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Biomedical subjects

M J Post

Publications and source records attributed to M J Post.

At least 109 records · Page 6Linked to original sources
PubMed1986

Cytomegalic inclusion virus encephalitis in patients with AIDS: CT, clinical, and pathologic correlation.

The computed tomographic (CT) scans of 10 patients with acquired immunodeficiency syndrome who had central nervous system (CNS) involvement by cytomegalovirus (CMV) were retrospectively reviewed and correlated with clinical data and pathologic findings. Diagnosis was established in all 10 patients by autopsy, which showed the pathognomonic "owl's eye" intracellular inclusions of CMV. In six patients CMV caused an initial CNS infection that was directly responsible for the patient's progressive encephalopathy and death. In four patients CMV caused a superimposed nondominant CNS infection that had no clinical expression in two. Cortical atrophy and mild hydrocephalus ex vacuo were seen on CT in all 10 patients. Positive findings on CT that could be attributed to infection with CMV were present in only three of the 10 patients, and in these three symptomatic cases autopsy correlation revealed that CT underestimated the degree of CNS involvement. In the other three symptomatic patients, CT showed no parenchymal abnormalities, while autopsy demonstrated diffuse cerebral involvement. In the four patients whose CNS was secondarily involved by CMV, CT showed changes proven at autopsy to be related only to the dominant infection with Toxoplasma gondii and to postoperative hematomas. CT did not demonstrate any abnormalities at the sites of CMV involvement, which were found at autopsy in this latter group. It was concluded that CT is not very sensitive for the detection of CMV encephalitis.

Acquired Immunodeficiency Syndrome↗
PubMed1986

MRI of the chronically injured cervical spinal cord.

Thirteen patients with prior cervical spinal cord injury resulting in quadriplegia were evaluated with magnetic resonance imaging (MRI) long after their initial injury, either because of the relatively recent onset of new and worsening neurologic symptoms or to rule our residual compression on the spinal cord or nerve roots. The results of MRI were compared with delayed metrizamide computed tomography (CT) in 10 cases, and in five of those the results were also compared with intraoperative spinal sonography. It was found that MRI more accurately demonstrated the intramedullary abnormalities in the injured spinal cord than did delayed metrizamide CT because the former could separate myelomalacia from a posttraumatic spinal cord cyst, a differentiation that was frequently difficult with delayed metrizamide CT. T2-weighted spin-echo pulsing sequences with long echo times were particularly useful in evaluating these patients.

Adolescent↗
PubMed1985

Cranial CT in acquired immunodeficiency syndrome: spectrum of diseases and optimal contrast enhancement technique.

A retrospective review of cranial CT scans obtained over a 4 year period in patients with acquired immunodeficiency syndrome (AIDS) and documented central nervous system (CNS) pathology is presented. The spectrum of diseases and the value of CT in detecting new, recurrent, and superimposed disease processes were determined. Fifty-one AIDS patients with confirmed CNS pathology were identified. Six of them had two coexistent diseases. Opportunistic infections predominated, especially Toxoplasma encephalitis and cryptococcal meningitis, while tumor was seen infrequently. Initial CT was positive in 76% of cases. In contrast to meningeal processes, where it was not very effective, CT was very sensitive in detecting most parenchymal disease processes. Characteristic although not pathognomonic CT patterns were found for certain diseases. Improvement or resolution of CT abnormalities in patients on medical therapy for Toxoplasma encephalitis correlated well with clinical improvement. Recurrence of CT abnormalities correlated well with medical noncompliance. The optimal contrast enhancement technique for detecting CNS pathology and for monitoring the effectiveness of medical therapy was also evaluated by a prospective study in which both immediate (IDD) and 1 hr delayed (DDD) double-dose contrast CT scans were compared. The examination found to be diagnostically superior in 30 of the 41 IDD/DDD studies was the delayed scan. It is recommended that CT be used routinely and with the 1 hr DDD scan to evaluate and follow AIDS patients with neurologic symptoms and/or signs.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Brain biopsies in patients with acquired immune deficiency syndrome.

Seven brain biopsies from patients with the acquired immune deficiency syndrome (AIDS) were reviewed. Toxoplasmic encephalitis was diagnosed in five patients, neurotuberculosis in one patient, and no diagnosis was made in the seventh patient. Frozen sections and smears enabled a rapid diagnosis to be made in four patients. Routine histochemical analysis was diagnostic in five patients, and the immunoperoxidase technique for Toxoplasma gondii was required for diagnosis in an additional case. Brain biopsy is a valuable and safe method in the evaluation of mass lesions in patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Toxoplasma encephalitis in Haitian adults with acquired immunodeficiency syndrome: a clinical-pathologic-CT correlation.

The clinical data, histologic findings, and computed tomographic (CT) abnormalities in eight adult Haitians with toxoplasma encephalitis were analyzed retrospectively. Diagnosis was established by identification of Toxoplasma gondii on autopsy in five and brain biopsy in three specimens and subsequently confirmed by the immunoperoxidase method. All these patients, six of whom had been in the United States for 24 months or less, had severe idiopathic immunodeficiency syndrome. All were lymphopenic and six were on treatment for tuberculosis when the toxoplasma encephalitis developed. All patients were studied with CT when they developed an altered mental status and fever associated with seizures and/or focal neurologic deficits. Scans before treatment showed multiple intraparenchymal lesions in seven and a single lesion in the thalamus in one. Ring and/or nodular enhancement of the lesions was found in six and hypodense areas in two. Progression of abnormalities occurred on serial studies. These CT findings that were best shown on axial and coronal thin-section double-dose contrast studies were useful but not diagnostically pathognomonic. In patients with similar clinical presentation CT is recommended to identify focal areas of involvement and to guide brain biopsy or excision so that prompt medical therapy of this often lethal infection can be instituted.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Computed tomographic evaluation of the cavernous sinus.

In evaluating over 300 patients with sellar and parasellar lesions, the computed tomographic (CT) appearance of the cavernous sinus was studied. Optimal visualization of the cavernous sinus was obtained with continuous contrast enhancement of both axial and coronal tomograms. The coronal projection and reformatted views provided imaging of the cranial nerves within the cavernous sinus. In addition to the physiologic CT appearance of the cavernous sinus, a variety of pathologic conditions are illustrated. CT criteria suggesting an abnormal cavernous sinus are: (1) asymmetry of size; (2) asymmetry of shape, particularly the lateral wall; and (3) focal areas of abnormal density within the sinus.

Adult↗
PubMed1981

Computed tomography in Wilson disease.

Computed tomography (CT) was performed on five patients with the "cerebral form" and one with the "hepatic form" of Wilson disease. The diagnosis was confirmed biochemically and by the presence of Kayser-Fleischer rings in all cases. In four patients, CT was done at the time of diagnosis; in two of these patients, the scan was repeated at intervals after initiation of treatment. CT was abnormal in all patients with the "cerebral form." All CT abnormalities were of low density and were not changed by contrast infusion. The abnormalities involved the basal ganglia in all five patients; in two patients, areas of low density also involved the cerebellar nuclei and surrounding white matter. CT abnormalities, however, did not always correlate well with the clinical state and in two patients, CT findings worsened despite successful cupruresis. The one patient with the "hepatic form" had no CT abnormalities.

Adolescent↗
PubMed1980

CT demonstration of dural metastases in neuroblastoma.

Computed tomography provides a graphic picture of dural involvement due to metastatic neuroblastoma. These metastases occur along the external surface of the dura and cause further separation of the brain parenchyma from the bony calvarium. The dural metastases are continuous with subcutaneous deposits via the separated sutures. Sutural separation is nonuniform, and the sutural margins are indistinct due to bony involvement. The lytic bony metastases may produce localized calvarial thickening that may have a sunburst appearance.

Adrenal Gland Neoplasms↗
PubMed1980

Pituitary apoplexy: diagnosis by computed tomography.

Computed tomography (CT) now enables the early diagnosis of pituitary apoplexy. Since CT can detect blood, it can document acute or chronic hemorrhage in pituitary adenomas. In addition, CT can discriminate between densities other than blood and can therefore be used to diagnose those cases of pituitary apoplexy in which infarction and necrosis predominate. These conclusions were verified by a review of 10 apoplectic patients studied by CT. Although nine diagnostic delays occurred tissue confirmation by surgery in eight cases and autopsy on one made us familiar with the CT findings which should be useful in future diagnosis.

Adenoma↗
PubMed1979

Malignant external otitis: a radiographic-clinical correlation.

Malignant external otitis is an infectious process of the ear which may cause marked destruction of the surrounding bony structures. After evaluation of the plain skull films, mastoid series, temporal bone tomography, arteriography, and venography in nine cases of malignant external otitis, we divided the disorder into an early stage and late stage. The early stage is manifested by a soft tissue mass within the external canal or clouding of the mastoid air cells with no bone destruction. In the late stage, bone destruction may extend to the middle ear cavity, temporomandibular joint, and/or base of the skull. A correlation can be made between the clinical findings and these radiographic stages. Complex motion tomography is essential to appreciate the bone destruction in patients with late stage disease.

Aged↗
PubMed1978

The radiographic recognition of two clinically elusive mass lesions of the cavernous sinus: meningiomas and aneurysms.

Cavernous sinus syndromes secondary to chronic mass lesions, although a relatively rare cause of ophthalmoplegia, represent a distinct challenge in neuroradiologic diagnosis. Puzzling neuro-ophthalmologic signs and often subtle radiologic changes consistently lead to erroneous and delayed diagnoses as exemplified by a review of 20 patients; a correct clinical or radiographic diagnosis was initially not made in any individual.

Aged↗
PubMed1978

Postoperative bony stenosis of the lumbar spinal canal: evaluation of 164 symptomatic patients with axial radiography.

Computed tomography (CT) and transverse axial tomography (TAT) were used to study the lumbar spines of 164 patients with persistent or recurrent low back pain and/or radiculopathy. Of those patients with previous spinal fusion and of those with previous disectomy, 43% and 28%, respectively, demonstrated bony stenosis of the lumbar spinal canal. Of the patients who underwent surgery for this narrowed canal, 91% showed clinical improvement.

Adult↗