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J Lodder

Publications and source records attributed to J Lodder.

At least 73 records · Page 4Linked to original sources
PubMed1988

Timing of autopsy-confirmed hemorrhagic infarction with reference to cardioembolic stroke.

We studied the temporal profile of hemorrhagic transformation in 34 cases with autopsy-confirmed hemorrhagic infarction who died within 15 days following a supratentorial brain infarct, provided they had undergone computed tomography. It appeared that within 4 days, at least 76% (95% confidence interval 39-100%) of 21 cardioembolic strokes had become hemorrhagic. We conclude that if anticoagulation is considered in cardioembolic stroke, such treatment should not be started sooner than at least 4 days after the onset of stroke, provided that computed tomography at that time shows no hemorrhagic infarction.

Aged↗
PubMed1987

Hemorrhagic infarction on CT in cardioembolic stroke.

CT-scans of 103 patients anticoagulated following cardioembolic stroke were evaluated. Data were taken from a prospective registry on the risk of early anticoagulant treatment in patients with cardioembolic stroke. Ninety-three patients had CT within 24 hours after stroke onset. Sixty-six of 103 CT-scans showed infarction. On initial CT five hemorrhagic infarcts were found (5%). Of 35 follow-up CT-scans randomly performed during anticoagulant treatment, six (= 17%) showed hemorrhagic infarction without clinical worsening. It is argued that a cardioembolic cause of stroke cannot be infered by the presence of HI on CT. In patients with a cardioembolic stroke the value of CT lies in minimizing the risk of early anticoagulant treatment.

Adult↗
PubMed1987

Risk of early anticoagulation in patients with small deep infarcts possibly caused by cardiogenic emboli.

From a prospective registry of 103 stroke patients on early anticoagulation for cardiac embolus we selected 23 patients with a small deep infarct. We studied the incidence of hemorrhagic infarction on CT, and the risk of early anticoagulation. We found no hemorrhagic infarction on CT in any case, and no bleeding complications during the three week observation period. Obviously, early anticoagulation can be started safely in patients with a small deep infarct possibly caused by cardiac embolism.

Aged↗
PubMed1987

[Secondary prevention of cerebral infarct].

This article reviews current treatment in the secondary prevention of cerebral infarction. Treatment of risk factors, together with treatment of the primary cause of cerebral infarction will significantly lower the recurrence rate. Therefore, it is argued that in patients with ischemic stroke medical history should be taken carefully, thorough physical examination should take place, and proper complementary diagnostic tests should be used when indicated.

Arterial Occlusive Diseases↗
PubMed1986

The value of immediate post-operative routine CT related to uncomplicated ventricle drainage in childhood hydrocephalus.

Retrospectively we assessed the value of routine postoperative CT scans in 113 children shunted for hydrocephalus. Of the 165 routine CT scans 13 showed fortuitous findings (= 8%) with a change in treatment accompanied by questionable benefits in only 2 (= 1.3%). Therefore we suggest that post-operative CT should not be performed as a routine examination but only on clinical grounds.

Adolescent↗
PubMed1985

Percutaneous radiofrequency Gasserian ganglion coagulation in the treatment of trigeminal neuralgia.

Fifty-three patients with trigeminal neuralgia were treated with percutaneous radiofrequency Gasserian ganglion coagulation. An individually adjusted degree of coagulation was applied. The procedure was successful in 45 patients (85%). The median follow-up was two years; only two of the remaining 45 patients had relapse of symptoms. Four patients experienced side effects consisting of troublesome facial dysaesthesia. Our data indicate that percutaneous radiofrequency coagulation of the Gasserian ganglion is a safe and reliable procedure in the treatment of medication resistant trigeminal neuralgia.

Adult↗
PubMed1985

Progressive stroke caused by CT-verified small deep infarcts; relation with the size of the infarct and clinical outcome.

In 73 of 83 consecutive patients with a CT-verified small deep infarct, the course of the initial deficit was retrospectively assessed. Sixty-four percent showed their maximal deficit at stroke onset, while 36% had progression of the initial deficit. Between these 2 groups, there was no difference in the number of patients with hypertension and in the number of patients with a probable cardiac embolic cause of the lacunar stroke. Patients with progressive lacunar stroke had larger volume infarcts and showed less favourable outcome at one month. Our data suggest that progression of symptoms in patients suffering a small deep infarct is due to an increase of the infarcted area. This offers a rationale for early anticoagulant treatment in patients with small deep infarcts. However, since any beneficial effect of such treatment has not been established so far, a prospective controlled study is warranted.

Adult↗
PubMed1985

Completely thrombosed giant aneurysm of the basilar artery trunk: a case report.

A patient with a completely thrombosed giant aneurysm arising from the trunk of the basilar artery is described. Although it is difficult to differentiate this anomaly from a posterior fossa tumor, negative angiographic findings combined with certain computed tomographic (CT) signs may point to the correct diagnosis. Our case demonstrates that one of these CT signs (viz. ringlike contrast enhancement) can be explained by the presence of vasa vasorum in the aneurysm wall.

Basilar Artery↗
PubMed1984

Causes of small deep infarcts detected by CT.

Clinical data of 83 patients with symptomatic CT detected small deep infarcts in one of the cerebral hemispheres were retrospectively reviewed. 61 Percent had hypertension. In 15 percent a cardiac embolus was the most probable cause of a small deep infarct. In 22 cases angiography had been performed and ipsilateral internal carotid stenosis was present in 6 cases. It is suggested that small deep infarcts visible on CT may be caused by cardiac emboli and artery-to-artery emboli from carotid lesions, besides small vessel disease due to hypertension. Therefore anticoagulation or angiography, if need be, followed by carotid endarterectomy, may be indicated in a number of cases.

Adult↗
PubMed1984

CT-detected hemorrhagic infarction; relation with the size of the infarct, and the presence of midline shift.

The incidence of mass effect indicated by midline shift, and the incidence of hemorrhagic infarction were studied in 952 consecutive CT scans with supratentorial infarcts. Hemorrhagic infarction was found in 5.1% indicating that the incidence of hemorrhagic infarction during life is far less than was suggested from pathological studies. Midline shift was found in 3.6% and, accordingly, the chance of finding a hemorrhagic infarct with mass effect indicated by a shift of the midline would be 0.2% if these 2 phenomena were not related. However, this incidence appeared to be 12 times higher, indicating they are closely related. In addition, the incidence of hemorrhagic infarcts and midline shift were both related to large infarcts with bad outcome. Cardiac emboli were not more prevalent in patients with hemorrhagic infarcts than in a control series, indicating that cardiac emboli do not produce hemorrhagic infarction more often than other causes of cerebral infarction, and that cardiac embolic cause cannot be inferred from hemorrhagic infarction on CT. This probably also applies to carotid emboli. When anticoagulation is considered in patients with cerebral infarction, CT-confirmed hemorrhagic infarction and shift of midline structures as well as decreased consciousness are contraindications to such treatment. In their absence, and in the absence of general contraindications, anticoagulant treatment can safely be started.

Adult↗
PubMed1983

Computed tomography in acute cerebral multiple sclerosis. A report of two cases.

In two cases of acute cerebral multiple sclerosis, computed tomographic (CT) scans with contrast disclosed several enhanced foci, mainly situated in the periventricular white matter and, in one patient, in the cerebellum. Administration of dexamethasone sodium phosphate in one patient and prednisone with cyclophosphamide in the other was followed by considerable clinical improvement. Successive CT scans with contrast enhancement showed a close correlation between improvement of symptoms and the subsidence of contrast-enhanced foci during treatment. Perhaps clinical improvement reflected restoration of the impaired blood-brain barrier.

Adult↗
PubMed1983

The symptomatology of megadolicho basilar artery.

Cranial nerve dysfunction, obstruction hydrocephalus, signs of brain stem dysfunction, and signs of a space-occupying lesion in the posterior fossa are presumed to be related to a megadolicho basilar artery, if present. Since there are no large series of patients with such vascular anomaly, a bias in relating symptoms with the presence of a megadolicho basilar artery is not excluded. We therefore studied retrospectively the incidence of megadolicho and dolicho basilar artery on cranial CT-scan of 3332 patients of 50 years and older. Patient records were reviewed for the above mentioned symptoms. 12 out of 22 patients with a megadolicho basilar artery and 2 patients out of 40 with a dolicho basilar artery had one or two of these symptoms. It is concluded that a megadolicho basilar artery can cause cranial nerve dysfunction, obstruction hydrocephalus, signs of brain stem dysfunction, and signs of a space-occupying lesion in the posterior fossa.

Aged↗
PubMed1982

Ruptured abdominal aortic aneurysms presenting as radicular compression syndromes.

Two patients are described: one with an aneurysm of the infrarenal aorta and common iliac artery that ruptured posteriorly into the iliac vein, the other with an aneurysm of the distal abdominal aorta that ruptured posteriorly into the iliopsoas muscle. Both patients had symptoms compatible with a radicular compression syndrome. Ruptured aneurysm of one of the major abdominal arteries should be considered in the differential diagnosis of affections of the lumbosacral neural outflow, because immediate operation can be life-saving.

Aorta, Abdominal↗