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Biomedical subjects

J K Curé

Publications and source records attributed to J K Curé.

12 recordsLinked to original sources

Magnetic resonance imaging in patients with low-tension glaucoma.

OBJECTIVE: To study diagnoses and anatomic findings found on magnetic resonance imaging in patients with low-tension glaucoma. PATIENTS: We included in this study magnetic resonance images of 20 consecutive patients with low-tension glaucoma. We individually matched each patient with low-tension glaucoma to a control with normal ocular findings who had magnetic resonance imaging for reasons unrelated to the visual pathway. DESIGN: We studied axial and coronal images of the orbit and optic nerve with digitizing software (Image-Pro Plus, Media Cybernetics, Silver Spring, Md). Statistical evaluation was with a Wilcoxon Signed Rank Test for anatomic findings and a McNemar Test for diagnosis. RESULTS: We found no difference between groups in the optic nerve diameter or length, the carotid artery area, or the distance from the optic nerve to the carotid artery (P > .05). Left optic nerve area was greater in the control patients than patients with low-tension glaucoma (P = .026). The prevalence of intracranial abnormalities, including meningioma, aneurysm, and arteriovenous abnormality, was similar between groups (P > .05). However, diffuse cerebral small-vessel ischemic changes were found more in patients with low-tension glaucoma (n = 8) than control patients (n = 1) (P = .0196). CONCLUSIONS: This study proposes a hypothesis that cerebral small-vessel ischemia is more common in patients with low-tension glaucoma and potentially reflects indirectly a vascular cause of the optic nerve head damage at least in a subgroup of patients. Importantly, further research still is required to provide direct evidence for a vascular cause involved in low-tension glaucoma.

Aged

Nonneoplastic intracranial cysts and cystic lesions.

This article reviews the gamut of cystic lesions, unrelated to neoplastic disease, that are found in the brain, subarachnoid space, and ventricles. The utility of MRI in diagnosing these entities is shown.

Arachnoid Cysts

MR of cystic aberrant cervical thymus.

The clinical, MR imaging, surgical, and histologic findings in two cases of cystic aberrant cervical thymus were reviewed. Aberrant cervical thymic tissue was sharply circumscribed and extended deep to the posterior pharyngeal wall at the level of the piriform sinus in both cases. Both lesions had cyst contents that were of increased signal intensity on T1-weighted images. Solid components displayed MR signal characteristics identical to normal thymus.

Child

Normal and variant anatomy of the dural venous sinuses.

The normal and variant anatomy of the cerebral veins and dural venous sinuses is poorly understood by many radiologists. Beginning with a discussion of cerebral venous anatomy, this review illustrates clinically pertinent anatomy of the cerebral sinovenous system. Various methods of imaging cerebral veins and dural venous sinuses are described. Techniques and pitfalls of MR venography are emphasized.

Cerebral Angiography

Congenital and acquired abnormalities of the dural venous sinuses.

The imaging features of a variety of dural venous sinus (DVS) abnormalities are reviewed. Congenital and heritable diseases affecting the DVS, tumor-related sinus compression, and traumatic injuries of the DVS are discussed. The causes, clinical manifestations, and imaging findings in cerebral sinovenous thrombosis are described, and pertinent imaging techniques and pitfalls are illustrated. Etiologic theories about the formation of dural arteriovenous malformations are discussed and their imaging features are demonstrated.

Arteriovenous Fistula

Encephalocraniocutaneous lipomatosis and the Proteus syndrome: distinct entities with overlapping manifestations.

We have studied three children with cutaneous (epidermal nevi), subcutaneous (lipomas, plantar skin thickening), vascular (hemangioma, lymphangioma), skeletal (osteoma, exostosis, localized hypertrophy), and neurological (hydrocephaly, lissencephaly, partial agenesis of the corpus callosum) developmental defects associated with the Proteus syndrome and related hamartoneoplastic conditions. We compared our findings in these three patients with those of 50 others with Proteus syndrome and nine with encephalocraniocutaneous lipomatosis (ECCL) reported in the literature. We found that Proteus syndrome and ECCL have distinct identities even though some clinical manifestations are shared by both and a few patients have manifestations of both conditions.

Bone Neoplasms

Variables that affect the expansion rate and outcome of small abdominal aortic aneurysms.

Seventy-three patients with small (less than 6 cm in diameter) abdominal aortic aneurysms (AAAs) were selected for nonoperative management and followed up with sequential ultrasound size measurements. Fifty-four men and 19 women, 51 to 89 years of age (mean 70 years), had an initial mean AAA size of 4.1 cm (anteroposterior) x 4.3 cm (lateral) diameter, with a calculated elliptic cross-sectional area of 14.3 cm2. After a mean of 37 months of follow-up, AAA area increased at a mean rate of 20% per year (3 cm2 yr; 0.4 to 0.5 cm/yr diameter). Expansion rate was not affected by initial aneurysm size. During follow-up, only 3 patients (4%) required urgent operation (1 died), 26 patients (36%) died of non-AAA causes, and 26 patients (36%) underwent elective AAA repair because of progressive size increase (1 died). Elective operations were performed at the rate of 10% per year, when mean AAA size had increased to 22 cm2 (5.1 cm in diameter). Multiple regression analysis of clinical parameters available at presentation indicated that subsequent elective AAA repair was predicted by younger age at diagnosis and larger initial aneurysm size. As anticipated, patients who underwent surgery had more rapid aneurysm expansion (5.3 cm2/yr) compared with patients who did not undergo surgery (1.6 cm2/yr; p less than 0.05). This difference was caused by more rapid expansion during later follow-up intervals among patients selected for operation and was not predicted by the change in aneurysm size observed during initial ultrasonographic follow-up. Final aneurysm size was predicted by initial size, duration of follow-up, and both systolic and diastolic pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis

Auditory dysfunction caused by multiple sclerosis: detection with MR imaging.

We reviewed the MR examinations of 167 patients who presented over a 3-year period with a chief symptom of hearing loss and/or tinnitus. In 14 of these patients the only MR abnormality was the presence of multiple parenchymal high-signal foci on T2-weighted images. Nine of the 14 had clinical evidence of multiple sclerosis; the remaining five had no clinical evidence of multiple sclerosis. Lesions in the auditory pathways, potentially responsible for the patients' symptoms, were identified in only five cases. We recommend T2-weighted images of the whole brain in addition to T1-weighted images of the internal auditory canals and cerebellopontine angles in patients with hearing loss. In some patients, lesions found at higher levels in the periventricular white matter may provide the only clue to the origin of auditory abnormalities.

Adult

Subacute combined degeneration of the spinal cord: MR findings.

The authors present the initial and follow-up MR findings in a patient with subacute combined degeneration of the spinal cord, a complication of vitamin B12 deficiency, and a rare cause of demyelination of the dorsal and lateral columns of the spinal cord. Initial study showed high intensity in the dorsal columns of the cervical and thoracic spinal cord on T2-weighted image. Five months after treatment, the abnormal signal intensity was noted to have decreased.

Aged