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Biomedical subjects

K Pardatscher

Publications and source records attributed to K Pardatscher.

At least 19 recordsLinked to original sources

MR imaging of transverse myelitis using Gd-DTPA.

A patient with subacute transverse myelitis (TM) had MRI studies, including scans after Gd-DTPA administration. The enhancement, with its intensity and persistence, seems to herald residual cord deficits. TM remains a clinical diagnosis of exclusion whereas MRI plays a valuable role in the assessment of the different abnormalities which may produce this syndrome and also defines accurately the location and extent of the intramedullary pathology.

Contrast Media

Traumatic primary brain stem haemorrhage. A clinical and experimental study.

We report 36 cases of post-traumatic "primary brain stem haemorrhage" visualized by the CT scan and confirmed at autopsy. Clinical experience shows that many technical factors influence the inability to visualize brain stem haemorrhages. Experimental injection of fresh blood into the pons and midbrain of cadavers shows that lesions as small as 0.25 ml in volume may be visualized. The volume and the anatomical configuration of traumatic lesions of the brain stem extended over a rostro-caudal direction, and their proximity to bony structures at the base of the skull are obstacles to the visualization of brain stem haemorrhages.

Adolescent

Opto-chiasmatic arachnoiditis in the young.

14 young patients, operated upon for opto-chiasmatic arachnoiditis by craniotomy are presented. 2 main etiopathogenetic forms (and their respective clinical equivalents) of the disease could be recognized. Only 1 postoperative death occurred, in a patient with a dominant clinical picture of intracranial hypertension. Results of surgery (craniotomy and lysis of adhesions) could be distinguished as positive (functional improvement) in 5 cases, indifferent or negative in the others, with a follow-up duration of up to 23 years. The role of the diagnostic value of the pneumoencephalogram as a basis for surgical indication is discussed: it is felt that this examination, when reported as negative, is not of sufficient value to rule out the diagnosis, which must essentially rely upon clinical data.

Adolescent

Spontaneous intracerebral haematomas. Aspects of treatment.

We report on 306 cases of spontaneous intracerebral haematomas located in the supratentorial compartment. 167 patients underwent surgical treatment and 87 died (52.09%); 139 patients were conservatively managed and 30 died (21.5%). We point out some indications and contra-indications to surgical or conservative treatment on the basis of the factors influencing the mortality rate.

Adolescent

[Epidural hematomas in the infant].

A report is given on eight cases of epidural haematoma in children aged 0 to 2 (11 per cent of a total of 70 epidural haematomas found in children). The individual clinical phenomena and courses of the disease are shown on the basis of our own patients. The prognosis of epidural haemorrhages is more favourable for such children than for older children and adults.

Brain Injuries

Traumatic posterior fossa haemorrhage in children.

We report ten cases of post-traumatic posterior fossa haemorrhage occurring in children. All patients were studied by CT scan. Five had an intracerebellar haemorrhage, three a brain stem haemorrhage, and two an extradural haematoma. In four cases we have found the coexistence of supratentorial and infratentorial haemorrhagic lesions. The incidence of posterior fossa haemorrhage in children, the importance of linear occipital fracture, the clinical course, the conservative or surgical treatment, and the prognosis are discussed.

Brain Injuries

[Computerized tomography in diffuse post-traumatic brain damage].

Among 851 patients admitted following a head injury at the Neuroradiological Service and Neurosurgical Department of the University Hospital of Padua from January 1979 to June 1981, 51 presented a diffuse damage of the white matter of the brain. The CT scan, the only neuroradiological method able to show such a lesion, does never reveal large lesions but only minimal alterations of the cerebral parenchyma, opposite to the severity of clinical picture. We discuss the etiopathogenetic, anatomopathologic and neuroradiologic aspect of diffuse brain damage, emphasizing, the technical difficulties in the demonstration, on CT scan, of some lesions, particularly at the level of the brainstem.

Adolescent

Posttraumatic intraventricular haemorrhages.

Of a series of 350 patients studied for blunt head trauma by CT scan 10 were found to have an intraventricular haemorrhage (IVH); in 8 cases we could find concomitant CT abnormalities as well as intracerebral contusion or haemorrhage, and in two cases no other CT abnormality was noted. CT scan represents the first reliable and non-surgical tool for identifying this process. Two possible mechanisms that govern the formation of an IVH are postulated: a) an erosion of the ventricular wall by an intracerebral haemorrhage; b) the rupture of subependymal veins deformed by the negative pressure following dilatation of the ventricular wall. The prognosis in our cases is severe.

Adolescent

[The diagnostic value of the CT scan in subarachnoid haemorrhage from intracranial aneurysms (author's transl)].

Fifty cases of subarachnoid haemorrhage from aneurysms are reported. Computer tomography gave direct evidence of aneurysm in 13 cases and indirect signs in 25 cases. In the remaining 12 cases the aneurysm could not be located. Apart from this we were able to demonstrate 16 intraventricular haemorrhages, 16 intracerebral haemorrhages, six cases of oedema of the brain, nine subarachnoid haemorrhages and, finally on 31 occasions enlargement of the ventricles. The role of the CT scan has been investigated in terms of its value in the planning and execution of surgical treatment.

Brain Edema

Gliomas of the optic nerve and chiasm. A clinical review.

A series of 24 children with anterior optic gliomas, observed and for the most part operated upon in a neurosurgical service, is reviewed. A low incidence of unilateral nerve tumors and of associated neurofibromatosis, and a rather high frequency of precocious or pseudoprecocious puberty were noted in comparison with other series. Most tumors were low-grade growths. The results of surgical treatment reflect a good prognosis for unilateral tumors and an increasing prognostic ominousness for the posterior neoplastic development. Cerebrospinal fluid shunts and radiation treatment do have a role as adjuncts to surgical exploration and biopsy, which are generally indicated since no preoperative test seems to grant an absolute diagnosis. The opinion that chiasmal tumors should not be treated at all is not shared. When the treatment of an illness falls as far short of the ultimate, as does the therapy of neoplastic disease, then it is necessary to reconsider frequently the principles upon which it is based and the results it achieves. These results are two-fold, curative and palliative and, while our efforts are directed toward the former, we realize only too frequently that the best results will sometimes lie in palliation. The disappointment in accepting this lesser goal must not allow us to underestimate its importance or neglect the help it may give.

Adolescent

Cerebral arteriovenous malformations in children (56 cases).

A survey of 56 patients aged less than or equal to 16 years, admitted (1954-1979) for cerebral arteriovenous malformations, is presented. The clinical manifestation was mostly related to hemorrhage, less frequently to epilepsy or to a cerebral 'steal' syndrome. The most frequent site was the parietal lobe, with supply from the middle cerebral artery. Deep malformations were not uncommon and most lesions were of medium or large size. 38 patients were operated upon, and 18 were given treatment other than surgical (including radiotherapy). 23 malformations were completely excised, in 4 patients only a partial excision could be carried out, and in 10 patients surgery consisted of occlusion (clipping or coagulation) of feeding vessels. In 1 patient, surgery had to be limited to removal of an intracerebral hematoma. The immediate and long-term results of treatment are much better in the surgical than in the nonsurgical group.

Adolescent