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M D Hourihan

Publications and source records attributed to M D Hourihan.

30 records · Page 2Linked to original sources
PubMed1991

Computed tomography of the brain: does contrast enhancement really help?

The contribution of intravenous contrast medium to the final diagnosis was assessed in 300 patients undergoing routine axial computed tomography (CT) of the brain. Two-hundred-and-twelve patients presented with symptoms or signs suggesting focal intracranial pathology and 88 with non-focal features. A total of 110 post-contrast scans were abnormal. The differential diagnosis was altered in 15 patients (5%) following contrast enhancement, 13 of whom presented with focal symptoms and signs. In three patients with normal plain scans and symptoms and signs suggesting focal intracranial pathology abnormalities were only seen after contrast medium and in only one was the lesion surgically treatable. In a further 15 patients (5%) contrast enhancement increased the certainty of the diagnosis that had been made on the uncontrasted scan. We feel that when the uncontrasted scan is normal contrast enhancement is only helpful in a limited number of patients with symptoms and signs suggesting focal intracranial pathology. Contrast enhancement is still important in differentiating abnormalities seen on the unenhanced scan even with modern high resolution CT scanners.

Brain↗
PubMed1991

Non-secretory adenomas of the pituitary treated by trans-ethmoidal sellotomy.

A consecutive series of 35 clinically non-secretory pituitary adenomas treated surgically by the transethmodial approach is presented. Mean age at presentation was 60 years, with a male-to-female ratio of 2:1. These tumours present later than hormone secreting tumours: 90% were over 2 cm in diameter at operation. Seventy-one per cent of patients had impaired vision and 89% had hypopituitarism. Surgical treatment relieved or significantly improved visual fields in 79% of patients with impaired vision. Ninety-one per cent required permanent hormone replacement. Mean follow-up was for 4.4 years. Five tumours recurred, causing recurrent visual symptoms. No tumours recurred in those patients treated with postoperative radiotherapy, but follow-up in this group was only for a mean of 2.7 years.

Adenoma↗
PubMed1990

Radiological assessment of hemifacial microsomia by three-dimensional computed tomography.

Hemifacial microsomia (HFM) is the commonest asymmetrical craniofacial deformity leading to underdevelopment of the craniofacial skeleton and soft tissues on the affected side. Timing of reconstructive surgery is based on a comprehensive analysis and classification of the deformity. Lateral cephalometric radiographs are of limited value because of superimposition of normal and abnormal bony structures. The skeletal and soft-tissue findings of six patients with HFM who underwent three-dimensional (3D) CT are presented. This method allows a comprehensive assessment of the deformity at a low radiation dose, 22% of that of a conventional CT scan, by the use of a low dose technique.

Adolescent↗
PubMed1989

Localisation of intraocular and intraorbital foreign bodies using computed tomography.

Accurate localisation of foreign bodies in the region of the orbit is vital for correct management. Fifteen patients with such foreign bodies are described. Computed tomography (CT) of the orbits proved accurate in differentiating extraocular and intraocular foreign bodies, and in localisation within the globe. If a foreign body is visible on a plain radiograph, axial 6 mm thick CT sections will demonstrate it in all cases. If plain radiographs are negative or equivocal, 3 mm thick CT sections are necessary. Coronal scans are of limited usefulness.

Adolescent↗
PubMed1989

The diagnosis of tumours involving the parapharyngeal space by computed tomography.

Tumours arising within or adjacent to the parapharyngeal space are usually large at presentation and present difficulties in the choice of surgical approach. The findings on contrast-enhanced computed tomography (CT) of 30 patients with mass lesions in this region are presented. Contrast-enhanced CT can provide reliable information regarding the size and extent of a mass, its site of origin and likely histological type, as well as its relationship to surrounding neurovascular structures.

Carcinoma, Squamous Cell↗
PubMed1988

Spontaneous carotid cavernous fistula in Ehlers Danlos syndrome.

A patient is described with Ehlers Danlos syndrome presenting with spontaneous carotid cavernous fistula, in whom there was biochemical evidence for defective type III collagen synthesis. Despite the risks associated with arterial manipulation, the fistula was successfully closed by interventional neuroradiology and the patient has since remained well. This outcome is in contrast with the results in previous reports.

Adult↗
PubMed1987

Intracranial angiolipoma.

Fat containing tumours within the central nervous system are rare. The second reported case of intracranial angiolipoma is described.

Aged↗
PubMed1986

Cerebellar haemangioblastoma and von Hippel-Lindau disease.

Von Hippel-Lindau disease is an autosomal dominant multisystem disorder, the commonest presenting manifestations of which are haemangioblastomas of the cerebellum and retina. Affected individuals are at risk of developing a number of other lesions, the most serious of which are renal carcinoma, haemangioblastomas elsewhere in the central nervous system and phaeochromocytoma. Patients with this disease can therefore present to a number of disciplines during their lifetime and unless the possibility of von Hippel-Lindau disease is considered, the patient may wrongly be assumed to have an isolated lesion. Twenty patients with cerebellar haemangioblastomas were seen between 1972 and 1985; the diagnosis of von Hippel-Lindau disease was subsequently established in 8. Although the diagnosis had not previously been considered, in retrospect 7/8 cases were known to be at risk of this syndrome. These cases came from 7 families and an additional 4 relatives are also known to have been affected. Mean age of presentation for the various manifestations of von Hippel-Lindau disease, each of which occurred in one or other of our cases, has been calculated from 9 of our patients and 107 others reported in the literature. Clinically significant manifestations almost invariably developed before the age of 50 years. Limited screening of our index cases and their at-risk relatives demonstrated one asymptomatic renal carcinoma. We propose a protocol for screening all individuals at risk of von Hippel-Lindau disease, which involves annual retinal examination from five years, and biennial computerized tomography of the head and abdomen from fifteen and twenty years, respectively.

Adolescent↗
PubMed1984

Subarachnoid hemorrhage in childhood and adolescence.

The authors have reviewed 167 cases of subarachnoid hemorrhage (SAH) occurring in patients aged 20 years and younger in a 23-year period. The modes of presentation and etiology of SAH are similar in childhood and adolescence and in the adult population, but there was a different incidence of the specific pathology producing the bleeding in this series. Twenty-six percent of cases were due to bleeding arteriovenous malformations, 52% were due to ruptured aneurysms, and in 19% no cause was found. Aneurysms in this young age group differed in several important respects from those in the adult population: there was a male predominance, a higher incidence of internal carotid bifurcation aneurysms was seen, and multiple aneurysms were encountered less commonly.

Adolescent↗