PubMed Health⌕ Search

Biomedical subjects

M A Weinstein

Publications and source records attributed to M A Weinstein.

At least 55 records · Page 3Linked to original sources
PubMed1983

Digital subtraction angiography in the evaluation of intracranial and extracranial vascular disease.

Digital subtraction angiography (DSA) is a method of visualizing the vessels of the body with the intravenous injection of contrast material. Improvements in computers, television systems, and image intensifiers have contributed to the increased image quality of DSA. With DSA, the vessels such as the carotid bifurcations and the intracranial vasculature can be visualized with a 2-3% concentration of contrast material, while with conventional angiography, the concentration of contrast in vessels is 40-50%. Using IV DSA, visualization of the carotid bifurcations is of good or excellent quality 85% of the time. In a high percentage of these cases, IV DSA replaces conventional angiography, although for imaging of the intracranial vessels, IV DSA is not as good as conventional angiography. In most tumor patients, however, conventional intracranial angiography is not needed because IV DSA combined with computed tomography gives sufficient information.

Angiography↗
PubMed1983

Ileostomy prolapse repair utilizing bidirectional myotomy and a meshed split-thickness skin graft.

The correction of an ileostomy prolapse by a modification of the technique of skin-grafted ileostomy as originally introduced by Dragstedt and emphasized by Turnbull and Weakley is reported. The operation is simple, safe, and effective, and provides a new dimension for the correction of a heretofore difficult and frustrating problem. A total of four patients have been similarly managed successfully with no recurrences in 1 to 4 years of follow-up.

Adult↗
PubMed1983

Intravenous digital subtraction angiography of the intracranial veins and dural sinuses.

When combined with computed tomography, IV DSA is usually of sufficient quality to replace conventional angiography in most patients with abnormalities of the larger intracranial veins and sinuses. Preoperatively, IV DSA can be used to evaluate normal anatomic variations of venous outflow to determine what sinuses can be safely occluded if necessary in the region of the temporal bone, jugular fossa, and base of the skull. Patients with glomus jugular tumors and carotid-cavernous fistulas also need conventional angiograms to define the feeding vessels of these lesions for obliteration by embolization or surgery.

Brain↗
PubMed1983

Intravenous digital subtraction angiography: peripheral versus central injection of contrast material.

Central and peripheral intravenous injections of contrast material for digital subtraction angiography were compared in 30 patients. With 40 ml of contrast material, visualization of the carotid bifurcations was as good with the peripheral as with the central injection. A more consistently high-quality examination of the small intracranial vessels was obtained with the central injection.

Arm↗
PubMed1983

Intra-arterial digital subtraction angiography of the head and neck.

Intra-arterial digital subtraction angiography (IA DSA) was compared with conventional film/screen angiography in 70 patients with suspected atherosclerotic disease or intracranial disease. It was found that, although the contrast detectability of IA DSA was superior to that of conventional angiography, its spatial resolution was not as great. In all 70 cases, however, the spatial resolution of IA DSA was satisfactory for diagnosis, and it is concluded that the increased spatial resolution of conventional angiography should be necessary only in rare circumstances. The main disadvantage of IA DSA is the smaller field size, and it has several advantages over conventional film/screen angiography: (a) it is safer, since less contrast material is needed to visualize large vessels; (b) costs are lower since the magnetic recording tape and hard copies result in a savings of between $45 and $140 per examination; and (c) there is less need for darkroom personnel and film storage.

Aorta, Thoracic↗
PubMed1983

Nuclear magnetic resonance imaging of the spine.

Forty subjects were examined to determine the accuracy and clinical usefulness of nuclear magnetic resonance (NMR) examination of the spine. The NMR images were compared with plain radiographs, high-resolution computed tomograms, and myelograms. The study included 15 patients with normal spinal cord anatomy and 25 patients whose pathological conditions included canal stenosis, herniated discs, metastatic tumors, primary cord tumor, trauma, Chiari malformations, syringomyelia, and developmental disorders. Saturation recovery images were best in differentiating between soft tissue and cerebrospinal fluid. NMR was excellent for the evaluation of the foramen magnum region and is presently the modality of choice for the diagnosis of syringomyelia and Chiari malformation. NMR was accurate in diagnosing spinal cord trauma and spinal canal block. The normal disc was seen, but with rare exceptions bulging of the annulus and herniation of the nucleus pulposus were not visualized.

Adolescent↗
PubMed1983

Computed tomographic, myelographic, and operative findings in patients with suspected herniated lumbar discs.

Fifty patients presenting with a suspected herniated lumbar intervertebral disc were evaluated with sector computed tomography (CT). Excluded from this series were patients with prior lumbar laminectomy or a clinical diagnosis of lumbar canal stenosis. Forty-six of the patients also underwent preoperative lumbar myelography. All patients subsequently underwent laminectomy. In 40 patients (80%), CT was positive. In the remaining 10 patients (20%), it was negative; in this group the myelogram correctly predicted the lesion in 8 (80%). Sector CT correctly predicted the nature of the lesion in 24 patients (48%), was incorrect in 14 (28%), and gave incomplete findings in 12 (24%). CT was most accurate when it demonstrated a disc protrusion as the only finding. In this group, sector CT correctly predicted the operative findings in 24 of 25 patients (96%). CT was less accurate when spondylitic compression was diagnosed. This study suggests that sector CT is a useful test in the evaluation of patients with sciatica and that, when a soft herniated disc is demonstrated on CT, myelography may be omitted.

Adult↗
PubMed1983

Magnetic resonance imaging of the cervical spine: technical and clinical observations.

Seventy-two patients were examined to determine the clinical potential for magnetic resonance imaging (MRI) of the spine. MRI using different pulse sequences was compared with plain radiography, high-resolution computed tomography, and myelography. There were 35 normal patients; pathologic conditions studied included canal stenosis, herniated disk, metastatic tumor, neurofibroma, trauma, Chiari malformation, syringomyelia, arteriovenous malformation, and rheumatoid arthritis. MRI provided sharply defined anatomic delineation and tissue characterization. It was diagnostic in syringomyelia and Chiari malformation and was useful in the evaluation of trauma and spinal canal block from any cause. MRI was sensitive to degenerative disk disease and infection. The spin-echo technique, with three pulse sequence variations, seems very promising. A short echo time (TE) produces the best signal-to-noise ratio and spatial resolution. Lengthening the TE enhances differentiation of various tissues by their signal intensity, while the combined increase of TE and recovery time (TR) produces selective enhancement of the cerebrospinal fluid signal intensity.

Arnold-Chiari Malformation↗
PubMed1983

Digital subtraction angiography in the evaluation of cerebrovascular disease.

Intravenous DSA provides a safe, accurate, and cost-effective means of examining the extracranial and intracranial vasculature on an inpatient or outpatient basis. Intra-arterial DSA provides better spatial resolution than IV-DSA and has advantages over conventional film-screen angiography. The authors demonstrate the applications and limitations of this revolutionary diagnostic technique.

Carotid Artery Diseases↗
PubMed1982

Intravenous digital subtraction angiography in brain ischemia.

Recent advances in computer and radiological technology have permitted a reassessment of intravenous (IV) angiography in the evaluation of extracranial and intracranial vessels. This report reviews our initial experience with IV digital subtraction angiography in the diagnosis and treatment of brain ischemia. Two hundred seventy-three IV digital subtraction angiograms (146 extracranial, 127 intracranial) were performed on a total of 178 patients with suspected cerebral ischemia (159 patients), brainstem/cerebellar ischemia (13 patients), or asymptomatic bruit (six patients). Extracranial studies clearly demonstrated ulceration, stenosis, and occlusion of the carotid arteries. Intracranial studies usually detected major artery occlusive disease and provided insight into the collateral flow patterns. Intravenous digital subtraction angiography allowed the accurate assessment of arteries after carotid endarterectomy and brain bypass surgery. Although conventional angiography was usually recommend in patients treated surgically, IV digital subtraction angiography obviated the need for conventional studies in the initial evaluation of many patients.

Arterial Occlusive Diseases↗
PubMed1982

The levator syndrome and its treatment with high-voltage electrogalvanic stimulation.

Electrogalvanic stimulation by means of a specially designed rectal probe is a simple, safe, and effective modality of treatment for patients with levator spasm. It probably acts by overstimulating and overcontracting the levator muscles and thereby fatiguing them. Results were excellent in 69 percent of the patients, good in 21 percent, and poor in only 10 percent. We recommend electrogalvanic stimulation as the primary treatment of levator spasm in which a neurologic cause cannot be documented.

Aged↗
PubMed1982

The use of digital subtraction angiography in the evaluation of carotid cavernous sinus fistulas.

Intravenous digital subtraction angiography (IV-DSA) is a safe, rapid procedure that can be performed on an outpatient basis and provide diagnostic information comparable to conventional angiography. This paper reviews the initial experience with intravenous digital subtraction angiography in the evaluation of five cases of carotid cavernous sinus fistula, digital subtraction angiography.

Angiography↗
PubMed1982

Sector computed tomographic spine scanning in the diagnosis of lumbar nerve root entrapment.

The diagnosis of lumbar nerve root entrapment was made by sector computed tomography (CT) scanning in 25 patients whose myelograms were normal at the site of the CT scan abnormalities. Sector CT scanning demonstrates preoperatively which neural foramina are narrow. This information, correlated with the patient's history and physical examination, indicates which foramina should be operated on and prevents unnecessary exploration of normal neural foramina. CT findings were confirmed surgically in 14 patients. Eleven of these 14 patients had excellent postoperative results and remain pain free.

Adult↗