Biomedical subjects

M Teksam

Publications and source records attributed to M Teksam.

11 recordsLinked to original sources

PubMed2006

Reversible findings of restricted diffusion in 5-fluorouracil neurotoxicity.

A 35-year-old woman presented with neurotoxicity correlated to an i.v. regimen of 5-fluorouracil as episodes of acute confusional state and abnormalities of symmetrically restricted diffusion in the periventricular white matter and corpus callosum. On discontinuing the medication, the areas of severely restricted diffusion had entirely resolved, with minimal residual T2 signal abnormality. In this case, immediate discontinuation of the chemotherapeutic agent apparently reversed the patient's symptoms and findings on MRI. The scant information available in the published literature regarding this phenomenon is reviewed with regard to 5-fluorouracil.

Adult↗

PubMed2005

Basal cell adenoma of the parotid gland: dynamic CT and MRI findings.

Imaging findings in basal cell adenoma (BCA) of the parotid gland have been rarely reported. We report dynamic CT and MRI findings of BCA in the parotid gland in a 78-year-old woman. Dynamic CT study demonstrated strong multinodular contrast enhancement in the early phase which decreased gradually in the later phases. The mass was isointense on T(1) weighted and hyperintense on T(2) weighted MR images with a central haemorrhagic-necrotic component. The microscopic findings were consistent with membranous type BCA.

Adenoma↗

PubMed2004

CT perfusion imaging in the management of posterior reversible encephalopathy.

A 13-year-old girl with a renal transplant presented with hypertension and seizures. CT and MRI demonstrated typical bilateral parietal, occipital and posterior frontal cortical and subcortical edema, thought to represent posterior reversible encephalopathy syndrome. The cause was presumed to be hypertension. Antihypertensive therapy was started, lowering of the blood pressure in the range of 110-120 mmHg systolic. However, stable xenon (Xe) CT perfusion imaging revealed ischemia within the left parietal occipital region. The antihypertensive was adjusted which increased both the systolic and diastolic blood pressure by 31 mm Hg. The patient was re-imaged with Xe CT and was found to have resolution of the ischemic changes within the left parietal occipital region. In this report, we present a case in which stable Xe CT was used to monitor the degree of cerebral perfusion and guide titration of antihypertensive therapy. Such brain perfusion monitoring may have helped to prevent infarction of our patient.

Adolescent↗

PubMed2004

Spontaneous corynebacterium discitis in a patient with chronic renal failure.

STUDY DESIGN: Case report describing spontaneous Corynebacterium diptheria discitis in a patient with chronic renal failure. OBJECTIVES: To describe this very rare form of discitis and the results of surgical and antibiotic therapy. SETTING: University Department of Neurosurgery, Turkey. CASE REPORT: A 55-year-old man with chronic renal failure presented with acute low-back pain. Lumbar magnetic resonance imaging (MRI) suggested discitis and osteomyelitis at the L5-S1 level. The L5-S1 disc was operated upon and the discectomy material was sent for pathological and microbiological analysis. RESULTS: Pathological examination revealed infection and bacterial culture grew C. diptheria. The patient was prescribed combination antibiotic therapy with vancomycin, a third-generation cephalosporin, and rifampicin. Clinical status improved after 8 weeks of therapy. Lumbar MRI revealed remission of the discitis and osteomyelitis after 10 months of follow-up. CONCLUSION: Chronic renal failure patients with low-back pain should be investigated for spinal infection. These individuals are prone to low-grade infection in the form of discitis or osteomyelitis. Corynebacterium subspecies rarely cause spontaneous discitis. This case is interesting because of the unusual causal organism and the occurrence of discitis in the setting of chronic renal failure.

Anti-Bacterial Agents↗

PubMed2004

A retained neurointerventional microcatheter fragment in the anterior communicating artery aneurysm in multi-slice computed tomography angiography.

We present a case of multi-slice computed tomography angiography of a 60-year-old patient with a retained fragment of microcatheter within an anterior communicating artery (AcomA) aneurysm. This is a rare complication of Guglielmi detachable coil embolization. After an unsuccessful embolization procedure, the patient underwent surgery. During clipping of an AcomA aneurysm, the microcatheter traveled up the pericallosal branch of the right anterior cerebral artery. Subsequently, the microcatheter fragment did not prevent normal blood flow through the artery, and the patient has been doing well without neurological sequelae.

Anterior Cerebral Artery↗

PubMed2004

Intracranial metastasis via transplacental (vertical) transmission of maternal small cell lung cancer to fetus: CT and MRI findings.

We present the computed tomography (CT) and magnetic resonance imaging (MRI) findings of brain metastases in an unusual case of a premature, 33-week gestational age neonate who was emergently delivered from a mother suspected of having lung cancer according to imaging performed during the third trimester of pregnancy. Owing to the presence of placental metastases noted after delivery, the fetus had initial screening with brain MRI and chest/abdomen CT as well as serial screening imaging studies during the first 5 months of life, all of which were apparently normal. However, serial examinations eventually revealed a cerebellar lesion that significantly improved after chemotherapy but recurred and enlarged within a few months. This lesion was later confirmed to be metastasis by subsequent biopsy and resection. More metastatic lesions were identified in the frontal and temporal lobes on follow-up MRI. In the setting of aggressive maternal malignancy (without known fetal primary malignancy) an intracranial mass can, on the exceedingly rare occasion, result from maternal high-grade malignancy and the neuroradiologist should be alerted to this phenomenon.

Adult↗

PubMed2004

Multi-slice computed tomography angiography in the detection of residual or recurrent cerebral aneurysms after surgical clipping.

PURPOSE: To assess the diagnostic accuracy of multi-slice computed tomography (MSCT) angiography compared to digital subtraction angiography (DSA) in detecting residual or recurrent aneurysms in patients undergoing aneurysm clipping surgery. MATERIAL AND METHODS: Eight patients with nine aneurysms who had both MSCTA and DSA were included in the study. Two independent experienced neuroradiologists evaluated the examinations. RESULTS: Accuracy, sensitivity, and specificity of detecting residual or recurrent aneurysms on MSCTA were 0.80, 0.60, and 1.00, respectively. Positive and negative predictive values were 1.00 and 0.71, respectively. CONCLUSION: MSCTA is a promising technique for evaluating residual or recurrent aneurysms in patients undergoing surgical treatment of aneurysm with titanium clips.

Adult↗

PubMed2002

Diffusion-weighted MR imaging findings in carbon monoxide poisoning.

Diffusion-weighted MR imaging (DWI) of two patients with carbon monoxide (CO) poisoning demonstrated white matter and cortical hyperintensities. In one patient, the changes on the FLAIR sequence were more subtle than those on DWI. The DWI abnormality in this patient represented true restriction. In the second patient, repeated exposure to CO caused restricted diffusion. DWI may be helpful for earlier identification of the changes of acute CO poisoning.

Acute Disease↗

PubMed2001

Subarachnoid hemorrhage associated with cyclosporine A neurotoxicity in a bone-marrow transplant recipient.

We report subarachnoid hemorrhage associated with cyclosporine A (CSA) neurotoxicity after bone-marrow transplantation for chronic myelogenous leukemia. CT showed occipital subarachnoid hemorrhage. MRI confirmed this, and demonstrated cortical and subcortical edema in the posterior temporal, occipital, and posterior frontal lobes bilaterally, which was typical of CSA neurotoxicity. Recognition of CSA neurotoxicity as the cause of the subarachnoid hemorrhage obviated angiographic investigation. After cessation of cyclosporine therapy, the cortical and subcortical edema resolved on follow-up MRI with some residual blood products in the subarachnoid space.

Adult↗

PubMed2001

Intraspinal epidermoid cyst: diffusion-weighted MRI.

We report a 7-year-old boy who presented with two-month history of worsening low back and right leg pain. Conventional MR images demonstrated a poorly outlined intradural mass recognized by the displacement of the conus medullaris and the nerve roots of the cauda equina at the L2-3 level. The signal intensity of the lesion was similar to CSF There was no contrast enhancement of the lesion. Diffusion-weighted images and ADC values revealed restricted diffusion within the mass. Myelography confirmed the mass as an intradural filling defect with myelographic block at the L2-3 level. The patient underwent total surgical excision of the mass. Pathologic examination revealed the diagnosis of epidermoid cyst.

Child↗

PubMed2000

Qualitative and quantitative volumetric evaluation of the efficacy of intravenous immunoglobulin in multiple sclerosis: preliminary report.

We conducted a double-blind, placebo-controlled study in 13 patients (aged 22 to 54 years) with relapsing-remitting multiple sclerosis (MS). They were randomly assigned to receive a loading dose of immunoglobulin IgG, 0.4 g/kg body weight/day for 5 consecutive days, followed by single booster doses of 0.4 g/kg/day, or placebo, once a month for 9 months. MRI was obtained before and during the 3rd and 6th months of treatment; examinations in the 9th and 12th months were planned. Qualitative and quantitative blinded assessments were performed. There were seven patients who received active treatment and six who received placebo. Statistical analysis was performed by the Wilcoxon test. A decrease in the size and number of lesions was observed on MRI in five patients (71%) in the treatment group, and in two (33%) of the placebo group at 3-month follow-up. At 6 months follow-up MRI, a decrease in the amount of lesions was observed in all patients treated with i.v. IgG, and in two (33%) of the placebo group; four patients (66%) receiving placebo showed an increase. Quantitative analysis showed a statistically significant decrease in the volume of lesions in treatment group at both 3 and 6 month follow-up. There was no statistically significant change in the placebo group.

Adult↗