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Biomedical subjects

R E Latchaw

Publications and source records attributed to R E Latchaw.

At least 91 records · Page 5Linked to original sources
PubMed1980

Thrombotic and hemorrhagic strokes complicating early therapy for childhood acute lymphoblastic leukemia.

Sudden cerebrovascular insults occurred during or immediately following remission induction therapy in 4 children with acute lymphoblastic leukemia. In 3, cerebral infarction was due to thrombosis. In the fourth, an intracerebral hematoma developed representing either frank hemorrhaging or a hemorrhagic infarction. None of the patients had central nervous system leukemia or extreme leukocytosis at the time of diagnosis. Symptoms were obtundation, hemiparesis, seizures, and headache. The induction chemotherapy included L-asparaginase which causes deficiencies of antithrombin, plasminogen, fibrinogen, and factors IX and XI. These hemostatic abnormalities may explain the thromboses and bleeding observed in these children.

Adolescent↗
PubMed1980

Vertebrobasilar injuries following cervical manipulation.

Four cases of brainstem stroke syndromes followed mechanical cervical manipulation; vascular injury was confirmed angiographically. A comprehensive review of the literature on vertebrobasilar injuries disclosed the various mechanisms of injury and pathogenesis of subsequent vascular complications following cervical manipulation. Emphasis is given to the potentially devastating neurological complications, particularly in view of the increasing utilization of chiropractic therapy.

Adult↗
PubMed1980

Malignant facial tumors in children: radiologic evaluation. Stressing value of conventional and computerized tomography.

Twenty-five cases of malignant tumors of the face in children under 16 years of age were reviewed. In each case the presenting complaint was related to a mass of the face, without a known primary malignancy. Rhabdomyosarcoma was the most common malignancy, followed by equal numbers of histiocystic malignancies and malignant lymphomas. Chloroma and neuroblastoma were less common. Plain films were obtained on every patient and were always felt to be an appropriate part of the work-up. The plain films suggested or made the diagnosis of malignancy in 16 of the patients. The most helpful additional study was tomography. CT was the modality of choice for tumors originating in or extending into the orbit, and for intracranial extension. Xeroradiography best demonstrated a superficial soft tissue tumor. In evaluating facial malignancies, the number and sequence of examinations must be individualized according to the presentation.

Adolescent↗
PubMed1980

Predicting brain tumor histology: change of effective atomic number with contrast enhancement.

Thirty-eight enhancing intracranial neoplasms were evaluated with a dual kilovoltage technique to measure the change of effective atomic number (delta Z), and linear attenuation coefficients with the use of iodinated contrast material. The change of effective atomic number was found to separate intracranial neoplasms into three major groups: gliomas, meningiomas, and metastases. Other parameters, including linear attenuation coefficients and CT numbers, varied from less accurate to inaccurate. The change of effective atomic number with contrast enhancement not only predicted the appropriate histologic group of the neoplasm, but also aided in the differential diagnosis of neoplasms without a characteristic delta Z value.

Adult↗
PubMed1980

Combined embolization and operation in the treatment of cervical arteriovenous malformations.

The effectiveness of a combined approach of embolization and operation for cervical vascular malformations is stressed. Lesions that seem to be inoperable may have their blood flow sufficiently reduced by preoperative embolization to allow surgical extirpation. Polyvinyl alcohol foam is an ideal embolic agent; not only may it be used preoperatively, but its permanency allows it to be used for primary therapy.

Adolescent↗
PubMed1979

Superficial temporal to middle cerebral artery anastomosis. Clinical outcome in patients with ischemia of infarction in internal carotid artery distribution.

The clinical outcome of our first 40 patients (six with transient ischemic attacks, 22 with mild ischemic infarctions, and 12 with moderate ischemic infarctions) treated with a superficial temporal artery-middle cerebral artery anastomosis was analyzed. All cerebral ischemias or infarctions occurred in the internal carotid artery distribution. An independent neurologist observer recorded the patients preoperative and postoperative medical and neurological histories and objective neurological findings. There was no operative mortality. During the period of observation (up to 36 months), four patients died of probable myocardial infarction. No patient suffered from recurrent cerebral infarction. Three patients experienced a single ischemic event postoperatively. Neurological deficits were either unchanged (21 patients) or improved (19 patients). Postoperative angiograms showed patency in 97% of the anastomoses.

Adult↗
PubMed1979

Polyvinyl foam embolization of vascular and neoplastic lesions of the head, neck, and spine.

Embolization of vascular and neoplastic lesions of the head, neck, and spine may be performed either as primary therapy (particularly for lesions which are difficult to approach surgically) or preoperatively to decrease blood loss. Polyvinyl alcohol foam (PAF) offers a number of advantages over other embolic material, including biocompatibility, promotion of progressive thrombosis and fibrosis, permanence, compressibility, and manageability. The clinical cases illustrate the kinds of lesions that are amenable to embolization, including arteriovenous malformations, arteriovenous fistulas, meningiomas, and nasopharyngeal tumors. Techniques and possible complications are discussed.

Adolescent↗
PubMed1979

Computed tomography of intracerebral leukemic masses.

Five patients with differing types of leukemia had clinical symptoms of a localized intracerebral leukemic mass. Computed tomography (CT) demonstrated a mass of equal or increased density relative to normal brain; a zone of surrounding edema was variable. In each case, the mass showed evidence of relatively uniform contrast enhancement. CT appearance of leukemic masses is consistent and quite different from the findings in other central nervous system complications of leukemia and its aggressive treatment.

Acute Disease↗
PubMed1979

Superficial temporal-middle cerebral artery bypass. A detailed analysis of multiple pre- and postoperative angiograms in 40 consecutive patients.

Pre- and postoperative angiograms on 40 patients undergoing superficial temporal-middle cerebral artery (STA-MCA) bypass surgery have been examined in detail. Multiple postoperative angiograms have been obtained to evaluate the change in both the bypass circuit and the intracranial circulation over time. A reproducible system for evaluating the degree of intracranial vascular filling via the bypass is introduced. The study shows that the STA and its anastomotic branch increase in size over time, measured in months, in the majority of patients. This is paralleled by a progressive increase in the degree of intracranial vascular filling. These changes are proportional to the severity of the vascular disease before surgery. The pattern of preoperative collateral circulation may change over time following the addition of the bypass circuit. The progressive change over time suggests that a static analysis at one time may belie the true effect of the surgery. The change of collateral circulation with augmentation of blood supply to areas of the brain other than those affected by the recent ischemic event, means that a total cerebral evaluation including neuropsychological testing may be necessary for adequate evaluation of the effect of the bypass surgery.

Brain Ischemia↗
PubMed1978

Effective atomic number and electron density as measured with a computed tomography scanner: computation and correlation with brain tumor histology.

The mathematical basis and methodology for determining the effective atomic number and electron density of a tissue are presented. Cranial computed tomography (CT) scanning is performed at two different energy levels, both with and without contrast enhancement. The histology of 15 brain tumors has been correlated with the effective atomic number and electron density of the tumor, with parameters of the linear attenuation coefficient, and with statistical values of the CT numbers. The most useful value in separating gliomas from meningiomas from metastases appears to be the percentage change of effective atomic number following contrast enhancement.

Absorptiometry, Photon↗
PubMed1978

Reiter disease with atlanto-axial subluxation.

The authors report the first known case of atlanto-axial subluxation in Reiter arthritis. The type of analysis, including radiographic and laboratory examinations, required for a diagnosis of atypical Reiter disease is an important feature of the case.

Adult↗
PubMed1978

A protocol for the use of contrast enhancement in cranial computed tomography.

There is some confusion regarding the indications for and methodology of the use of contrast material in cranial computed tomography. Some authors recommend a nonenhanced scan in all cases, followed by an enhanced scan if indicated by the symptoms or the appearance of the unenhanced scan. Others have questioned the value of the nonenhanced scan in patients with tumor. The authors offer a protocol for the use of contrast material. Possible tumor patients are scanned with contrast material alone; other patients are scanned either (a) without contrast material or (b) both with and without contrast material, depending upon the most likely clinical diagnosis.

Adult↗
PubMed1977

The nonspecificity of absorption coefficients in the differentiation of solid tumors and cystic lesions.

Eleven lesions of the brain were analyzed and compared; they had absorption coefficients uniformly at the cerebrospinal fluid (CSF) level following contrast enhancement, and ranged from benign to malignant and solid to cystic. Grossly solid tumors may have absorption coefficients on the CT scan equal to CSF even after contrast enhancement. Absorption coefficients are misleading as histological indicators and in diagnosis; it is impossible to separate cystic from non-cystic, benign from malignant, and neoplastic from non-neoplastic lesions by absorption coefficients alone.

Absorption↗
PubMed1977

Periventricular spread of tumor demonstrated by computed tomography.

Spread of intracranial neoplasms through the periventricular tissues of the brain is well known to neuropathologists, but is almost never recognized by the usual neuroradiologic techniques of angiography and pneumoencephalography. Periventricular tumor spread can, however, be readily dmonstrated by contrast-enhanced CT scanning. This report documents 4 cases of periventricular tumor diagnosed by CT scanning.

Adult↗
PubMed1976

Intracerebral venous angioma.

Intracerebral venous angioma is a rare congenital vascular malformation of the brain. Three cases are reported, all of which had strikingly similar angiographic findings in the venous phase, viz., a local network of small medullary veins which converge centrally into a single large venous channel which courses transcerebrally to reach the superficial venous system. No gross abnormalities are seen in the arterial phase with the usual techniques. However, magnification delineated enlarged arterial branches supplying the periphery of the malformation in 2 of the 3 cases. A poorly marginated homogeneous blush and early filling of the draining veins were also seen in these 2 patients. The findings in the venous phase agree with those described in previous isolated case reports and appear to be highly suggestive of this rare malformation.

Adult↗