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Biomedical subjects

J P Glass

Publications and source records attributed to J P Glass.

At least 19 recordsLinked to original sources
PubMed1998

High-dose gadolinium-enhanced MRI for diagnosis of meningeal metastases.

We compared high-dose (0.3 mmol/kg) and standard-dose (0.1 mmol/kg) gadolinium-enhanced MRI for diagnosis of meningeal metastases in 12 patients with suspected meningeal metastases. They were imaged with both standard-dose and high-dose gadolinium. All patients with abnormal meningeal enhancement underwent at least one lumber puncture for cerebrospinal fluid (CSF) cytology, while patients with normal meningeal enhancement were followed clinically. All patients with negative CSF cytology also were followed clinically. A single observer reviewed all the images, with specific attention to the enhancement pattern of the meninges. Abnormal leptomeningeal enhancement was present in three cases, and abnormal pachymeningeal enhancement in three other patients. All of these patients had abnormal CSF analyses. In two of the three cases of abnormal leptomeningeal enhancement the disease was more evident on high-dose than on standard-dose imaging; in one case the abnormal enhancement was visible only on high-dose imaging. In one of the three cases with abnormal pachymeningeal enhancement, the disease was evident prospectively only with high-dose imaging.

Adult↗
PubMed1996

MRI in hemiballismus due to subthalamic nucleus hemorrhage: an unusual complication of liver transplantation.

A 60-year-old man developed hemiballismus due to an intracranial hemorrhage involving the subthalamic nucleus 8 weeks after orthotopic liver transplantation. The hemorrhage was thought to be due to alterations in cerebral blood flow following a period of hypotensive shock due to sepsis, in the presence of anticoagulant therapy and thrombocytopenia. This represents a rare neurologic complication of liver transplantation.

Cerebral Hemorrhage↗
PubMed1996

Gliomatosis cerebri presenting with optic nerve involvement: MRI.

Gliomatosis cerebri is a rare form of astrocytoma characterized by extreme infiltration of the brain structure in conjunction with a relative paucity of clinical findings. We describe the MRI findings in a patient with gliomatosis cerebri widely infiltrating the brain who presented with symptoms related to involvement of the optic nerves and chiasm. Contrast-enhanced MRI showed enlargement of the optic nerves and chiasm with pathological enhancement; T2-weighted images showed extensive infiltration of the brain by tumor. Histopathologic examination of the biopsy specimen showed anaplastic astrocytoma with gemistocytic predominance and a diagnosis of gliomatosis cerebri was reached.

Adult↗
PubMed1996

Pure motor hemiplegia including the face induced by an infarct of the medullary pyramid.

Four autopsy cases of pure motor hemiparesis due to medullary pyramid infarcts have been previously reported. The deficits that were described included overt limb weakness and "slight facial weakness". According to current neurological teaching, the lesion responsible for an upper motor neuron facial palsy affects the corticobulbar tract at the level of the midpons or more rostrally.

Aged↗
PubMed1993

The diagnosis and treatment of stroke in a patient with cancer: nonbacterial thrombotic endocarditis (NBTE): a case report and review.

Stroke in patients with cancer is different in terms of its etiology from stroke in the general population. Clinicians should be altered to the possibility of non-bacterial thrombotic endocarditis (NBTE), associated coagulopathy, and viable treatment options. We review the case of a 42-year-old woman with cerivcal carcinoma and no risk factors for stroke who suddenly developed difficulty with speech and right-sided sensory changes. Her complete work-up and course are addressed.

Adult↗
PubMed1993

Uncovering ocular pseudomyasthenia.

A 61-year-old woman who presented with unilateral ptosis and subsequently a lateral rectus weakness was followed for 2.5 years with the diagnosis of ocular myasthenia. Signs then developed that led to the discovery of a cavernous sinus meningioma. When ruling out ocular myasthenia, the importance of checking for diminished corneal sensation, an anisocoria that increases in the light, and aberrant regeneration of the third cranial nerve is pointed out.

Blepharoptosis↗
PubMed1987

Syncope and hypotension due to carcinoma of the breast metastatic to the carotid sinus.

Tumors involving the carotid sinus and glossopharyngeal nerve may produce syncope due to bradycardia and hypotension. Carotid sinus syncope unrelated to cancer is usually caused by bradycardia and responds to control of the heart rate. When neoplastic disease involves the carotid sinus, vasodepressor hypotension, with or without bradycardia, is more common. Control of the heart rate alone is not effective. Although this syndrome is not common, it is probably not recognized in milder forms. Most patients in whom this syndrome develops have cancer of the head and neck. A patient with breast carcinoma metastatic to the neck and carotid sinus is described in whom syncope with hypotension and bradycardia developed. Although a temporary cardiac pacemaker controlled bradycardia, severe hypotensive episodes recurred despite treatment with anticholinergic and sympathomimetic drugs. The pathophysiology and therapy of this syndrome in patients with cancer are reviewed.

Aged↗
PubMed1987

Central nervous system complications of a newly recognized subtype of leukemia: AMML with a pericentric inversion of chromosome 16.

Ten patients with acute myelomonocytic leukemia (AMML) and inversion of chromosome 16 who had CNS involvement were identified at M.D. Anderson Hospital between January 1972 and December 1984. The nervous system signs and symptoms were evaluated in detail. CT scans, CSF cytologies, and treatment modalities were reviewed. Two patients underwent biopsies of lesions that proved to be granulocytic sarcomas. AMML with inversion 16 carries a much higher (33%) incidence of CNS involvement in the form of leptomeningeal metastasis and/or granulocytic sarcoma than all other acute nonlymphocytic leukemias (5%). The reason for this appears to be related to the chromosomal aberration and not to prolonged survival.

Adult↗
PubMed1987

Regional nerve injury after intra-arterial chemotherapy.

Eleven patients at M.D. Anderson Hospital were referred for neurologic evaluation after having their internal or external iliac arteries catheterized for the treatment of localized pelvic or lower extremity tumors. Nine patients developed lumbosacral plexopathies and two patients, mononeuropathies. All symptoms occurred within 48 hours of the intra-arterial infusion. All patients received cis-dichlorodiammine-platinum (cisplatin; CDDP) intra-arterially, alone or in combination with other agents. Follow-up examinations revealed that only one patient had made partial recovery from the neurologic dysfunction. Chemotherapy-induced small vessel injury, with subsequent plexus or nerve infarction, appears to be the most likely cause, although a direct neurotoxic effect of CDDP cannot be excluded.

Adult↗
PubMed1986

Treatment-related white matter changes in cancer patients.

Forty cancer patients with bilateral diffuse cerebral white matter hypodensities on computerized tomography (CT) scan were reviewed. Brain irradiation and/or chemotherapy were considered responsible for the CT abnormalities in all patients but one, whose changes were presumably due to demyelination related to the aging process. Among these 39 patients, 7 had clinical symptoms of leukoencephalopathy. Two patients had acute transient leukoencephalopathy, and one of them experienced permanent neurologic changes after continuing treatment. Six additional patients had delayed leukoencephalopathy. The interval between whole-brain irradiation (WBXRT) alone and the CT detection of white matter hypodensities was almost always longer than 1 year. This interval was shortened to less than 1 year in a significant number of patients when WBXRT was followed by various chemotherapeutic protocols. More importantly, there was an increased incidence of clinical leukoencephalopathy. A higher incidence of clinical leukoencephalopathy in patients receiving intracarotid chemotherapy in the treatment of brain tumors and in patients receiving combination chemotherapy for central nervous system relapse of adult leukemia suggests a need for further investigation.

Adult↗
PubMed1986

Treatment-related leukoencephalopathy. A study of three cases and literature review.

The etiology and pathogenesis of treatment-related leukoencephalopathy remain obscure. The evidence is substantial, however, that radiation therapy in combination with higher cerebral concentrations of certain chemotherapeutic agents such as MTX increases the likelihood of permanent damage. There is no therapy of apparent benefit for treatment-related leukoencephalopathy, but reasonable alternatives include 1) withholding chemotherapy and/or radiation, 2) administering calcium leucovorin in high doses intravenously in methotrexate-induced leukoencephalopathy (26), or 3) perfusing the subarachnoid space (2) from above through an Ommaya reservoir and out from below through a lumbar puncture needle or lumbar subarachnoid catheter. Because CT scan abnormalities and subtle mental or intellectual changes are often noted before the full-blown clinical presentation, a prospective study involving periodic CT scanning as well as formal neuropsychologic testing appears worthwhile in all patients who are to receive cranial irradiation and/or chemotherapy in the prophylaxis or active treatment of CNS disease in order to detect and perhaps even to prevent this adverse side effect of cancer therapy.

Adolescent↗
PubMed1985

Medulloblastoma in infants and children: computed tomographic follow-up after treatment.

Thirty-six proven cases of medulloblastoma were reviewed by serial CT follow-up examinations from 4 months to 10 years, 2 months after the initial diagnosis, with a mean follow-up time of 3 years, 9 months. The children ranged in age from 10 months to 16 years, 7 months at the time of follow-up. The tumor recurred at the primary site in 20 cases (56%). Leptomeningeal metastasis was demonstrated on CT in 14 cases (39%); seven of these patients also presented with solid subarachnoid metastases. Thirteen patients (36%) showed evidence of severe brain atrophy, which was confined to the posterior fossa in seven of the 13. Calcification resulting from mineralizing microangiopathy developed in five cases (14%), including three patients who had extensive dystrophic calcification in the corticomedullary junction and the deep-seated nuclei of the cerebrum and cerebellum. Only one case of leukoencephalopathy was observed. The patterns of tumor recurrence in the posterior fossa that is severely deformed by surgery and other treatment modalities and leptomeningeal spread of tumor are discussed.

Adolescent↗
PubMed1985

Metoclopramide-induced phantom dyskinesia.

A 58-year-old woman was receiving chemotherapy for carcinoma of the breast. She was given 1,700 mg metoclopramide IV for 2 months to prevent nausea and vomiting. Within hours after metoclopramide was given, she had hand tremor, akathisia, and truncal and orofacial dyskinesia. These symptoms resolved, but she was left with persistent shoulder stump chorea, the perception of the phantom left arm involuntarily adducted at the shoulder and flexed at the elbow, and dystonic pronation and extension of the hand away from her body. The motor aspects of the phantom dyskinesia will be emphasized.

Amputation, Surgical↗
PubMed1985

Neurologic complications of a coral snake bite.

A 27-year-old man was bitten by a coral snake in Mexico. Within 24 hours he had ptosis, dysphonia, difficulty chewing, and limb weakness. His symptoms peaked at 72 hours with loss of ambulation. Neurologic examination was consistent with severe myasthenia. Repetitive stimulation of the median nerve showed a postsynaptic defect that was not corrected by edrophonium. He was monitored in an intensive care unit, but received no antivenom globulin or acetylcholinesterase inhibitors. The syndrome abated in 3 weeks.

Adult↗