Biomedical subjects
Publications and source records attributed to F Thun.
This is a description of the radiologic procedure and its importance for the diagnosis of intracranial aneurysms (19 personal cases) and arteriovenous malformations (27 personal cases) in the pre-adult age-group. The value of each method is discussed and the results are compared with those of other authors in order to reveal particular features of this group of patients.
Migraine accompagnée is associated with cerebral signs of irritation or failure, aphasic or paraphasic disturbances and Jacksonian attacks which appear together with the migraine attack. Present-day ideas on the pathogenesis of migraine headache indicate that such cerebral focal signs should be ascribed to vessel-dependent changes with transitory ischaemia. The article reports on a 24-year-old woman patient who had three Jacksonian attacks within a severe attack of migraine besides neurological signs originating from various cerebrovascular areas, as well as certain mental anomalies; this patient had a previous history of migraine with familial affiliations. The computerized tomogram, produced on the 5th day of disease, showed frontally-paramedially a zone with unsharp outlines without enhancement after administration of a contrast medium. All neurological signs, including the Jacksonian attacks, gradually receded in the course of time. Extensive additional diagnosis was performed, including angiography, to exclude any other underlying disease which could have been made responsible for the observed symptoms.
The value of CT was investigated in sixteen children and adolescents with neurofibromatosis affecting the skull and neck. Its advantage is the simultaneous demonstration of bone and soft tissue changes, which frequently occur together in this condition. Demonstration of the extent of the neurofibromatous soft tissue changes is of crucial importance to the surgeon when planning treatment. Serial observations provide information on progress of the disease and helps in the decision of the optimal time for surgery. The differential diagnosis is discussed.
Explore the source record for details and available documents.
The basic abnormality of neurofibromatosis consists not only of a maldevelopment of the neuroectoderm but also of the mesoderm. Therefore any organ or system of the body may be involved. Following a short clinical review of the central (acoustic) and peripheral type the well known and the more unusual radiographic findings are summarized. They include cranial and intracranial manifestations (orbitosphenoid dysplasia, bone defects of the skull, acoustic neuroma, glioma of the optic nerve and chiasm, meningioma), spinal lesions (scoliosis, vertebral scalloping, meningocele, neuroma, ependymoma), skeletal abnormalities (pseudarthrosis), cardiovascular manifestations, pulmonary fibrosis, tumors of the gastrointestinal and urinary tract and different endocrinopathies. Some of the roentgenologic symptoms are very characteristic and allow definitive diagnosis.
Following a brief survey of myelographic results with aqueous contrast media, the article reports on the results obtained in 150 myelographies with the new contrast medium Lopamidol = Solutrast. This substance was found to be very well tolerated, involving low risk, and is suitable for examining the entire vertebral canal. The image quality is faultless.
Explore the source record for details and available documents.
An accurate analysis of calcifications and of their localization enables a tentative diagnosis, not as rarely as is often assumed, especially if anamnestic and clinical findings are utilized for better interpretation. However, an accurate determination of the area covered by the disease, and of the kind of process, is possible only via neuroradiologic contrast medium diagnostics and computed tomography.
As a casuistic contribution to differential diagnosis of thrombosis of cerebral veins and sinuses a case of occlusion of sinus sagittalis superior by infiltration of an intracerebral metastasis from a teratoma of testis is reported. The leading symptoms - epileptic seizures, progressive hemiplegia, choked papilla and clouding of consciousness - gave rise to the tentative diagnosis of a cerebral tumor; in carotis angiography however, the metastasis was not detected, merely the occlusion of the sinus was demonstrated. Therefore the progress of the syndrome was misinterpreted as caused by an advancement of a venous thrombosis. Only autopsy showed the symptomless primary tumor and its formation of metastases.
The physical and technical principles of this revolutionary method of investigation are described. They explain the advantages over usual radiological techniques, i.e. mainly the possibility of showing far smaller density steps of intracranial structures, as well as some drawbacks. Finally, indications, limits and sources of possible errors are outlined.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Clinical data of 19 arteriovenous malformations (AVM) and 15 aneurysms (AN) are presented. Combined clinical, neurophysiological and neuroradiological follow-up studies have been carried out on the surviving patients (14 AVM and 10 AN). Two patients with multiple AN had coarctation of the aorta. Three AVM of the Vein of Galen showed typical symptoms within the 1st year of life, all other lesions became evident later than 5 years of age. In the acute phase of the disease clinical history and neurological deficits of AVM and AN tend to be very similar. Subarachnoid hemorrhage with or without intracranial hematoma is the most frequent initial symptom. A CT scan is valuable as a first orientating investigation but morphology and operability of the vascular lesion is only demonstrated by angiography. The prognosis of AVM and AN is promising as soon as the first critical period has been survived. AVM patients show significantly less severe residual neurological and psychiatric defects than AN cases. EEG-follow-up studies and CT scans are helpful for controlling residual functional and morphological cerebral damage in survivors.
The first case of a pinealis region tumor of the hematopoietic system without known leukemia (so-called primary myeloblastoma, primary granulocytic sarcoma) is reported. Two weeks after resection, the 3.5-year-old patient suffered from a local recurrence. At this time, a bone marrow infiltration by leukemic blasts was diagnosed for the first time. An aggressive chemotherapy and radiation induced a complete remission, over a 26-month follow-up period. We examined the removed tumor tissue by routine histology methods, immuno- and enzyme histochemistry and electron microscopy. The CSF was studied by conventional microscopy and enzyme cytochemistry. We discuss the epidemiological data of nine previously published cases of primary intracranial myeloblastoma.