PubMed HealthSearch

Biomedical subjects

J J Wasenko

Publications and source records attributed to J J Wasenko.

10 recordsLinked to original sources

Acute internal jugular vein thrombosis associated with pseudoabscess of the retropharyngeal space.

We present four patients in whom evidence of edema or a pseudomass in the retropharyngeal space was found on CT scans obtained after thrombosis of the internal jugular vein. The clinical condition of one patient led to surgery, which documented the sterility of the retropharyngeal space despite the CT appearance of an inflammatory process. The CT findings, which are confusing initially, are found to be typical in retrospect.

Acute Disease

Cystic meningiomas: MR characteristics and surgical correlations.

PURPOSE: To describe the MR appearance of cystic meningiomas, and to correlate the MR appearance with the surgical and neuropathologic findings. METHODS: Eight patients with cysts associated with meningiomas were studied on a 1.5-T MR system. Unenhanced sagittal T1- and axial T2-weighted images were obtained in all patients. Axial and coronal gadopentetate dimeglumine-enhanced T1-weighted spin-echo images were obtained in seven patients. Additional sagittal T1-weighted spin-echo contrast-enhanced images were obtained in four patients. RESULTS: The cystic components were intratumoral and eccentric in two cases, intraparenchymal in one case, and extraparenchymal (trapped cerebrospinal fluid) in five cases. Cyst wall enhancement was present in two of seven cases performed with intravenous gadopentetate dimeglumine. There was no correlation between cyst signal intensity and cyst content. A preoperative diagnosis of cystic meningioma was possible in all eight cases. CONCLUSIONS: MR demonstrates the extradural location of the tumor and its cystic component, correlates well with the surgical presentation and the neuropathologic results, and allows the preoperative diagnosis of cystic meningioma based on the MR findings. Division into three types of cysts aids the neurosurgeon, who must decide whether total resection is feasible. To obtain total resection and reduce the risk of recurrence with an intratumoral cyst, the surgeon must ensure that the plane of resection is in fact between the thin enhancing membrane of the tumor cyst and the adjacent arachnoid. In cases in which the cyst is trapped cerebrospinal fluid or intraparenchymal in location, the cyst wall adjacent to or within the brain parenchyma is not included in the resection.

Aged

Congenital hypopituitarism as part of suprasellar dysplasia. A case report.

Congenital hypopituitarism may be due to hypothalamic failure. The case presented below belonged to this category. In addition, the demonstration of absent septum pellucidum placed this case in the category of suprasellar dysplasia. The patient was 21 years old, with primary amenorrhea and lack of development of secondary sex characteristics. The laboratory findings confirmed the diagnosis of hypothyroidism, hypocortisolism, hypogonadotropism, hyperprolactinemia and normal growth hormone. Stimulation studies revealed a subnormal response of cortisol to adrenocorticotrophic hormone stimulation, subnormal response of follicle stimulating hormone and luteinizing hormone to gonadotropin releasing hormone stimulation, normal response of prolactin to thyrotropin releasing hormone stimulation and exaggerated response of thyroid stimulating hormone to thyrotropin releasing hormone stimulation. The patient was treated with thyroid supplementation. Magnetic resonance imaging showed a hypoplastic infundibulum, ectopic neurohypophysis, small anterior pituitary gland and absent septum pellucidum. Congenital hypopituitarism may be part of a large spectrum of midline brain abnormalities.

Abnormalities, Multiple

Dynamic computed tomography: intracranial applications.

Rapid sequential computed tomography of the brain after the bolus injection of contrast material provides invaluable information as to the characteristic blood flow of intracranial lesions in a noninvasive manner. Plotted dynamic curves permit accurate diagnosis of particularly difficult cases of infarcts and neoplasms. Dynamic computed tomographic (CT) scanning has become a part of the CT work-up for infarcts, which has allowed their earlier demonstration, detected as areas of hypoperfusion not clearly evident on an initial conventional CT study. Quantitative assessment of vasogenic edema and hypoperfusion are helpful in establishing the diagnosis of infarction and neoplasia. Orbital and parasellar neoplasms can be distinguished accurately from vascular lesions. Dynamic CT studies complemented conventional film screen arteriography in the evaluation of three cases of intracavernous internal carotid artery aneurysm, defining thrombus formation and wall thickness and thus influencing the therapeutic approach. In addition, this modality is useful in differentiating jugular fossa neoplasm from vascular malformation. This review elaborates on the technique involved in dynamic CT scanning and the subsequent results.

Arteriovenous Malformations

Magnetic resonance of intracranial epidermoids.

The magnetic resonance images of seven patients with biopsy-proven epidermoids were evaluated. The epidermoids were hypointense on T1-weighted images. Intermediate density images revealed the tumors to be heterogeneous in signal intensity consisting of areas of hypo- and isointensity. Signal intensity on T2-weighted images was hyperintense and inhomogeneous in all but one case. CT performed in five patients demonstrated the tumors to be well-defined hypodense lesions without contrast enhancement.

Adolescent

Gradient echo imaging of the lumbar spine.

Journal articles have presented pro and con views of gradient recalled echo (GRE) imaging of the lumbar spine, while it has been illustrated in textbooks that have advanced its diagnostic applicability. This paper reappraises GRE in light of evolving MRI technology. The conspicuity of anatomic structures on axial T1-weighted (T1W) spin-echo (SE) images were matched with T2 GRE images in 55 patients referred for evaluation of low back pain. Disc herniations were hyperintense on GRE images and readily separable from hypointense spondylophytes.

Adipose Tissue

Cerebral venous thrombosis. Demonstration with magnetic resonance angiography.

Three patients with cerebral venous thrombosis (CVT) were imaged with magnetic resonance angiography (MRA). Initial spin-echo magnetic resonance (MR) demonstrated acute or subacute thrombosis in all patients. The presence of thrombosis was confirmed with MRA. Repeat MRA in the three patients revealed partial recanalization in one and almost complete recanalization in two patients. The etiology of CVT is reviewed, and the advantages of MRA are compared with conventional MR imaging and computed tomography in the evaluation of CVT.

Adult

Temporomandibular joint chondrosarcoma: CT demonstration.

Chondrosarcoma of the temporomandibular joint is a rare lesion. A 49-year-old woman presented with painless left preauricular swelling. Computed tomography demonstrated a soft tissue mass in the left temporomandibular joint with extraarticular extension along the mandibular ramus. Calcification was present in the extraarticular component.

Chondrosarcoma

The Sturge-Weber syndrome: comparison of MR and CT characteristics.

Four patients with Sturge-Weber syndrome were evaluated with CT and MR. MR demonstrated the characteristic features of the disease: cerebral atrophy (four patients), ipsilateral bone and sinus hypertrophy (three), ocular findings (one), intracranial calcification (four), prominent deep venous system (three), and enlarged choroid plexus (two). CT demonstrated the following: cerebral atrophy (four), ipsilateral bone and sinus hypertrophy (three), calcification (four), gyral enhancement (two), prominent deep venous system (two), and enlarged choroid plexuses (three). The features of Sturge-Weber syndrome were visualized equally well with MR and CT with the exception of intracranial calcification. Conventional spin-echo MR revealed fewer calcifications, and those visualized appeared smaller than with CT. Gradient-echo acquisition sequences were more effective in the detection of intracranial calcification.

Adolescent