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Biomedical subjects

J P van Heesewijk

Publications and source records attributed to J P van Heesewijk.

9 recordsLinked to original sources

Acute spontaneous spinal epidural haematoma in a child.

Spontaneous spinal epidural haematomas rarely occur. Patients tend to be in their sixties or seventies. Acute spontaneous spinal epidural haematomas in children without a predisposition for bleeding disorders, trauma, vascular malformations or anticoagulant therapy have seldom been described. We present a case of a 4-year-old girl with a spontaneous cervical epidural haematoma diagnosed with MR.

Acute Disease↗

Impact of microembolism and hemodynamic changes in the brain during carotid endarterectomy.

BACKGROUND AND PURPOSE: Monitoring of carotid endarterectomy with electroencephalography and transcranial Doppler ultrasonography provides instantaneous information about hemodynamic changes and embolic signals. However, a relation between these findings and intraoperative infarcts has not yet been demonstrated. METHODS: In this study we compared preoperative and post-operative computed tomographic scans (58 patients) or magnetic resonance imaging (40 patients) of the brain, assessed by two independent observers, to detect intraoperative infarcts, and we related any such new lesions to the findings of intraoperative monitoring. RESULTS: In the computed tomography series one intraoperative infarct occurred, with corresponding clinical deficits. In the magnetic resonance group four patients developed new lesions that occurred intraoperatively, all of which were clinically silent. There was a significant relation between the number of embolic signals during the surgical dissection of the carotid artery and the occurrence of intraoperative infarcts (P < .005). Three of the four infarcts were of the lacunar type; the fourth patient had a border-zone infarct, associated not only with many embolic signals but also with low flow during cross-clamping. There were no demonstrable ultrasound side effects on brain tissue. CONCLUSIONS: Embolic signals detected by transcranial Doppler monitoring in the dissection phase of carotid endarterectomy show a significant relation to new ischemic lesions and therefore are potentially harmful. The phenomenon should alert the vascular surgeon.

Adult↗

Computed tomography of pleural hyaloserositis.

Pleural hyaloserositis is an uncommon finding on routine chest X-rays. The images may simulate metastatic lesions. Four cases of pleural hyaloserositis are described in which computed tomography (CT) demonstrated calcified pleural pseudotumors.

Aged↗

Psoas abscess and giant fistula twenty-one years after nephrectomy.

Vague abdominal complaints and low back pain are common in modern medicine. We describe the case of a patient who presented these symptoms twenty-one years after a nephrectomy accompanied by persistent elevated erythrocyte sedimentation rate for unknown reason. CT and fistulography showed a psoas abscess and a giant fistula.

Abscess↗