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Biomedical subjects

P Pevsner

Publications and source records attributed to P Pevsner.

6 recordsLinked to original sources

Penetrating war injuries of the basal forebrain: neurology and cognition.

We compared the neurologic and cognitive performance of 15 young veterans who suffered unilateral penetrating missile wounds to the basal forebrain 15 years ago in the Vietnam War with uninjured controls and patients with lesions elsewhere in the brain. The subjects performed worse on tests of episodic memory, reasoning, and arithmetic and had more prolonged unconsciousness after injury; but their performance usually compared favorably with that of uninjured controls on tests of intelligence, attention, and language and was not consistent with that of a demented patient. The data suggest that the basal forebrain is functionally related to the reticular formation and to the basal forebrain is functionally related to the reticular formation and to the limbic-hippocampal memory system.

Basal Ganglia↗

Embolization of arteriovenous malformations by direct percutaneous puncture.

Permanent control of arteriovenous malformations requires obliteration of the intrinsic vasculature of the lesion with a nonresorbable occlusive material. When tortuous feeding arteries prevent successful catheter positioning, it may be possible to percutaneously puncture the malformation with a Chiba needle for direct embolization with cyanoacrylate. Three illustrative cases are presented. In each, previous surgical ligation of feeding vessels was ineffective and embolization by catheter was not possible when the fistula recurred. Direct puncture of one or more feeding vessels with occlusion by cyanoacrylate controlled these fistulas, two of which were massive. No complications occurred.

Adult↗

Interventional radiology in the treatment of internal carotid artery gunshot wounds.

PURPOSE: To review the indications for and techniques and results of interventional radiology in the management of internal carotid artery gunshot wounds. PATIENTS AND METHODS: The demographics, clinical presentations, angiographic findings, methods of treatment, and outcomes were reviewed in 20 patients who underwent 21 interventional procedures. RESULTS: Seventeen coil embolizations were successful in controlling hemorrhage. One intimal flap was compressed with balloon angioplasty, with subsequent nonoperative healing. Temporary balloon occlusions were used as a method of preoperative assessment of intracranial collateral circulation or of preoperative vascular control in three patients. There were no complications. The mortality rate was 20%. CONCLUSION: Penetration of the internal carotid artery is a very severe injury with a high mortality rate due to neurologic sequelae. Interventional radiology plays an important role in the management of these wounds, and it often obviates surgical exploration.

Adolescent↗