careful pre-operative assessment to avoid hemorrhages and undue injury to the surrounding normal brain tissue.
A case of a traumatic vertebral arteriovenous fistula associated with a high cervical fracture-dislocation is reported. The fistula was not suspected clinically but was fortuitously diagnosed by brachial arteriography carried out for a deteriorating level of consciousness. The patient's complex injuries were managed by conservative treatment of the fracture-dislocation and later by ligation of the proximal and distal vertebral artery for trapping of the fistula. The indications and the various surgical procedures for the treatment of vertebral arteriovenous fistula are discussed. The report emphasizes the value of cerebral angiography in head and neck injuries.
A rare case of sphenoethmoidal encephalocele with detailed pathological studies is reported. Only a few cases have been documented and were reviewed. The etiology and embryology of the congenital malformation remains speculative with an agreement on their development at an early embryonic stage. The mass presenting in the nasopharyngeal cavity remains often undetected unless causing respiratory embarrassment and is frequently misdiagnosed. Thorough radiological investigations detect the bone defect and outline the extent of the herniated mass and associated cerebral abnormalities. Small lesions have been successfully repaired. Larger ones prove less amenable to surgery and carry a high mortality.
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The authors present the case of a 5-year-old boy with a chronic petrous pyramid abscess and without a history of otitis media. Treatment by posterior fossa exploration and drainage with antibiotics was successful.
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Isotope studies are well-tolerated examinations in various congenital CNS anomalies and are valuable in demonstrating the presence of associated hydrocephalus, abnormal accumulation of isotope associated with abnormal CSF flow or a failure of absorption. In some cases these studies may be of differential diagnostic value and a helpful indicator in the choice of surgical treatment. These tests do not disturb the CSF equilibrium which is often observed following air or other contrast studies.
The author discusses the value of isotope cisternography and ventriculography in the diagnosis of a variety of congenital anomalies of the central nervous system (CNS) associated with either hydrocephalus or a disturbance in cerebrospinal fluid (CSF) flow and absorption. In sincipital encephaloceles the techniques demonstrate CSF communication with the anomalous sac and the frequently associated hydrocephalus with occipital lesions. In porencephaly and cerebral agenesis, the isotope demonstrates ventricular reflux and remains in the cystic dilatation indicating abnormal CSF absorption; isotope ventriculography also reveals a delayed CSF absorption and the possible sites of CSF obstruction in Arnold-Chiari malformations and Dandy-Walker syndrome. In addition to their differential diagnostic value isotope studies can be a helpful guide in the choice of the proper surgical treatment of some CNS anomalies.
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