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Biomedical subjects

J E Knake

Publications and source records attributed to J E Knake.

At least 37 records · Page 2Linked to original sources
PubMed1982

Intraoperative sonography for brain tumor localization and ventricular shunt placement.

Intraoperative sonography using portable real-time equipment at the dural or brain surface in 16 patients provided accurate localization of a variety of brain lesions for direct dissectional or needle aspiration biopsies as well as for decompression of cysts. The technique has proven to be reliable and rapid, reducing brain exploration in the search for small or poorly accessible lesions and eliminating complex stereotactic procedures. Ventricular shunt catheter placement was also monitored intraoperatively in two infants.

Adolescent↗
PubMed1982

Intraoperative use of real-time ultrasonography in neurosurgery.

The authors' experience with the intraoperative use of real-time ultrasonography during 21 neurosurgical procedures is reported. These procedures include neoplasm surgery in 18 cases, treatment of an arteriovenous malformation in one case, and ventricular catheter placement for hydrocephalus in two cases. In each of the neoplasm cases, the tumors were imaged just as well through the intact dura as on the brain surface itself. There were no cases in which the pathology could not easily be identified. The use of portable intraoperative ultrasonography in sterile coverings has proven to be extremely useful in localizing small subcortical neoplasms, as well as locating the solid and cystic portions of deep lesions. It has assisted in guiding needles for both biopsy and aspiration. It has also accurately identified and guided Silastic catheters during their placement in the ventricular system in cases of hydrocephalus. The authors have found real-time ultrasonography to be an important new tool in the operating room and will continue to rely on its imaging ability during selected procedures in the future.

Adolescent↗
PubMed1981

Computed tomographic and angiographic evaluation of hemangioblastomas.

The computed tomographic (CT) and angiographic findings in 14 patients with proved cerebellar hemangioblastomas were reviewed. Although the CT scan was abnormal in all patients who had hemangioblastomas which produced symptoms, angiography was far more sensitive than CT in detecting hemangioblastoma nodules and was usually more specific in characterizing the lesions. Angiography is recommended in any patients with CT demonstration of a cerebellar cyst, whether or not a mural nodule is apparent, and in patients with von Hippel-Lindau disease who have an abnormal cranial CT scan.

Adult↗
PubMed1981

The nearly occluded internal carotid artery: a diagnostic trap.

Nine cases of nearly occluded internal carotid artery (ICA) origins, usually simulating total occlusion, are presented. Correct diagnosis is aided by an awareness of the possibility of near occlusion of the ICA origin and by careful study of selective common carotid angiography with a long imaging sequence and subtraction. Carotid endarterectomy is the operative procedure of choice, since there may be startling apparent increase in size of the arterial lumen distal to the surgical repair. Many cases reported previously as internal carotid artery occlusion with successful endarterectomy may actually have been severe stenoses.

Aged↗
PubMed1981

Radiology of cerebral vein occlusion without dural sinus occlusion.

The angiographic findings in eight patients having cerebral vein occlusion without dural sinus occlusion are presented. The role of other radiologic examinations is discussed. Occlusive disease involving the dural venous sinuses and/or cerebral veins is a more frequent cause of cerebral symptoms than is generally assumed. An increased awareness of the variable clinical and computed tomographic manifestations is recommended, with liberal recourse to more definitive angiography in suspected cases.

Adult↗
PubMed1980

Radiology of olfactory neuroblastoma.

Olfactory neuroblastoma is often misdiagnosed pathologically. The authors reviewed eight such cases in which the pathological findings met strict criteria. These neoplasms are locally invasive in the nose and paranasal sinuses, with frequent intraorbital and intracranial extension as well as distant metastases. A rare primary presentation in the sphenoid sinus-clivus region is described. Computed tomography is the procedure of choice in defining intraorbital extension and is complementary to precision laminagraphy for defining intracranial extension. Angiography frequently shows hypervascularity and may be of further help in assessing intracranial extension.

Angiography↗
PubMed1979

Rapid detection of neonatal intracranial hemorrhage by transillumination.

Using transillumination and a sensitive cadmium sulfide light meter, 145 newborns were screened for the presence of intracranial hemorrhage. Intracranial hemorrhage (ICH) was suspected when the light meter could not detect any light passing through the anterior fontanel when the light beam was directed through the frontal eminence. ICH was confirmed by branial computed tomography or postmortem examination in all 17 infants not transmitting light. Spectrophotometry was performed on samples of cerebrospinal fluid (CSF) to demonstrate the mechanism through which blood in the CSF blocks light transmission.

Cadmium↗
PubMed1975

A device to aid in positioning for the Andrén-von Rosen hip view.

The authors describe a device which simplifies positioning of the infant when using the Andrén-von Rosen hip view. This device facilitates achievement of the precise angles of abduction and rotation and aids in the diagnosis of congenital hip dislocation.

Hip Dislocation, Congenital↗
PubMedDate not supplied

Atypical progressive stroke syndrome associated with oral contraceptives and cigarette use.

We report a case of progressive multifocal intracranial distal arterial branch occlusive disease in a young adult who smoked heavily and used oral contraceptives. The distribution of the angiographic lesions and the associated telangiectasias and rete mirabile resemble Moya-Moya disease except for clearly absent proximal carotid arterial disease. This type of distal multifocal cerebral arterial occlusive pattern appears to be a very rare manifestation of cigarette and oral contraceptive use. The patient has remained without symptoms for greater than 3 years off oral contraceptives and cigarettes and on antiplatelet agents.

Adult↗
PubMedDate not supplied

Giant cholesterol cysts of the petrous apex: radiologic features.

Four cysts are described that expanded and destroyed the bone of the petrous apex. All patients with these cysts had a sensorineural hearing loss. Mild symptoms referable to cranial nerves VI, VII, IX, X, XI, and XII were seen also. The cysts range in size from 1.5 X 1.5 X 3 cm to 5 X 5 X 6 cm. Grossly and histologically, they were distinct from any lesions seen previously. The lesions were large and contained glistening brown, watery fluid filled with cholesterol crystals. The cyst wall was predominantly fibrous tissue without an epithelium. Minimal chronic inflammatory change and granuloma formation were present within and just outside the cyst wall. These cysts have been described as mastoid cysts, epidermoids, mucoceles, and cholesterol granulomas; until now, they have not been recognized as a single distinct entity. A name emphasizing the pathologic characteristic of the lesion, giant cholesterol cyst, has been suggested. Distinguishing them from other petrous apex lesions preoperatively is difficult, but if the cystic nature of the lesion can be recognized or at least anticipated, more conservative surgery, such as simple drainage versus a more radical procedure, may be possible.

Adult↗
PubMedDate not supplied

Iohexol versus metrizamide for cervical myelography: double-blind trial.

Cervical myelography was performed by lateral C1-C2 puncture in 60 patients. Thirty patients received iohexol (an investigational aqueous contrast agent) and 30 received metrizamide in order to provide a prospective, randomized, double-blind trial comparing these contrast media. The two media produced radiographs of equal quality. Contrast-related morbidity was suffered by four patients (13%) in the iohexol group and by 11 patients (37%) in the metrizamide group. These features indicate that iohexol is superior to metrizamide as a contrast agent for cervical myelography.

Adult↗