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K L Salzman

Publications and source records attributed to K L Salzman.

9 recordsLinked to original sources
PubMed2006

Early pathologic findings and long-term improvement in anti-Ma2-associated encephalitis.

A 67-year-old man sequentially developed anti-Ma2-associated paraneoplastic encephalitis (PNE) and contralateral herpes simplex encephalitis (HSE). Brain biopsy 1 month before HSE revealed extensive infiltrates of T cells, B cells, and plasma cells. Most T cells expressed the cytotoxic granule-associated protein TIA-1 and the membranolytic protein granzyme-B. Although recovery was thought to be unlikely, treatment of the PNE with corticosteroids and resection of the associated lung cancer resulted in dramatic improvement for 21 months.

Aged↗
PubMed2006

The many faces of facial nerve schwannoma.

BACKGROUND AND PURPOSE: The imaging appearance of facial nerve schwannomas (FNSs) has been described as an enhancing tubular mass (using T1-enhanced MR) within an enlarged facial nerve canal (using CT). The purpose of this study is to identify how often the FNS imaging findings conform to this description and determine whether there are underlying anatomic explanations for the discrepant imaging appearances identified. MATERIALS AND METHODS: The clinical, pathologic, and radiologic records of 24 FNS in 23 patients were retrospectively reviewed. Each FNS was evaluated for location along the facial nerve. The lesions were cataloged by facial nerve segment with the imaging characteristics of each segment described. RESULTS: The average age at time of first imaging was 39 years (age range, 10-70 years). Eighteen (71%) of the 24 FNSs were pathologically confirmed, while the others were determined intraoperatively or diagnostically by the presence of both enlargement of the facial nerve canal and enhancement on contrast-enhanced T1 MR examination. The most common location was in the geniculate fossa (83%), followed by the labyrinthine and tympanic segments of the facial nerve (both 54%). The most common clinical presentation was facial neuropathy (42%). CONCLUSION: The classic description of FNS on enhanced T1 MR is that of a well-circumscribed fusiform enhancing mass along the course of the intratemporal facial nerve with bone algorithm CT showing sharply defined bony canal enlargement. Modern imaging techniques, however, demonstrate the importance of the surrounding anatomic landscape, leading to various imaging appearances. Lesions traversing the labyrinthine segment can demonstrate a dumbbell appearance. When FNSs track along the greater superficial petrosal nerve, they may present as a round mass projecting up into the middle cranial fossa. FNS of the tympanic segment of the facial nerve preferentially pedunculate into the middle ear cavity, clinically presenting as a middle ear mass. When the mastoid segment of the facial nerve is involved, irregular and "invasive" tumor margins seen on MR can be explained on CT as tumor breaking into surrounding mastoid air cells.

Adolescent↗
PubMed2001

Intratemporal facial nerve neuroma: anatomical location and radiological features.

OBJECTIVES: To present the imaging findings and anatomical locations of a series of 88 facial nerve neuromas from two centers over a 30-year period. We describe the salient radiological features of neuromas in each anatomical location and outline the ways in which modern imaging techniques have altered our perception of this entity. STUDY DESIGN: A retrospective review of tumors presenting to two tertiary care referral institutions since 1970. METHODS: The charts and available imaging of patients with the diagnosis of facial neuroma were reviewed. These patients presented to the House Ear Clinic between 1970 and 1994 and to the University of Utah Medical Center (Salt Lake City, UT) between 1986 and August 2000. We examined anatomical location to determine patterns of tumor presentation and compared the findings before and after the era of magnetic resonance imaging (MRI). RESULTS: All segments of the facial nerve were represented. Overall, multiple-segment tumors were almost twice as common (63.6%) as single-segment tumors (36.4%). Before the advent of MRI, all segments of the nerve from the cerebellopontine angle to the tympanic portion were almost equally represented (29.5%-36.3%). After MRI, the geniculate ganglion (68.2%) and labyrinthine portion (52.3%) were by far the most commonly affected areas. Before MRI, there were, on average, 1.89 segments involved per tumor. After MRI, this average number increased to 2.57 segments per tumor. Radiologically, the high-resolution computed tomography and MRI features cannot be generalized. Rather, the imaging features depend on which segments are involved. This is because of the variation in the surrounding anatomical landscape of the facial nerve in its course through the temporal bone. CONCLUSION: The more sensitive imaging provided by newer radiological techniques has altered our perception of facial neuroma. It has provided us with an increased ability to diagnose and fully evaluate this neoplasm preoperatively, allowing improved patient counseling and surgical planning.

Adolescent↗
PubMed2001

Dumbbell schwannomas of the internal auditory canal.

BACKGROUND AND PURPOSE: Benign tumors of the internal auditory canal (IAC) may leave the confines of the IAC fundus and extend into inner ear structures, forming a dumbbell-shaped lesion. It is important to differentiate dumbbell lesions, which include facial and vestibulocochlear schwannomas, from simple intracanalicular schwannomas, as surgical techniques and prognostic implications are affected. In this article, the imaging and clinical features of these dumbbell schwannomas are described. METHODS: A dumbbell lesion of the IAC is defined as a mass with two bulbous segments, one in the IAC fundus and the other in the membranous labyrinth of the inner ear or the geniculate ganglion of the facial nerve canal, spanned by an isthmus. Twenty-four patients with dumbbell lesions of the IAC had their clinical and imaging data retrospectively reviewed. Images were evaluated for contour of the mass and extension into the membranous labyrinth or geniculate ganglion. RESULTS: Ten of 24 lesions were facial nerve dumbbell lesions. Characteristic features included an enhancing "tail" along the labyrinthine segment of the facial nerve and enlargement of the facial nerve canal. Dumbbell schwannomas of the vestibulocochlear nerve (14/24) included transmodiolar (8/14), which extended into the cochlea, transmacular (2/14), which extended into the vestibule, and combined transmodiolar/transmacular (4/14) types. CONCLUSION: Simple intracanalicular schwannomas can be differentiated from transmodiolar, transmacular, and facial nerve schwannomas with postcontrast and high-resolution fast spin-echo T2-weighted MR imaging. Temporal bone CT is reserved for presurgical planning in the dumbbell facial nerve schwannoma group.

Adolescent↗
PubMed1997

Upper extremity bursitis.

Upper extremity bursae are injured through a number of processes, including overuse, hemorrhage, crystal deposition, autoimmune diseases and infection. These injuries may be disabling and can pose significant diagnostic and therapeutic challenges for the clinician. Treatment of the most common forms is directed at pain management and functional rehabilitation through a structured exercise program. Early recognition of infectious bursitis, followed by appropriate surgical and antibiotic treatment, is critical to prevent severe sequelae in these cases. This article reviews the pathophysiology, evaluation and treatment of the three most commonly involved upper extremity bursae: the subacromial, the olecranon and the subscapular bursae.

Bursitis↗
PubMed1996

Lower extremity bursitis.

Bursitis is a common cause of lower extremity pain in patients presenting to primary care physicians. Several bursae in the lower extremity account for most of these injuries, including the ischiogluteal, greater trochanteric, pes anserine, medial collateral, prepatellar, popliteal and retrocalcaneal. Often the symptoms are mild, with the patient successfully self-treating through activity modification and other conservative measures. A systematic approach to the evaluation and treatment of patients with bursitis, including prevention, relative rest, ice, compression, elevation, anti-inflammatory medication and treatment modalities such as ultrasound and electrical stimulation, combined with a structured rehabilitation program, will greatly facilitate the healing process.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Imaging and clinical characteristics of temporal bone meningioma.

BACKGROUND AND PURPOSE: Imaging characteristics of temporal bone meningioma have not been previously reported in the literature. CT and MR imaging findings in 13 cases of temporal bone meningioma are reviewed to define specific imaging features. METHODS: A retrospective review of our institutional case archive revealed 13 cases of histologically confirmed temporal bone meningioma. CT and MR imaging studies were reviewed to characterize mass location, vector of spread, bone changes, enhancement characteristics, and intracranial patterns of involvement. Clinical presenting signs and symptoms were correlated with imaging findings. RESULTS: Thirteen temporal bone meningiomas were reviewed in 8 women and 5 men, aged 18-65 years. Meningiomas were stratified into 3 groups on the basis of location and tumor vector of spread. There were 6 tegmen tympani, 5 jugular foramen (JF), and 2 internal auditory canal (IAC) meningiomas. Tegmen tympani and JF meningiomas were characterized by spread to the middle ear cavity. IAC meningiomas, by contrast, spread to the cochlea and vestibule. Hearing loss was the most common clinical presenting feature in all cases of temporal bone meningioma (10/13). The presence of tumor adjacent to the ossicles strongly correlated with conductive hearing loss (7/9). CONCLUSION: Meningioma involving the temporal bone is rare. Three subgroups of meningioma exist in this location: tegmen tympani, JF, and IAC meningioma. Tegmen tympani and JF meningiomas spread to the middle ear cavity. IAC meningiomas spread to intralabyrinthine structures. Conductive hearing loss is commonly seen in these patients and can be surgically correctable.

Adolescent↗
PubMedDate not supplied

Primary intracranial germ cell tumors: clinicopathologic review of 32 cases.

Primary intracranial germ cell neoplasms are rare tumors and constitute a heterogeneous group. We have reviewed 32 cases, over a 21-year period, from the University of Florida. The cases include 22 germinomas, 6 mixed germ cell tumors, and 4 teratomas. The clinical presentations in these cases were more closely related to the location of the tumor, that is, pineal or suprasellar, rather than the histologic subtype. Neuroimaging evaluation was useful in distinguishing between germinomas, teratomas, and other mixed germ cell tumors (MGCTs), primarily by evaluation of cystic versus solid lesions (teratoma versus germinoma), contents of cysts (teratoma versus MGCT), and infiltrative nature of the tumors (MGCT), although cytologic-histopathologic confirmation remains necessary. Germinomas responded favorably to radiation therapy with survival periods of over 16 years; MGCTs were treated with combination chemotherapy and radiation, with a markedly poorer prognosis. This study underlines the critical significance of histopathologic evaluation of the tumor in determining therapeutic interventions as well as prognosis.

Adolescent↗