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Biomedical subjects

F Thun

Publications and source records attributed to F Thun.

At least 19 recordsLinked to original sources
PubMed1992

[Magnetic resonance tomographic diagnosis of vascular processes in the vertebrobasilar system--analysis of 35 of our own cases and a literature review].

35 patients with abnormalities of the vertebrobasilar system were studied via magnetic resonance imaging (11 saccular aneurysms, 10 vascular malformations, 9 basilar arteries with dolichoectasia, 5 thromboses of the vertebral or basilar artery). The two smallest aneurysms of the basilar top had a diameter of 2-3 mm. Most vascular malformations could be differentiated by typical MRT symptoms. All 5 cavernous angiomas were negative in angiography (cryptic). The shape and size of the basilar artery and its relationship to the third ventricle were best demonstrated on coronal slices. Flow-related intraluminal loss of signal allows a differentiation between vascular perfusion and thrombosis already on plain images (partial) thrombosis and artery dissection can be differentiated from flow effects based on identical findings in at least two planes or additional gradient echo images.

Adult↗
PubMed1991

[Intracranial giant aneurysm due to the effects of radiation].

Two cases of intracranial giant aneurysms of the carotid artery are presented, probably caused by radiation damage. Both patients had been treated for hypophyseal adenoma by transfrontal implantation of yttrium seeds (35 and 45 mCi). Preoperative carotid angiographies had shown no vascular abnormalities; the aneurysms were revealed 8 and 11 years after these examinations. No identical cases could be found in the literature. Further etiological hypotheses are discussed.

Adenoma↗
PubMed1990

Clinical correlates of erythropoiesis in chronic subdural hematoma.

Histologic investigation was performed in 38 out of 224 chronic subdural hematomas treated at our institution from 1978 to 1988. Nucleated red blood cells were found in 33% of the chronic subdural membranes examined. Additional sections were examined in 14 of these 38 patients, revealing erythroblasts in 57%. The clinical course and radiographic findings in the patients whose membranes contained erythroblasts were compared with those whose specimens did not. Neither history, presentation, size of hematoma, nor postoperative recovery differed from one group to the other. By comparing histologic and clinical findings, we are able to conclude that the production of erythrocytes by chronic subdural membranes is of no surgical significance.

Adult↗
PubMed1990

[Nuclear magnetic resonance tomographic diagnosis of brain tumors in children and adolescents. A comparison with computed tomography].

Thirty-one pediatric patients with brain tumors--25 primarily diagnosed, 6 recurrences--underwent MR and CT examinations before and after application of contrast media. Tumor detection, delineation of the tumor extent and definition of the tumor type were compared. Gd-DTPA-enhanced MR was superior in delineating the extent of primarily diagnosed tumors, which showed enhancement (n = 22). The tumor detection (1/6) and the identification of the tumor margins (5/6) were improved by Gd-DTPA in the 6 recurrences. Tumors without enhancement (n = 3) were judged by T2-weighted images better than by CT. The results suggest that Gd-DTPA is indicated for the evaluation of brain tumors in pediatric patients as well, especially since it offers advantages distinguishing between tumor types. Only the detection of tumor calcifications, which is rarely specific, is not possible by MR.

Adolescent↗
PubMed1990

Growth rate of incidental meningiomas.

A meningioma was incidentally identified with computerized tomography (CT) in 17 patients without relevant clinical signs. The tumor was not removed, but biopsy confirming a meningioma was obtained from one patient. Tumor growth rate was calculated from repeat CT scans or follow-up magnetic resonance imaging. The annual growth rate ranged from less than 1% to 21%. It is concluded that in nonsymptomatic meningiomas with a low growth rate a nonsurgical approach may be warranted.

Aged↗
PubMed1990

Cysts of the third ventricle.

Cysts of the third ventricle, predominantly being of congenital origin, are often summarized under the heading of ependymal or neuroepithelial cysts, if they contain an epithelial covering. Though surely they form a heterogeneous group, even by histochemistry and electron microscopy a differentiated classification on a histogenetic basis is difficult because of overlaps in structural details. The aim of this study is checking by immunohistochemistry with antibodies to cytokeratins (KL 1), epithelial membrane antigen (EMA), S 100 protein (S 100), and glial fibrillary acidic protein (GFAP). Fourteen colloid cysts showed clear reaction differences of their epithelium in relation to neuroepithelium, which render feasible the verification of the earlier presumed bronchogenic origin of the former. Two other "ependymal cysts" could be classified as diverticulum respectively meningeal glioependymal cyst. A review is given about localization, clinical and neuroradiological aspects of these partly extreme rare lesions together with differential diagnosis.

Adolescent↗
PubMed1989

Encapsulated subdural hematoma.

In 45 out of 103 cases with chronic subdural hematoma a definite membrane was found. Membranectomy was performed in 37 cases, mostly as a secondary procedure after burr-hole evacuation and closed system drainage. The mortality rate was 6.6% and in the survivors a complete recovery was achieved in 90%. CT monitoring of the diameter of the hematoma and midline shift did not reveal any correlation of size of the hematoma with neurological findings. The indication for membranectomy can, therefore, not be based on radiological findings alone, but on the clinical course of events and with due regard to the CT findings.

Adult↗
PubMed1989

Fractures of the thoraco-lumbar spine with neurological deficits.

We present 78 patients with spinal cord injuries. Operation is not indicated in cord contusion, extended bleeding into the spinal canal or severe fracture dislocation. However, it would seem advisable to operate on patients with vertebral fractures, particularly at the lower thoracic and lumbar levels, if intraspinal bone fragments are detected by CT scan.

Adolescent↗
PubMed1989

Neural tolerance of iotrolan 300 in ascending cervical myelography: results of a multicenter study.

This study examined the opacification, dose, and tolerance of iotrolan 300 on 231 patients in ascending cervical myelography. The contrast was rated good in 188 (81.4%) of the cases and satisfactory in 40 (17.3%) of the cases. The contrast was poor in only three (1.3%) cases. In 152 patients a dose of 10 ml or less of iotrolan 300 was administered. A good contrast quality was obtained in 84.2% of all examinations. From a total of 231 patients, 146 exhibited no concomitant effects. The intensity of the headache and neck ache was recorded by the patients themselves by means of an analog scale. The frequency and degree of the postmyelographic complaints did not increase with higher doses, i.e., they were not dose dependent. Neurologic irritation, in the form of radicular symptoms, appeared in only 2 of 231 examinations. These data demonstrate that iotrolan 300 is excellent for use in ascending cervical myelography.

Adult↗
PubMed1989

[Posture-related arrest of contrast medium in the myelogram].

An increase in intraabdominal pressure leads to the filling of the epidural vein plexus and thereby to an increased epidural pressure and consecutive compression of the dural sac. This has often been demonstrated in myelography as an ascending of the contrast medium. We observed a complete stop of the contrast medium in ascending myelography although neither computed tomography nor magnetic resonance tomography could demonstrate an intraspinal tumour. We suppose, therefore, that this phenomenon is of "functional origin".

Aged↗
PubMed1988

Acute hydrocephalus in infectious spinal disorder.

Two patients with infectious spinal disorders and increased intracranial pressure are described. One patient with spinal empyema lapsed into coma but improved after external ventricular drainage to relieve increased intracranial pressure. The second patient, who had a severe wound infection after repeated operative stabilization of a cervical spine fracture, developed increased intracranial pressure and subsequent hydrocephalus 6 months after the trauma. The pathogenesis of hydrocephalus in infectious spinal disorder is discussed.

Adult↗
PubMed1988

Early involvement of the nervous system by human immune deficiency virus (HIV). A study of 79 patients.

We report on 79 patients of different stages of human immune deficiency virus (HIV) infection according to the Walter-Reed staging classification (WR). Comparing the HIV antibody content per weight IgG in serum and cerebrospinal fluid (CSF), 54 patients (68%) showed higher antibody activity in CSF than in serum, indicating intrathecal antibody production and thus a local challenge with the virus. The percentage of patients with these antibodies in CSF increased from stage WR 1 (33%) to WR 5 (90%). It decreased again in WR 6 (68%). Twenty-one patients with intrathecally produced antibodies but without evidence for opportunistic or preexistent neuropsychiatric diseases were further analyzed. Even in stages WR 1 and 2 these patients showed distinct clinical signs. These consisted mostly in apathic personality change (n = 13), peripheral neuropathy (n = 8) or mild hemisyndrome (n = 9). Progression to severe dementia solely caused by HIV encephalitis seems to be possible. More often acceleration of the mental disorder indicates a synergistic action of other pathogens. Our study gives further evidence for very frequent, early and clinically active involvement of the nervous system by the HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Multiple brain infarcts in zoster infection].

The clinical, CSF, CCT and PET findings in a 14-year-old female patient are reported. CCT and PET investigations demonstrated multiple cerebral infarctions; CSF examinations revealed inflammatory changes. Zoster antibodies were synthesized intrathecally, as detected by an ELISA after adjusting serum and CSF to identical IgG concentrations. Therefore the diagnosis of a cerebral zoster angiitis was made. Diagnostic and therapeutic problems of inflammatory vascular lesions are discussed.

Adolescent↗
PubMed1987

[CT cisternography in the diagnosis of nasal cerebrospinal fluid fistulas].

Four out of 12 patients with CT-cisternography were operated on. The CT findings were all confirmed at operation. In three patients with positive CT findings, the fistula was located at operation. In one case with negative CT findings, operation revealed no fistula either. Advantages of CT-cisternography are reliability of positive findings and the possibility of locating the fistula in some cases. The procedure bears relatively little risk and can be repeated.

Cerebrospinal Fluid Rhinorrhea↗