PubMed Health⌕ Search

Biomedical subjects

R W Baumgartner

Publications and source records attributed to R W Baumgartner.

81 records · Page 5Linked to original sources
PubMed1993

[Transcranial color-coded duplex ultrasonography in adults].

UNLABELLED: Transcranial color-coded duplex sonography (TCCD) represents an improvement in ultrasound technology for study of the intracranial circulation. This new method was applied in 33 healthy volunteers and 63 neurological patients in order to study the following questions: (1.) how often can non-occluded intracranial arteries be delineated; (2.) reliability of pathological TCCD findings in comparison with cerebral angiography; (3.) reference blood flow velocity data. RESULTS: 99% of vertebral (VA), 98% of basilar (BA), 96% of middle (MCA) and posterior cerebral (PCA), 95% of internal carotid (ICA; siphon and terminal segment), 93% of anterior cerebral (ACA), and 86% of posterior inferior cerebellar (PICA) arteries were delineated. In conjunction with the findings of extracranial color-coded duplex sonography (ECCD), 4 stenoses (2 MCA, 1 ICA and PCA each), 8 occlusions (4 ICA, 1 ACA, MCA, BA and VA each; differential diagnosis: subtotal stenosis), 9 collateral circulations (anterior and posterior communicating arteries in 4 cases each, occipital artery-intracranial VA in one), 4 cerebral arteriovenous malformations, and 2 giant aneurysms of the terminal ICA were suspected and confirmed by angiography. However, 2 hypoplastic VA's and ipsilateral PICA's were missed. (3.) Maximal +/- SD values were 83 +/- 27, 110 +/- 18, 67 +/- 12, 64 +/- 13, 53 +/- 13, and 51 +/- 12 cm/sec for systolic, and 36 +/- 9, 49 +/- 9, 30 +/- 7, 29 +/- 8, 24 +/- 7, and 25 +/- 7 cm/sec for end-diastolic velocity in the ACA, MCA, PCA, BA, VA, and PICA.

Adult↗
PubMed1993

[Treatable diseases of the nervous system with cataract formation].

The detection of a cataract in combination with a neurological deficit may provide the physician with important diagnostic help. But a minority of underlying diseases (angiokeratoma corporis diffusum, cerebrotendinous xanthomatosis, diabetes mellitus, galactosemia, hypocalcemia, Refsum's disease, Wilson's disease; Charles Bonnet syndrome; relapsing Perichondritis; adverse effects of medication and intoxications) can be treated causally. Therefore they are summed up and discussed in this paper.

Cataract↗
PubMed1993

Bilateral neuropsychological deficits in unilateral paramedian thalamic infarction.

The neuropsychological deficits in 5 patients with chronic and MRI-proven unilateral infarctions in the perfusion territory of the paramedian thalamic arteries were studied. All patients showed deficits pointing to a dysfunction of frontotemporal hemispheric structures on the side of the thalamic lesion. However, 4 patients revealed additionally neuropsychological deficits pointing to a dysfunction of frontotemporal hemispheric structures overlying the nonaffected thalamus. The contralateral deficits showed (in 4 patients) signs of temporal and (in 3 patients) frontal lobe dysfunction. It is suggested that the bilaterality of the neuropsychological deficits results from additional contralateral thalamic lesions not detected by MRI and/or from bilateral cortical hypometabolism.

Adult↗
PubMed1992

Anterior spinal artery syndrome of the cervical hemicord.

Three patients developed signs of a unilateral cervical cord lesion 6 to 36 h after the acute onset of severe cervico-brachial pain. The neurological deficit progressed over 6 to 18 h. On the painful side a central Horner's syndrome, a hemiparesis with plegia of the hand, and a slight pallhypaesthesia were found. On the opposite side thermhypaesthesia and hypalgesia were noted with a level at the dermatome C5 or C6. T2-weighted MR images revealed in one patient a small area of increased signal intensity restricted to one half of the cervical cord, and electromyography in another patient showed after 6 months evidence of segmental chronic denervation. Both abnormalities were found at the clinically expected level. The findings are consistent with a small infarction of the cervical cord in the perfusion territory of a central (sulco-commissural) artery, a duplicated anterior spinal artery or an anterior spinal branch of the vertebral artery.

Cerebellum↗
PubMed1991

[Cerebrotendinous xanthomatosis].

Cerebrotendinous xanthomatosis (CTX) is a rare lipid storage disorder due to an autosomal-recessive inherited defect of the hepatic mitochondrial steroid 26-hydroxylase. The resultant reduced biosynthesis of cholic and especially chenodeoxycholic acid and the increased production and accumulation of cholestanol and cholesterol in most tissues is described and pathogenetic aspects as well as typical pathological findings are discussed. In the light of three personal observations the clinical symptoms and the results of auxiliary investigations are discussed and compared with the literature. The suspected diagnosis of CTX may be confirmed by demonstration of a pathologically elevated concentration of cholestanol or biliary alcohols in serum and urine respectively. The chronically progressive neurologic deficit can be halted or is in some cases partially reversible by treatment with chenodeoxycholic acid. Therefore, early diagnosis is mandatory and CTX should be considered in every patient presenting with intellectual impairment, spastic-ataxic signs, juvenile cataracts and tendon xanthomas.

Achilles Tendon↗
PubMed1990

Comparison of carbon-dioxide-enriched, oxygen-enriched, and normal air in treatment of acute mountain sickness.

Twenty mountaineers with acute mountain sickness (AMS) at an altitude of 4559 m were randomly allocated to treatment with oxygen-enriched (33% oxygen), carbon-dioxide-enriched (3% carbon dioxide), or normal compressed air. Treatment with oxygen significantly improved the arterial partial pressure of oxygen (PaO2), relieved symptoms of AMS, and reduced cerebral blood flow as estimated by transcranial doppler ultrasound examination of the median cerebral artery. The only significant effect of carbon dioxide was increased ventilation resulting in a slight rise in PaO2. Thus, in contrast to previous uncontrolled trials, this study does not support the usefulness of carbon dioxide treatment in AMS.

Acute Disease↗
PubMedDate not supplied

Autologous fat injection for soft tissue augmentation in the face: a safe procedure?

Autologous fat injection for soft tissue augmentation in the face is claimed to be a safe procedure. However, there are several case reports in the literature where patients have suffered from acute visual loss and cerebral infarction following fat injections into the face. Acute visual loss after injection of various substances into the face is a well-known complication of such interventions. We report two further patients who suffered from ocular and cerebral embolism after fat injections into the face. For the intravasation of fat particles there are three preconditions: well-vascularized tissue, fragmentation of parenchyma, and, especially, a local increase in pressure in the affected tissue. Fat injections into the face lead to an acute local increase in pressure in highly vascularized tissue. We assume that fragments of fatty tissue reach ocular and cerebral arteries by reversed flow through branches of the carotid arteries after they are introduced into facial vessels. The manifestation of fat embolism appears either immediately after the fat injection or after a latency period. Fat embolism can remain subclinical and may not be recognized, or the clinical features may be misinterpreted. To minimize the risk of such a major complication, fat injections should be performed slowly, with the lowest possible force. One should avoid fat injections into pretraumatized soft tissue, for example, after rhytidectomy, because the risk of intravasation of fat particles may be higher. Metabolic disturbances such as hyperlipidemia may also contribute to the clinical manifestation of fat embolism Routine funduscopic examinations after fat injections into the face could help to provide data for future estimation of the patient's general risk.

Adipose Tissue↗
PubMedDate not supplied

Venous microemboli in patients with artificial heart valves.

BACKGROUND: Detection of microemboli signals (MES) in patients with artificial heart valves has been extensively described, but the underlying material remains unclear. We assumed that the detection of MES in the jugular vein of patients with prosthetic valves would clearly argue for gaseous embolic material, since formed emboli are unable to cross through the capillaries. METHODS AND RESULTS: Twenty-five patients with artificial heart valves, 15 patients with asymptomatic carotid artery disease, and 25 normal controls were examined. Monitoring was performed simultaneously over the dominant jugular vein and the ipsilateral middle cerebral artery for 30 min per subject, using 2-MHz transducers of a color duplex scanner for the jugular vein and a pulsed-wave Doppler for the middle cerebral artery. Data were harvested in an eight-channel digital recorder and MES counts evaluated by two separate observers. MES prevalence in the middle cerebral artery was 100, 13 and 0% in patients with artificial heart valves, asymptomatic carotid artery disease, and normal controls, respectively. No MES were detected in the jugular veins of patients with carotid artery disease or in normal controls, while their prevalence was 68% in patients with artificial heart valves. The interobserver agreement was satisfactory. CONCLUSION: Our results suggest that the embolic material of at least a part of MES in patients with artificial heart valves is gaseous.

Cerebral Arteries↗