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Biomedical subjects

M Mafee

Publications and source records attributed to M Mafee.

At least 19 recordsLinked to original sources
PubMed1998

Diagnosis of vertebrobasilar insufficiency: time to rethink established dogma?

As isolated symptoms, vertigo, dizziness and imbalance are not regarded by neurologists as reflections of transient ischemia in the vertebrobasilar circulation. The purpose of this retrospective study was to demonstrate that these symptoms can and do occur in isolation. To this end, we analyzed the symptoms, stroke risk factors and diagnostic algorithms in 27 patients with a diagnosis of transient vertebrobasilar ischemia. None of the 27 patients included in the review complained of any associated neurologic symptoms. Against the reference standard of brain imaging, the site of the pathologic lesion was defined in the brainstem/cerebellum with the Torok monothermal caloric test, with a sensitivity greater than 86%. Vestibular decruitment and hyperactive caloric responses were of particular diagnostic value. Thus, we recommend that the neurologic dogma with regard to brainstem cerebellar ischemia be rethought.

Adolescent↗
PubMed1997

Post-cranioplasty cerebrospinal fluid hydrodynamic changes: magnetic resonance imaging quantitative analysis.

The syndrome of the trephined has been described in many patients with cranial defects as an indication for cranioplasty. Cerebral blood flow changes, the effect of the atmospheric pressure on the brain, as well as cerebrospinal fluid hydrodynamic changes have been postulated as the possible reasons for this syndrome. Using dynamic phase-contrast magnetic resonance imaging we measured arterial, venous, and cerebrospinal fluid flow into and out of the skull, before and after cranioplasty in one patient whose bone flap was removed because of osteomyelitis. We report significant changes in the oscillatory CSF flow after cranioplasty. A moderate increase in venous outflow as well as a two-fold increase in craniocaudal cerebrospinal fluid systolic flow velocity was measured after the skull closure. The changes in the cerebrospinal fluid oscillatory flow at the level of the craniovertebral junction could reflect changes in the compliance of the craniospinal system produced by closure of the cranial defect.

Adult↗
PubMed1993

Three-dimensional imaging for evaluation of head and neck tumors.

OBJECTIVE: To determine the usefulness of three-dimensional imaging in addition to computed tomography in presurgical examination of patients with head and neck tumors. DESIGN: Two-dimensional computed tomographic information from 31 patients with oral facial tumors was converted to three-dimensional images. SETTING: University teaching hospital. PATIENTS OR OTHER PARTICIPANTS: A consecutive sample of 31 patients with oral facial tumors. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Improved treatment planning with the use of three-dimensional images used in conjunction with computed tomographic scans. RESULTS: The three-dimensional images from patients with minimal tumor invasion of bone or with massive soft-tissue tumors allowed easy appreciation of tumor dimensions, an important factor in treatment planning. In patients with small soft-tissue tumors with no evidence of bone involvement on two-dimensional scans, massive tumors with complete bone destruction, and recurrent tumors, the three-dimensional representations added little to the obvious presentation of the two-dimensional scans. CONCLUSIONS: Three-dimensional imaging is a useful adjunct to diagnosis and treatment planning in patients with minimal tumor invasion of bone or with massive soft-tissue tumors.

Color↗
PubMed1993

Case report: nuclear magnetic resonance imaging in a patient with a pacemaker.

The presence of a pacemaker has been considered a contraindication for magnetic resonance imaging (MRI) examination. The authors describe a patient with a pacemaker who underwent MRI of the head without sequelae. Spine-echo MRI was preformed with 1.5 Tesla imager using head coil only. Prior to imaging, the pacemaker was programmed to the OOO mode. In carefully selected pacing-independent patients, with a pacemaker in a bipolar configuration, MRI of the head appears to be safe provided the pacemaker is programmed to OOO and enough scar tissue has developed to prevent pacemaker or lead movement.

Adult↗
PubMed1989

Developmental defects of the tympanic plate: case reports and review of the literature.

A complete otoscopic examination should be performed in all patients seeking treatment of temporomandibular disorders. The presence of a bulge in the external auditory meatus that disappears with mouth opening may suggest the persistence of the foramen of Huschke. The clinician should rule out the presence or history of infection, trauma, or neoplasm before ascribing the etiology of a defect to a developmental aberration.

Aged↗
PubMed1988

Simulated superior oblique tendon sheath syndrome.

Three patients with simulated Brown's superior oblique tendon sheath syndrome are presented. With the use of computed tomographic (CT) findings, the site of the pathology could be demonstrated. In all three patients, there were definite abnormal findings in the anterior sheath of the reflected tendon of the superior oblique. The abnormal findings in one case were confirmed at the time of surgery. Therapy in two of the cases was determined by the abnormal findings on the CT scan.

Adolescent↗
PubMed1988

Intracranial and intratemporal meningiomas with primary otologic symptoms.

Intratemporal extensions of cerebellopontine angle (CPA) meningiomas are unusual and primary intratympanic meningiomas are extremely rare. The initial symptoms of both types are otologic. The presenting symptoms of even large meningiomas of the cerebellopontine angle can also be otologic. In this article we report the clinical features, diagnosis, and management of five CPA meningiomas, three combined intratemporal and CPA meningiomas, and one primary intratympanic meningioma.

Adolescent↗
PubMed1986

Unilateral sensorineural hearing loss: analysis of 200 consecutive cases.

The spectrum of diseases diagnosed and the protocol used in the investigation of 200 consecutive patients with unilateral sensorineural hearing loss (SNHL) is presented. The diagnostic tests found most useful in defining the site of the lesion were a combination of a well-masked pure tone audiogram, speech discrimination score (SDS), acoustic reflex test (ART), and a vestibular evaluation using photoelectric nystagmography (PENG) and the Torok Monothermal Differential Caloric Test. With this protocol, the site of the lesion was correctly defined in 94% of patients with unilateral progressive SNHL. Laboratory and radiological studies confirmed a variety of lesions other than acoustic tumors. It is, therefore, felt that the primary objective of investigations should be to define the site of the lesion rather than aim to diagnose a specific disease entity.

Adolescent↗
PubMed1986

Skull base lesions: a classification and surgical approaches.

An anatomic classification of lesions affecting the skull base is proposed according to which this region can be divided into a midline compartment and two lateral compartments: a petrotemporal and an infratemporal. The majority of lesions studied radiographically in 56 patients were confined to one of these anatomic subdivisions. The advantages of such a classification are discussed. The surgical approaches to these compartments and to the anterior middle and posterior cranial fossae are described relative to the lesions we have encountered.

Adolescent↗
PubMed1984

Metastatic neck disease. Evaluation by computed tomography.

Computed tomographic (CT) scanning has been used in the preoperative examination of patients with head and neck cancer. Although early reports on the use of CT scanning for cervical lymphadenopathy were encouraging, the accuracy of CT in detecting nodal metastases has not been well established. Fifty consecutive patients underwent radical neck dissection and preoperative CT scanning. The clinical staging of the neck, CT diagnoses, and pathologic findings were correlated; CT accuracy was then compared with clinical accuracy. Our findings show the overall accuracy of CT diagnoses to be 90%. Comparison with clinical accuracy shows the CT scan to be superior to the clinical examination, particularly in detecting occult metastases.

Diagnostic Errors↗
PubMed1984

Computed tomography in choroidal detachment.

Computed tomography proved valuable in localizing and differentiating serous or hemorrhagic choroidal detachment and scleral infolding. The mean attenuation values (CT numbers) in the region of fresh hemorrhagic choroidal detachment were 74 Hounsfield units (HU). The 90% confirmation limit of the mean was 55 to 84 HU. For serosanguineous choroidal detachment, the mean was 50 HU, with a 90% confirmation limit of 46 to 54 HU. For serous choroidal detachment the mean was 46 HU, with a 90% confirmation limit of 39 to 53 HU. Inflammatory choroidal detachment showed uveoscleral enhancement, which in cross section appeared as a ring (ring sign), and subchoroidal or intrauveal accumulation of fluid. Ocular hypotony produced the characteristic CT "umbrella sign."

Adolescent↗
PubMed1983

Cytologic diagnosis of renal carcinoma in the presence of inferior vena cava obstruction: case report.

Diagnostic work-up and staging of patients with renal tumors usually includes inferior vena cavography. In this case, complete occlusion of the cava was demonstrated by cavography while catheter aspiration yielded tumor fragments diagnostic of renal adenocarcinoma. Transcatheter aspiration in the presence of caval obstruction can provide preoperative tissue diagnosis as well as accurate tumor staging information.

Adenocarcinoma↗
PubMed1983

Computed tomography for diagnosis of persistent hyperplastic primary vitreous (PHPV).

Leucocoric eyes with persistent hyperplastic primary vitreous (PHPV) were studied by computed tomography (CT). Maximum information was derived from use of an intravenous contrast agent and repetition of the scanning in the lateral decubitus position. Eight diagnostically helpful radiologic findings were noted, some for the first time. (1) Radiodense retrolental soft tissue can be demonstrated along Cloquet's canal. (2) The retrolental tissue enhances after administration of intravenous iodine-containing contrast material. (3) Congenital nonattachment of the retina is demonstrable by CT. (4) There may be localized or generalized increased radiodensity of the vitreous body. However, some minimally affected cases have vitreous chambers with normal attenuation values, and CT evidence for PHPV may be lacking in such patients. (5) There may also be layered, high density fluid (blood) in the retrohyaloid space, which shifts location in the lateral decubitus position. Thus far, this finding appears to be unique to PHPV, but computed scanning of other neonatal ocular conditions will be necessary before concluding it is pathognomonic. (6) There is absence of ocular and intraorbital calcification. (7) Abnormalities in configuration of the eyeball, including microphthalmos, can be demonstrated. (8) Retrobulbar tissues and other orbital structures appear normal, and the optic nerves appear normal or minimally reduced in size.

Adolescent↗