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Biomedical subjects

R E Latchaw

Publications and source records attributed to R E Latchaw.

At least 73 records · Page 4Linked to original sources
PubMed1985

Intracerebral hemorrhage in the full-term neonatal infant.

Supratentorial intracerebral hemorrhage was diagnosed in 18 full-term neonates, including six with primarily intraparenchymal hemorrhage and 12 with primarily intraventricular hemorrhage. Precipitating or associated factors were hypoxic-ischemic injury in five patients, polycythemia in two, and cranial birth trauma in two. Nine other infants had no identifiable medical risk events. The pathogenesis of intraparenchymal hemorrhage was probably related to hemorrhagic infarction, but the pathogenesis of intraventricular hemorrhage was often unknown. All 17 survivors returned for neurologic and developmental examinations between 1 and 7 years of age. Follow-up assessments were normal in nine children and abnormal in eight. Two had perceptual difficulties, three had moderate-to-severe cognitive deficiencies (two of the three had hemiplegia), and three had severe mental and neurologic handicaps. Eight of nine children with known or suspected hypoxic-ischemic or traumatic insults suffered moderate-to-severe disabilities whereas eight of nine children with no known precipitating cause for their hemorrhage developed normally.

Apgar Score↗
PubMed1984

Rapid and accurate diagnosis of herpes simplex encephalitis with computed tomography stereotaxic biopsy.

Four patients with suspected herpes simplex encephalitis underwent cerebral biopsies using a stereotaxic technique coupled with computed tomography (CT) scanning. Typical histopathologic features of viral encephalitis were identified on frozen section, allowing rapid introduction of systemic antiviral therapy. Herpes simplex virus was isolated from cultures from the brain within 24-48 hours. Despite antiviral therapy, three patients died and the fourth patient remains severely neurologically impaired. Treatment was started too late in the clinical course to be effective. To reduce the strikingly high mortality and morbidity associated with herpes simplex encephalitis, a biopsy must be performed as early as possible to confirm the diagnosis or to exclude other treatable conditions. Appropriate antiviral therapy must be predicated on a positive biopsy and instituted immediately after diagnosis. We prefer the CT stereotaxic technique to other biopsy methods because it defines the involved locus in the brain, obviates the need for other time-consuming neurodiagnostic procedures, and provides 1-mm accuracy in reaching the desired biopsy site. Performed early in the clinical course, CT stereotaxic biopsy provides rapid histologic and virologic diagnosis and may eventually reduce the still unacceptably high mortality and morbidity associated with herpes simplex encephalitis.

Aged↗
PubMed1984

An experimental study of the influence of antifibrinolytic therapy on post-subarachnoid-hemorrhagic cerebral vasospasm and hydrocephalus.

The incidence and severity of cerebral vasospasm and hydrocephalus following induced subarachnoid hemorrhage in an experimental group of animals that subsequently received epsilon-aminocaproic acid was compared to that seen in a control group that received no antifibrinolytic therapy. No augmentation of either vasospasm or hydrocephalus could be attributed to the epsilon-aminocaproic acid in the treated as compared to the control group.

Aminocaproates↗
PubMed1984

Intracranial and systemic effects of hetastarch in experimental cerebral edema.

These experiments were done to determine the effectiveness of oncotic and oncotic/diuretic ( oncodiuretic ) therapy in dogs with experimental cerebral edema induced by a cold lesion. Dogs were divided into 3 groups and were treated for 6 h with either crystalloid (control group), a 12% hetastarch solution, or a 24% hetastarch solution plus furosemide. The cerebral effects of treatment were evaluated by intracranial pressure (ICP) measurements and by autopsy measurements of brain density and brain water content. The systemic effects were evaluated by measuring fluid balance, wedge pressure, hematocrit, free-water clearance, and serum vasopressin level. Hetastarch and hetastarch /furosemide significantly reduced ICP, increased brain density, and decreased water content of the edematous brain. Hetastarch alone caused a positive fluid balance and marked hemodilution but did not normalize vasopressin levels, whereas hetastarch /furosemide caused a marked diuresis without changing the hematocrits, and normalized vasopressin levels. Oncodiuretic therapy, in contrast to traditional fluid restriction, seems to decrease ICP effectively by causing normovolemic dehydration.

Animals↗
PubMed1984

Local cerebral blood flow alterations (Xe-CT method) in an accident victim.

Computed tomography was used before and during inhalation of nonradioactive xenon gas to measure and map local cerebral blood flow noninvasively at two PaCO2 levels in a 19-year-old accident victim. The technique demonstrated normal response to elevated PaCO2 with only a regional loss of autoregulation.

Adult↗
PubMed1984

Lumbar myelography with iohexol and metrizamide: a comparative multicenter prospective study.

Diagnostic quality of radiographs and adverse reactions associated with the use of metrizamide and iohexol as contrast agents in lumbar myelography were compared in a prospective randomized double blind study in 350 patients at seven centers. The contrast media were administered in comparable volumes at a concentration of 180 mg I per ml. Overall quality of radiographic visualization was graded good or excellent in 95% of 175 metrizamide studies and in 98% of 175 iohexol studies. Ninety-three patients examined using metrizamide (53%) and 130 patients examined using iohexol (74%) experienced no discomfort during or after myelography. Postmyelographic headache was associated with 38% of metrizamide examinations and 21% of iohexol examinations. Nausea and vomiting were also more common with metrizamide. Five patients examined using metrizamide (3%) experienced transient confusion and disorientation following lumbar myelography. No such reactions were observed following iohexol myelography.

Adolescent↗
PubMed1984

Mapping cerebral blood flow by xenon-enhanced computed tomography: clinical experience.

Local cerebral blood flow was measured and mapped using xenon-enhanced x-ray transmission computed tomography. Studies involving 4-6 minutes of xenon-oxygen inhalation can be performed routinely in awake and anesthetized patients with acceptable patient tolerance and compliance. Several case studies of patients with acute and chronic ischemic injuries and other cerebral abnormalities are presented to illustrate characterization of flow pattern in normal and abnormal tissue, as well as the relevance of this flow information to clinical patient management.

Aged↗
PubMed1984

Intracranial and systemic effects of osmotic and oncotic therapy in experimental cerebral edema.

Experiments were carried out to compare the effectiveness of oncotic and osmotic therapy in dogs with experimental cerebral edema caused by a left parietal cold lesion. Animals were divided into five groups and treated for 6 hours with either crystalloid (control group), or mannitol, albumin, furosemide, or albumin/furosemide (treatment groups). The cerebral effects of therapy were evaluated by intracranial pressure (ICP) measurements and by postmortem evaluations of water content, using computerized tomography (CT) density measurements and wet-dry weight measurements. The ICP was significantly reduced by all treatments except albumin alone, and was reduced equally by mannitol, furosemide, and albumin/furosemide. The CT density of the lesion area was significantly increased by all treatments. The density of the contralateral nonlesioned hemisphere was significantly increased by all treatments except albumin. The water content of the lesion area was significantly decreased by all treatments; water content of the opposite hemisphere was not significantly reduced. The systemic effects of therapy were evaluated by measuring net fluid balance, wedge pressures, hematocrits, free water clearance, and vasopressin. Negative fluid balance without an increase in hematocrit or in vasopressin secretion occurred only in dogs treated with albumin/furosemide. Such oncodiuretic therapy seems to cause normovolemic dehydration and to have cerebral effects similar to mannitol and furosemide, without their undesirable systemic effects.

Albumins↗
PubMed1983

Childhood oligodendrogliomas presenting with seizures and low-density lesions on computed tomography.

Three children with cerebral oligodendrogliomas causing partial complex or generalized seizures presented with completely normal neurologic examinations. CT showed low-density, nonenhancing surface lesions. Although these CT features are usually associated with infarcts or cysts, neoplasm was suspected because of irregularity of the margins and erosion of the adjacent inner table of the skull. Oligodendrogliomas often enlarge slowly and may cause seizures years before they produce focal neurologic signs. CT of all children with seizures not responsive to anticonvulsant medication and focal clinical or EEG abnormalities will hasten diagnosis of slowly growing intracranial mass lesions.

Brain Neoplasms↗
PubMed1983

Posterior dural arteriovenous malformations in infancy.

A 23-month-old infant with an extensive dural arteriovenous malformation (AVM) developed a heart murmur and cardiomegaly. The AVM involved the occipital and suboccipital dura mater and the tentorium, bilaterally. We embolized the AVM with Gelfoam and polyvinyl alcohol particulates, subtotally resected it, and embolized residual vessels with isobutyl cyanoacrylate. In spite of this extensive therapy, the malformation was not totally eradicated and an occipital pial AVM developed. This infant and the eight infants with posterior dural AVMs reported previously emphasize the difficulty of eradicating these lesions in infancy. We contrast the clinical features and therapy of infants and adults with posterior dural AVMs. Infants develop heart failure and cranial bruits because of arteriovenous shunts, whereas adults complain of headache and intracranial bruits. Infants need therapy to prevent progressive heart failure, intracranial hypertension, and perhaps cerebral ischemia. Ligation of arterial tributaries is inadequate therapy for these lesions. Embolization and resection of the malformation, when feasible, offers the best chance of curing posterior dural AVMs with extensive arterial tributaries.

Dura Mater↗
PubMed1983

Stereotactic implantation of deep brain electrodes using computed tomography.

The selection of intracranial targets for stereotactic functional neurosurgical procedures traditionally has relied on information derived from pooled brain atlases and supplemented by contrast encephalographic or angiographic data from the individual patient. The integration of stereotaxy with computed tomography (CT) has permitted direct identification of intracranial targets based on multiplanar reformatted CT images from each individual patient. Four patients underwent the CT stereotactic implantation of a single deep brain electrode for the control of chronic pain (two cases) or of multiple depth electrodes for long term electroencephalographic recordings in the management of seizure disorders (two cases). In all patients, accurate and precise electrode placement was achieved from CT images alone. The use of CT permitted detailed anatomical stereotactic study of each patient's brain, the preplotting of electrode trajectories before probe insertion, and the rapid confirmation of precise electrode placement. Intraoperative contrast encephalography was not necessary. Functional neurosurgery was performed successfully and advantageously using CT stereotactic technique alone.

Adult↗
PubMed1982

Errors associated with single-scan determinations of regional cerebral blood flow by xenon enhanced CT.

Possible errors in the determination of xenon concentrations in arterial blood, and uncertainties in CT tissue enhancements during inhalation of xenon-oxygen mixtures, are used to assess errors in the determination of regional cerebral blood flow by the in vivo autoradiographic (single-scan) technique. The results of this study indicate that errors associated with the determination of xenon concentrations in arterial blood decrease rapidly as the time of scanning after the initiation of xenon inhalation is increased. Analysis of errors caused by statistical uncertainties in image enhancement indicate that time of scanning is optimal between 1.5 and 2.5 min for determination of fast flow, while errors in slow-flow determinations gradually decrease as the time of scanning increases.

Autoradiography↗
PubMed1982

Redundant lumbar nerve root syndrome: myelographic features.

Nine patients with redundant lumbar nerve root syndrome were identified using positive-contrast myelography, seven with metrizamide and two with iophendylate. Serpiginous intradural filling defects occurred in conjunction with a complete or partial extradural block and spinal stenosis. These redundant nerve roots were seen on the cephalic side of the block. Eight of the nine patients had pseudoclaudication. One case was found incidentally during a cervical myelogram. This series is presented to demonstrate the characteristic myelographic pattern that should be recognized and differentiated from tortuous intradural blood vessels. Possible causes are discussed.

Adult↗
PubMed1982

Diode array digital radiography: initial clinical experience.

Initial clinical results are described for a new method of digital radiography based on high-detail self-scanning linear diode arrays which overcome many of the limitations of present film or other digital methods. The technique uses a fan-shaped x-ray beam to produce a nearly scatter-free image on a phosphor strip that is fiber-optically coupled to six self-scanning arrays of light-sensitive diodes spaced 0.025 mm, thus providing 6,144 discrete sensors across the field of view. Because these diodes have a greatly expanded dynamic range and operate at very low noise, it becomes possible to visualize small density differences or contrast below 1% both in the light and dark areas of the image. Because of the efficiency of detection and display, radiation doses can be reduced for a given information content. Our preliminary clinical studies have shown to broad application of our method in examining the chest and abdomen and in performing intravenous digital arteriography.

Angiography↗
PubMed1981

Case report. Bilateral cerebellar venous angioma.

A case of posterior fossa venous angioma involving both cerebellar hemispheres and responsible for a subarachnoid hemorrhage is reported. The computed tomographic appearance was characteristic and closely corresponded to the angiographic findings. One of the draining veins of this angiomatous lesion had a transpontine course.

Adult↗