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Biomedical subjects

N E Leeds

Publications and source records attributed to N E Leeds.

At least 55 records · Page 3Linked to original sources
PubMed1987

Bilateral symptomatic intraspinal T12-L1 synovial cysts.

A 72-year-old man presented with several months of increasing lumbar pain, sciatica, lower extremity weakness, numbness in his buttocks and posterior thighs, burning sensations in his scrotum, and urinary incontinence. Myelogram-computed tomography scan demonstrated a high grade incomplete block at the T12-L1 level due to bilateral synovial cysts and simultaneously a high grade partial block at L4-L5 due to spinal stenosis. Laminectomy of the T-12 vertebra and partial laminectomy of the L-1 vertebra with excision of both synovial cysts and laminectomies of the L-4 and L-5 vertebrae with foraminotomies resulted in a reversal of the patient's symptomatology.

Aged↗
PubMed1987

Lateral pontine tegmental hemorrhage presenting as isolated trigeminal sensory neuropathy.

A 45-year-old man awoke with numbness and paresthesias on the right side of his face, scalp, ear, and tongue. CT and MRI demonstrated a focal hemorrhage in the dorsolateral right pontine tegmentum. Cerebral angiography was negative for vascular malformation or aneurysm. CT performed 1 month later showed complete resolution of the pontine hematoma, with residual minimal lateral pontine atrophy.

Brain Diseases↗
PubMed1986

Extraspinal abnormalities identified on lumbar spine CT.

Retrospective review of 1517 lumbar CT examinations revealed extraspinal pathology in 22 (1.45%). Retroperitoneal tumors and lymphadenopathy as well as vascular, urinary tract and gynecologic abnormalities were identified. This study demonstrates the need to carefully evaluate the visualized portions of the abdomen and pelvis on all lumbar spine CT examinations even when the patient's symptomatology is suggestive of spinal abnormalities.

Adult↗
PubMed1986

Tolerance of iohexol, iopamidol, and metrizamide in lumbar myelography.

Iohexol and iopamidol, two new nonionic contrast media, have been extensively studied in comparison with metrizamide for lumbar myelography. Review of the literature with statistical analysis indicates both agents are superior to metrizamide in terms of number of patients with adverse reactions (p less than 0.001). Preliminary data suggest, but do not prove, that use of iohexol may result in fewer side effects than iopamidol.

Humans↗
PubMed1986

[Multifocal glioma of the brain--an autopsy case].

This is an autopsy case report of a 76 year old woman with multifocal glioblastoma multiforme. CT scan revealed three separate mass lesions in the left temporal lobe, left parietal lobe and right fronto-parietal lobes. CT-guided needle biopsy of the right fronto-parietal mass revealed glioblastoma multiforme. At autopsy, serial horizontal sections of the brain confirmed the CT scan findings and demonstrated extension of the tumor in the left parietal lobe to the subarachnoid space. The lesion in the right fronto-parietal region infiltrated a large area and was not demarcated. Microscopic examination of all three lesions revealed glioblastoma multiforme. The left temporal lobe tumor consisted of gemistocytic astrocytes predominantly. Reaction of the tumor to glial fibrillary acid protein (GFAP) antibody ranged from markedly positive in the gemistocytic astrocytes to negative in the anaplastic cells. The reported incidence of multifocal glioma is about 2-10%. The main pathophysiologic mechanisms invoked for this phenomenon are simultaneous neoplastic transformation and seeding from one tumor. The pathophysiology of this particular case is discussed in reference to the differences in the histopathology of the 3 separate foci of glioblastoma multiforme.

Aged↗
PubMed1985

Progressive multifocal leukoencephalopathy: clinical and radiographic features.

Between April 1982 and March 1984 7 pathologically confirmed cases of progressive multifocal leukoencephalopathy (PML) were diagnosed at our institution. Only 1 case had been seen in the preceding twenty years. Four patients had acquired immunodeficiency syndrome (AIDS). The others had chronic lymphocytic leukemia, Hodgkin's lymphoma, and systemic lupus erythematosus. All patients presented with progressive neurological deficits. In most, the initial computed tomographic (CT) scan was disproportionately less abnormal than the clinical findings. In 5 patients the first CT scan revealed hypodensities of the cerebral white matter which lacked mass effect and did not enhance with contrast agent. The lesions were observed to enlarge progressively on CT scans but often lagged behind the rate of clinical evolution. Although 3 patients were treated with cytosine arabinoside, none improved. PML had similar clinical, radiographic, and pathological features in the AIDS and non-AIDs patients. Of 79 AIDS patients cared for at our institution between December 1979 and December 1983, 3.8% had PML. PML should be suspected in AIDS patients in the presence of the characteristic CT features, especially when CT-clinical dissociation occurs.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Subdural empyema: CT findings.

CT scans in 49 patients with surgically proven subdural empyema were evaluated. The empyemas were crescentic or lentiform extra-axial hypodense collections (density approximating that of cerebrospinal fluid) with prominent, sharply etched medial rim enhancement. Enhancement of the adjacent cerebral cortex was identified in many cases. Mass effect was always present and in 10 cases so extensive that it overshadowed a small extra-axial collection. CT allowed for precise localization of the lesion, including contiguous or isolated involvement of the interhemispheric subdural space. Mortality was 12% (6/49 cases), a marked improvement when compared with mortality figures obtained prior to the advent of CT (40%). CT findings indicative of involvement of the adjacent parenchyma via retrograde thrombophlebitis with resultant infarction and/or abscess formation were associated with poor prognosis. Improvement in prognosis since the advent of CT is the direct result of early accurate diagnosis and timely intervention.

Adolescent↗
PubMed1983

Spontaneous regression of intracerebral lymphoma.

Transient spontaneous regression of lesions was identified in four patients with intracerebral lymphoma. This finding, which may be related to cyclic changes in biological tumor activity as well as infarction and/or hemorrhage within the neoplasm, is not a good prognostic sign. Furthermore, when initial neuroradiologic studies suggest a diagnosis of lymphoma, subsequent spontaneous resolution of lesions should not be mistaken for a reliable sign of a benign, self-limiting disease. The diagnosis of this malignant neoplasm, despite regression of lesions, should be aggressively pursued early in the patient's clinical course when therapy would be most beneficial.

Aged↗
PubMed1983

Pseudospread of the atlas: false sign of Jefferson fracture in young children.

Jefferson fractures are rare prior to teen-age. Three young children examined after trauma exhibited the characteristic spread appearance of the atlas, but fractures were excluded radiographically and clinically. A retrospective study demonstrated a similar appearance, termed "pseudospread," in most children aged 3 months to 4 years, including over 90% during the second year. Pseudospread results from a discrepancy between the "neural" growth pattern of the atlas and the "somatic" pattern of the axis. An "atlas spread index" is defined and a normal range presented. When an atlas fracture is suggested by apparent lateral spread of the lateral atlas masses, computed tomography is useful to demonstrate an intact atlas ring.

Axis, Cervical Vertebra↗
PubMed1982

Falx and interhemispheric fissure on axial CT: I. Normal anatomy.

To determine the normal appearance of the flax and interhemispheric fissure, 200 consecutive normal CT scans were evaluated prospectively. On unenhanced scans, the normal falx is visualized in 90% of patients and therefore interhemispheric hyperdensity alone should not be considered a sign of subarachnoid hemorrhage. The flax is most often (88%) visualized in the posterior part of the interhemispheric fissure, as a hyperdense, pencil-thin line extending from the calvarium to the splenium of the corpus callosum. In the anterior part of the fissure, the falx is visualized in only 38% of patients, when its appearance differs significantly from that of the fissure. It is seen as a thin, hyperdense line extending posteriorly from the calvarium for a variable distance, but it never reaches the genu of the corpus callosum. The interhemispheric fissure is a hypodense structure broader than the falx with a zigzag configuration due to medial frontal sulci. The difference in configuration between the anterior part of the fissure and the anterior falx is very helpful in differentiating subarachnoid hemorrhage from normal falx visualization.

Adolescent↗
PubMed1980

CT in the early diagnosis of herpes simplex encephalitis.

Herpes simplex is the most common cause of sporadic viral encephalitis. The recent development of specific antiviral chemotherapeutic agents offers new optimism for patients with this disorder if therapy is begun on or before the fifth day of the disease. Eight patients with herpes simplex encephalitis were studied by CT, and a characteristic but not pathognomonic pattern was observed. In each case a low density lesion was noted in the medial portion of the temporal lobe with extension into the Island of Reil. Sparing of the lenticular nucleus was observed in all cases. Mass effect and streaky linear enhancement after contrast administration was also seen. Unfortunately, the findings may be subtle or absent before the fifth day of disease, and thus CT scans must be examined with a high index of suspicion if the correct diagnosis is to be made at a time when therapy may prove useful. Hemorrhagic areas are rarely observed on CT in this disorder despite the frequent occurrence on pathologic studies. The full extent of involvement may not be appreciated on scans obtained during the first 10 days of the disease.

Adult↗