Acute hemorrhagic leukoencephalitis: diagnosis by computed tomography.
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Adult↗
Biomedical subjects
R G Quisling
Publications and source records attributed to R G Quisling.
The cerebrovascular effects of intraarterial CO2 in quantities required for diagnostic imaging.
The recent development of digital subtraction angiography (DSA) has renewed interest in the use of gases, especially carbon dioxide, as contrast agents. Both early physiologic studies and recent clinical reports suggest that arterial CO2-DSA is a safe and useful diagnostic tool in the examination of extremity circulation. The present study examined the neurologic sequelae, pathologic changes, and effects on the blood-brain barrier to intravenous Evans-Blue and horseradish peroxidase of intracarotid CO2, in albino rats. As with other forms of cerebral gas embolization, CO2 produced multifocal ischemic infarctions and disrupted the blood-brain barrier to macromolecular tracers. The site of the barrier lesion is the endothelial cell membrane, although the precise mechanisms of damage remain unknown. Caution must be urged in the use of CO2-DSA to avoid embolization of the central nervous system.
Animals↗
Temporal comparative analysis of computed tomography with ultrasound for intracranial hemorrhage in premature infants.
This study focuses on comparison of computed tomography and ultrasound in premature infants with intracranial hemorrhage and its complications. It was determined that close correlation (95%) exists between CT and ultrasound for evaluation of ventriculomegaly. Although there is reasonable correlation for the identification and localization of periventricular, intraventricular and choroidal hemorrhages, ultrasound defined such lesions at higher rates. Subarachnoid blood and periventricular edema were diagnosed better or exclusively by CT.
Cerebral Hemorrhage↗
Computed tomographic and nuclear magnetic resonance correlation of canine ceroid-lipofuscinosis with aging.
Canine ceroid lipofuscinosis is a degenerative neuronal disorder which has as a distinct pathologic counterpart, neuronal ceroid lipofuscinosis or Batten's disease in humans. The disease occurs in English setters and is associated with abnormal accumulation of autofluorescent lipopigments. As such, a study of this animal model may allow insight into the aging process as well. This investigation explores the computed tomographic features of canine ceroid-lipofuscinosis and correlates these findings (progressive atrophy, inherent changes in CT/NMR tissue characteristics) with clinical and pathologic features.
Animals↗
The neonatal cisterna magna: ultrasonic evaluation.
The normal topography of the region of the cisterna magna can be delineated by cranial ultrasound in neonates. Evaluation of this region requires ultrasonic imaging of the echodense occipital bone and the inferior vermis, as well as approximation of the plane of the foramen magnum. It also requires imaging of the anechoic cisterna magna and fastigium of the fourth ventricle. In order to appreciate subtle alterations in size and/or position of these structures, standardized measurements for the midsagittal height of the cisterna magna and the distance of the fastigium of the fourth ventricle from the plane of the foramen magnum were established. Normal values established by measurement in 59 patients were cisterna magna 4.52 +/- 1.29 mm and fastigium of the fourth ventricle 16.05 +/- 3.03 mm. These dimensions were demonstrated to be abnormally increased in posterior fossa arachnoid cysts, Dandy-Walker syndrome, and hydrocephalus.
Arachnoid↗
Aneurysms of the posterior inferior cerebellar artery. A clinical and anatomical analysis.
The clinical and anatomical features of 21 surgically treated saccular aneurysms of the posterior inferior cerebellar artery (PICA) are analyzed. Seventeen of these lesions originated from the PICA-vertebral junction, and four arose from distal PICA branching sites. Twelve lesions arose from the left PICA, nine were right-sided, and all were small (less than 12.5 mm). Most of these aneurysms occurred in females (16 of 21) and presented as classic subarachnoid hemorrhage. The lack of specific focal deficits prevented an accurate pre-angiographic determination of aneurysm location in most instances. Clinically significant vasospasm and aneurysm multiplicity occurred with approximately equal frequency as at other locations. The angiographic and surgical features of these lesions are determined by the course of the vertebral artery and PICA; that is, they occur at branching sites and at curves in the parent vessel, and point in the direction in which flow would have continued if the curve at the aneurysm's origin had not been present. Aneurysms at the PICA-vertebral junction usualthese lesions are determined by the course of the vertebral artery and PICA; that is, they occur at branching sites and at curves in the parent vessel, and point in the direction in which flow would have continued if the curve at the aneurysm's origin had not been present. Aneurysms at the PICA-vertebral junction usualthese lesions are determined by the course of the vertebral artery and PICA; that is, they occur at branching sites and at curves in the parent vessel, and point in the direction in which flow would have continued if the curve at the aneurysm's origin had not been present. Aneurysms at the PICA-vertebral junction usually occur at least 1 cm above the foramen magnum level, arise distal to the PICA origin in the angle between the two vessels, and are best approached by a paramedian incision with the patient in the lateral recumbent position. Isolated clipping of the aneurysm neck is essential in this instance, as trapping may compromise vital perforating arteries of the brain stem. More distal (retromedullary) PICA aneurysms are sometimes associated with another vascular anomaly (two cases in this series), and are best handled through a bilateral suboccipital craniectomy. Clipping of the neck is the preferred treatment, but trapping is usually safe, if necessary.
Adult↗
Intracranial spread of squamous carcinoma along the trigeminal nerve.
Two patients with intracranial dissemination of squamous carcinoma along the trigeminal nerve had facial dysesthesias mistakenly diagnosed as tic douloureux. In one case, tumor originated in the skin of the lateral canthus and spread along an orbital nerve to involve the cavernous sinus and Gasserian ganglion. In the other, the primary site was the retromolar trigone, with preponderantly deep intraosseous growth. Perineural spread occurred along the inferior alveolar nerve to eventually involve the facial and the ocular motor nerves. Such neurotropic spread of tumors is unfamiliar to many clinicians, yet early diagnosis may be life-saving. If intracranial foramina have not been transgressed, surgery and radiotherapy have been curative; otherwise, treatment is largely palliative. Adequate initial treatment of the primary lesion would seem to be the best preventive measure. Treatment of recurrent lesions should include consideration of neural invasion.
Aged↗
Development of a mathematical model of the cervical spinal canal and its use in detecting early pathologic changes.
Detection of subtle osseous changes on plain film roentgenograms of the cervical spine is essential in expediting the evaluation of suspected intraspinal tumors. It is our experience that the earliest osseous changes in such cases involve thinning or erosion of the adjacent pedicles and/or lamina and a subsequent increase in the oblique diameter of the cervical spinal canal. A statistical model is established which accurately describes the normal cervical vertebral column in terms of its spinal canal size (sagittal and oblique diameters) as well as pedicle and lamina thickness. Data was obtained from a series of 86 normal exams. Six surgically proven cases of cervical intraspinal tumors were analyzed using this model. Variations from expected normal values reveal statistically significant osseous changes involving thinning of the lamina and increased oblique diameter of the spinal canal, while the sagittal diameter of the canal remains normal. Because of these findings we feel that oblique cervical spine films should be included in the initial evaluation of neural canal tumors.
Adult↗
Balloon embolization of high-flow traumatic arteriovenous fistulae to the brain.
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Adult↗
Intrapetrous carotid artery branches: pathological application.
Small intrapetrous internal carotid branches, including the vidian and periosteal arteries, may enlarge in response to hypervascular lesions affecting the posterosuperior nasopharnyx or base of the skull. Periosteal artery hypertrophy indicates extension of lesions, usually neoplasms, to the carotid canal. Vidian artery hypertrophy may occur with either neoplasms or collateral arterial demand between intracranial and extracranial circulations. Such collateral routes may have special relevance when interventional embolization procedures are being considered.
Angiography↗
Cervical carotid dissecting aneurysms.
Thirteen cases of cervical carotid dissecting aneurysm have been seen at the University of Florida during the past 3 years. In our experience, two groups of patients with this disease can be distinguished clearly by either clinical or angiographic criteria. One group of cervical carotid dissecting aneurysms is characterized by spontaneous onset, unilaterality, and the absence of pseudoaneurysm formation. These lesions have a strong tendency to resolve with appropriate medical therapy. The other group is characterized by an association with obvious predisposing factors, such as fibromuscular dysplasia, angiography, or trauma. These lesions are often associated with pseudoaneurysms and rarely resolve spontaneously. These two groups of lesions probably represent a spectrum of the same basic disease process. The natural history of patients who survive a cervical carotid dissection is usually one of stability or improvement. A trial of medical therapy (to prevent embolic symptoms) and repeat arteriography are indicated before the consideration of surgical therapy.
Adult↗
Ascending pharyngeal artery collateral circulation simulating internal carotid artery hypoplasia.
Complete occlusion of the cervical segment of the internal carotid artery may result in a collateral circuit between an enlarged ascending pharyngeal artery and the intracranial segment of the internal carotid artery. This anastomosis may simulate a severely stenotic or hypoplastic internal carotid artery. Differentiation between these entities is particularly important if carotid endarterectomy for relief of stenosis is contemplated.
Adolescent↗
Computed tomographic evaluation of the early phase of adrenoleukodystrophy.
Analysis of computed tomograms of patients with adrenoleukodystrophy in the early disease phase reveals a dinstinct CT apperance. It is suggested that brain or adrenal biopsy may not be necessary for diagnosis of adrenoleukodystrophy when these particular CT features are correlated with the clinical course and other laboratory parameters.
Biopsy, Needle↗
Intrapetrous carotid artery branches: radioanatomic analysis.
Intrapetrous carotid artery branches were analyzed angiographically and anatomically. Such branches appeared in 23% of normal carotid angiograms and 38% of microsurgical dissections. These branches included the vidian artery and small periosteal arteries. The caroticotympanic artery was not clearly defined in either analysis. The vidian artery contributed to two separate vascular anastomoses: the first was within the mucosa of the posterior-superior nasopharynx, the latter was in the anterior nasopharynx via the artery of the pterygoid canal.
Carotid Artery, External↗
Fracture and complete dislocation of the thoracic or lumbosacral spine: report of three cases.
Severe fracture/dislocation of the thoracic (T) or lumbar (L) spine is usually associated with complete neurological dysfunction below the level of injury. Three cases of severe spinal fracture/dislocation are presented in this report. Two of these patients suffered only partial neurological deficit, which improved after open reduction, internal fixation, and bone fusion. Severe fracture/dislocation of the T or L spine may be quite obvious on lateral roentgenograms. Occasionally, however, the fracture site may be obscured by the overlying shoulders, hips, or soft tissues. If no lateral displacement is evident on anteroposterior (AP) films, a false impression of normal alignment may be given, as was the case in two of our patients. A careful interpretation of the AP view will provide the diagnosis in such cases. The subtle AP radiographic changes suggesting fracture/dislocation of the T or L spine are detailed. The mode of injury, physical findings, prognosis, and surgical treatment of such severe injuries are also briefly reviewed.
Adolescent↗
Angiographically cryptic cerebrovascular malformations.
Three cases of angiographically cryptic cerebrovascular malformations are presented and a review of the cases in the English literature is tabulated. The typical patient is a 30- to 40-year-old woman with a history of seizures and headache. There is no antecedent history suggesting hemorrhage. On nonenhanced computerized tomographic scans, these lesions are denser than normal brain. They enhance with contrast administration. The angiogram demonstrates an avascular mass. The history, physical findings, and radiographic studies suggest brain tumor. An accurate diagnosis requires operation and pathological examination of the lesion.
Cerebral Angiography↗
Ganglioglioma of the medulla oblongata.
A patient with signs and symptoms suggestive of symptomatic Arnold-Chiari malformation was encountered. Neuroradiologic investigation revealed the presence of a medullary tumor, which later proved to be a ganglioglioma. A review of the literature suggests that this presentation is typical of medullary gangliogliomas. It is proposed that the pathophysiology of this lesion renders it amenable to decompressive therapy via suboccipital craniotomy.
Arnold-Chiari Malformation↗
Spinal epidural hematoma.
A diagnosis of acute, cervical, spontaneous spinal epidural hematoma was made in two patients by combining clinical signs and myelographic findings. If surgical decompression can be accomplished early, the results are favorable.
Acute Disease↗