Biomedical subjects

M Deck

Publications and source records attributed to M Deck.

At least 19 recordsLinked to original sources

PubMed2001

Unusual appearance of an en plaque meningioma of the cervical spinal canal. A case report and literature review.

STUDY DESIGN: A case report of a patient with cervical spinal cord and nerve root compression caused by a meningioma en plaque together with calcification of the posterior longitudinal ligament is presented,with a review of the literature. OBJECTIVE: To present the diagnosis of a calcified dural meningioma en plaque, with extradural extension into the ligamentum flavum, in a woman with cervical myelopathy and neuropathy. SUMMARY OF BACKGROUND DATA: This case demonstrates that the cervical spine can be involved in dural meningioma en plaque with calcifications, in a manner mimicking ossification of the ligamentum flavum, which has never been previously reported. METHODS: A patient presenting with cervical cord and nerve root compression caused by ossification of the posterior longitudinal ligament and a concurrent calcified dural meningioma en plaque was treated surgically and has made a gradual recovery. Imaging studies,surgical findings, and histopathologic evaluation were analyzed to support the diagnosis. RESULTS: At surgery, ossification of the posterior longitudinal ligament was noted, along with a calcified lesion involving the posterior cervical dura and the adjacent ligamentum flavum. A calcified meningioma was diagnosed by histopathologic examination of the dural-based lesion. CONCLUSION: Although previously not described, the diagnosis of calcified dural meningioma en plaque should be considered in all patients presenting with spinal cord and/or nerve root compression,even at cervical levels. Although ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum are more common etiologies of partially circumferential spinal calcification, dural-based meningiomas with extension into the surrounding ligaments demand early recognition because they can be associated with a poorer prognosis.

Cervical Vertebrae↗

PubMed1996

Induction and subsequent rupture of aneurysms of the circle of Willis after radiation therapy in Ehlers-Danlos syndrome: a plausible hypothesis.

Multiple aneurysms of the circle of Willis developed in a 62-year-old woman with Ehlers-Danlos syndrome (EDS) within 7 months of initiation of radiation therapy to the brain. A major response of the arterial wall to radiation damage is the formation of collagen. In patients with EDS, in whom there is a defect in collagen, this repair is incomplete. We propose that the incomplete repair of the arterial wall consequent to EDS resulted in weakness of these walls, formation of an aneurysm, and, ultimately, fatal subarachnoid hemorrhage.

Aneurysm, Ruptured↗

PubMed1988

Cognitive impairment in schizophrenia: specific relations to ventricular size and negative symptomatology.

A number of studies of schizophrenia have demonstrated associations between cognitive impairment and both cerebral ventricle size and negative symptomatology. The nature of these associations, however, have been obscured by interstudy differences in the assessment of cognitive functioning and by the lack of function-related specificity in measures of structural brain abnormality. In this study, 28 SCID-diagnosed chronic schizophrenic inpatients were administered a brief comprehensive battery of neuropsychological tests, a computed tomography (CT) scan, and were rated for positive and negative symptomatology. Enlarged ventricle-to-brain ratio (VBR) of the anterior portion of the lateral ventricles, the frontal horns, was found to be related to deficits in general intellectual level, conceptual thinking, immediate verbal memory, and psychomotor speed. VBR of the more usually studied bodies of the lateral ventricles was associated only with deficits in verbal memory and motor speed. VBRs were unrelated to both positive and negative symptom measures in this sample. Results suggest that more widespread impairment of schizophrenics' cognitive functioning may be related to structural abnormality within the frontal lobes, complementing recent findings linking structural and metabolic abnormalities of this area of the brain to the disease itself.

Adult↗

PubMed1988

Bilateral cholesterol granuloma of the skull base: case report and review of the literature.

A unique case of bilateral cholesterol granuloma of the skull base and its treatment is presented. Cholesteatoma, a pathological entity often confused with cholesterol granuloma, is differentiated from cholesterol granuloma. Cholesterol granuloma is not rare. This tumor seems to derive from an inflammatory process at the skull base that results in bony erosion surrounding a cyst wall of inflammatory tissue. Neurological abnormalities reflect the location of the tumor in relation to the brain stem. Radiographically, the cyst wall enhances with the administration of i.v. contrast agent, and the center of the lesion is isodense with brain on computed tomography, unlike cholesteatoma. Magnetic resonance imaging characteristics are currently being defined. At operation, cholesterol granuloma consists primarily of a viscous fluid within a capsule of inflammatory tissue. Treatment requires establishing a pathway for drainage of the granuloma. The advantages of transsphenoidal, transclival drainage of such lesions are outlined.

Adult↗

PubMed1987

Magnetic resonance imaging in choroidal tumors.

Magnetic resonance imaging (MRI) was performed on 13 patients with choroidal tumors to determine whether this technique could detect and portray an intraocular tumor and to investigate additional biochemical parameters of the diseased tissue. In 11 of 13 patients, the lesion was depicted, and its gross morphology was outlined with a clarity approaching that of computed tomography. We were able to apply principles derived from MRI studies in other portions of the body and identify trends in the characterization of lesions of different etiologies. The relative T1 and T2 values for each of the major pathologic categories (malignant melanoma, metastatic carcinoma, and benign choroidal lesions) are presented and discussed. In addition, MRI was clearly superior to other techniques in the detection and delineation of associated intracranial lesions.

Choroid Neoplasms↗

PubMed1986

Value of magnetic resonance imaging in the evaluation of patients with complete and high degree block due to intracanal neoplasm.

Magnetic resonance imaging (MRI) of 26 patients with high degree or complete epidural and/or intradural myelographic block, due to primary or secondary neoplasm were analysed. The ratio of false negative MRI was 11.5 per cent. MRI findings were considered to be indicative of lesser block than indicated by myelography in almost 50 per cent of patients. Correlation between the two modalities was highest in cases associated with significant vertebral collapse, malalignment and angulation of the spine and angulation of the spinal cord.

Humans↗

PubMed1985

Magnetic resonance imaging in the evaluation of leukocoria.

Leukocoria is an important clinical sign in ophthalmology. Conditions producing this white pupillary reflex must be differentiated from retinoblastoma to insure appropriate and timely treatment. Auxiliary diagnostic testing has been helpful in securing a clinical diagnosis. A new diagnostic modality, magnetic resonance imaging, provides similar morphologic information with the additional potential for biochemical characterization. A series consisting of 14 patients presenting with leukocoria as a result of retinoblastoma and simulating conditions was examined. The magnetic resonance imaging findings are discussed.

Child↗

PubMed1983

Brainstem glioma: clinical manifestations of meningeal gliomatosis.

Brainstem gliomas of children are variably malignant tumors that rarely have been reported to produce subarachnoid dissemination. Nevertheless, during a two-year period, 5 of 15 such patients treated by us developed symptoms of leptomeningeal metastases. The diagnosis of an anaplastic astrocytoma with meningeal gliomatosis was confirmed postmortem in all 5. In 3 children, meningeal symptoms preceded other signs of posterior fossa recurrence. Symptoms of meningeal gliomatosis included local or radiating back pain (5 patients), segmental weakness (3), paresthesia (2), and incontinence (2). Myelography, performed in 4 patients, was the most useful diagnostic technique, disclosing multiple intradural filling defects or a high degree of block in 3 patients. Although the cerebrospinal fluid was abnormal in all 4 examined patients, in only 1 were malignant cells detected. Prolonged survival, which appears to predispose to dissemination of adult malignant gliomas, was not an apparent factor in our patients.

Adult↗

PubMed1983

Computed tomography of axial chordomas.

Preoperative computed tomography (CT) of 19 patients with axial chordomas was reviewed. These tumors characteristically feature a well-demarcated paraspinal soft tissue mass which is usually anterolaterally situated and has a homogeneous density comparable to that of muscle. The soft tissue component is disproportionately large compared to the area of bony involvement. Lytic or mixed vertebral lesions were noted. Amorphous calcifications that tended to occur at the periphery of the tumor were particularly common (89%) in chordomas of the sacrum. Epidural extension of tumor was noted in all spinal cases. Although it appears that CT studies will generally not enable a specific diagnosis of chordoma, the above features should alert the examiner to the possibility of this tumor.

Adult↗

PubMed1982