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Biomedical subjects

S E Byrd

Publications and source records attributed to S E Byrd.

At least 19 recordsLinked to original sources

Imaging modalities for the pediatric spine.

The role of MR imaging is emphasized in the evaluation of paraspinal and intraspinal soft tissue abnormalities. The technical aspects in performing a high-resolution MR image of the pediatric spine in reference to imaging parameters, sedation protocol, and the use of intravenous gadolinium are detailed. The changes in the normal pediatric spine on MR imaging are demonstrated. The diagnosis and evaluation of specific intraspinal and paraspinal neoplastic disorders in infants and children are outlined in terms of their clinical presentation and MR characteristics.

Child

The radiological evaluation of the child with a myelomeningocele.

Seven hundred fifty-five children with myelomeningoceles were evaluated radiologically at the Children's Memorial Hospital in Chicago. From our material, we propose a diagnostic radiologic model to accurately evaluate the neurological problems in the myelomeningocele child. This model is based on the clinical symptoms in these children and the radiologic modalities of magnetic resonance imaging (MRI), computed tomography (CT), ultrasound, myelography, and plain radiographs. We found MRI to be the best modality to evaluate the posterior fossa and total spine. Computed tomography and ultrasound are used to evaluate ventricular size. At times MRI may not adequately diagnose subtle cases of tethering of the spinal cord, cord infarction, arachnoid cysts, or diastematomyelia. In these cases, further evaluation may be necessary with real time ultrasound to look at cord pulsations and water soluble myelography with follow through CT to differentiate cord infarction, arachnoid cyst, localized hydromyelia, or diastematomyelia. If MRI is not adequate to completely visualize the cord because of the severe nature of the scoliosis, then water soluble myelography with CT is indicated.

Adolescent

Developmental disorders of the pediatric spine.

Developmental disorders of the pediatric spine are a group of congenital malformations commonly referred to as spinal dysraphism. These malformations are characterized by incomplete or absent fusion of midline mesenchymal, bony, and neural structures. They can be classified according to the presence or absence of an associated back mass. A detailed analysis of the embryology, clinical findings, and radiologic characteristics of the common forms of spinal dysraphism is outlined.

Humans

The CT and MR evaluation of migrational disorders of the brain. Part II. Schizencephaly, heterotopia and polymicrogyria.

The migrational disorders are a rare group of congenital malformations of the brain. They consist of the following entities - lissencephaly (agyria - pachygyria), pachygyria, schizencephaly, heterotopia and polymicrogyria. We studied 40 children with migrational disorders radiologically with CT and MR. This article (Part II) deals with our patients with schizencephaly, heterotopia and polymicrogyria. These patients presented clinically with a variety of symptoms. The most common were seizures, delayed development, failure to thrive and hydrocephalus. CT and MR both demonstrated the characteristic findings in all of our patients except the polymicrogyria group. The gray matter and cleft abnormalities seen in these disorders were demonstrated with CT and MR. However, MR provided better delineation of these disorders than CT. Because some forms of migrational disorders can be inherited, it is extremely important for the radiologist to understand the characteristic findings for correct diagnosis which is essential for parental counseling.

Brain

The CT and MR evaluation of migrational disorders of the brain. Part I. Lissencephaly and pachygyria.

The migrational disorders are a rare group of congenital malformations of the brain. They consist of the following entities--lissencephaly (agyria-pachygyria), pachygyria, schizencephaly, heterotopia and polymicrogyria. We studied 40 children with migrational disorders radiologically with CT and MR. This article (part I) deals with our patients their characteristic CT and MR findings along with their clinical presentation and course. These patients presented with one or a combination of the following symptoms, hypotonia, seizures, failure to thrive, microcephaly and occasionally hydrocephalus. These two groups of migrational disorders have abnormalities affecting the gyral-sulcal pattern of the cortex and gray-white matter distribution of the brain. MR provided better delineation of these disorders than CT. Because some forms of the migrational disorders can be inherited, it is extremely important for the radiologist to understand the characteristic findings for correct diagnosis which is essential for parental counseling.

Brain

Cerebral cysticercosis: documentation of natural history with CT.

The purpose of this study was to describe the natural history of untreated cysticercosis as monitored by cranial computed tomography (CT) and correlate it when possible with the pathologic stage of the disease noted at surgery. Serial CT was performed in 113 patients; two to four scans were obtained in each patient. Correlation with surgical specimens and clinical presentation is given. In the early, acute stage, focal nonenhancing areas of edema progress to homogeneously enhancing lesions. In the chronic phase, beginning a few months after infestation, nonenhancing cysts are seen, which later demonstrate ring enhancement. Lesions may then completely resolve or may resolve only to appear later as punctate calcifications. This radiologic progression suggests the need to reevaluate current concepts in therapy and diagnosis of this disorder. Studies on therapeutic efficacy should be based on both the improvement of clinical symptoms and evidence of lesion regression at CT.

Brain Diseases

Magnetic resonance imaging of supratentorial congenital brain malformations.

The common supratentorial congenital malformations of the brain were analyzed with magnetic resonance (MR) at the Children's Memorial Hospital in Chicago over a two-year period. Three hundred children with one or more of the following congenital malformations were imaged with MR: (1) dysgenesis of the corpus callosum; (2) holoprosencephaly; (3) migrational disorders; (4) cephaloceles; and (5) septo-optic dysplasia. The characteristic findings in each of these disorders are described based on the MR scans as well as the clinical spectrum.

Abnormalities, Multiple

Magnetic resonance imaging of infratentorial congenital brain malformations.

The common infratentorial congenital malformations of the brain were analyzed with magnetic resonance imaging at the Children's Memorial Hospital in Chicago over a 2-year period. Over 200 children with one of the following congenital malformations were imaged using magnetic resonance: Dandy-Walker malformations, Chiari malformations, and cerebellar aplasia-hypoplasia malformations. The characteristic findings in each of these disorders are described based on the magnetic resonance image scans along with the clinical spectrum.

Cerebellar Diseases

Radiation exposure to the ocular lens during CT scanning.

Measurements of radiation exposure during routine CT scanning were found to average 4.2 R at the level of the ocular lens. This data was combined with CT scanning rate data from a sample of 100 patients followed in the myelomeningocele clinic. The number of scans averaged 7.75/patient with a range of 0-34 scans. Cumulative radiation exposure to date ranged from 0 to 143 R. Radiation dosage nomenclature and acceptable limits are discussed and recommendations for reduction of dosage are presented.

Child

The CT and MR evaluation of lissencephaly.

Lissencephaly is a rare congenital malformation of the brain that has characteristic radiographic and clinical findings. Fifteen cases of lissencephaly were studied with CT and/or MR, and a classification was developed based on these cases and the description of this abnormality found in the literature. These findings can be divided into two groups, primary and secondary. The primary findings consist of (1) a cerebral surface that is agyric or agyric with pachygyric areas, (2) a cerebral contour that is oval or "hourglass" due to lack of or incomplete opercularization of the brain, and (3) an abnormal gray-white-matter distribution in the cerebral hemispheres. The primary findings are necessary to make the diagnosis, which can be made with either CT or MR; however, MR provided better delineation than CT of the cerebral surface and contour as well as better gray-white-matter differentiation in the lissencephalic brains. We believe MR is the technique of choice for evaluating patients with lissencephaly because it is safer and more versatile than CT and provides better delineation of the brains of children.

Brain

The clinical and radiological evaluation of lissencephaly.

Lissencephaly is a rare congenital malformation of the brain that has characteristic clinical and radiographic findings. Thirteen cases of lissencephaly were studied clinically and radiographically with computed tomography and magnetic resonance imaging. A classification was developed based on the findings in these cases and the literature. The clinical and radiographic evaluation of lissencephaly is emphasized, with a thorough discussion of the clinical spectrum of each type, radiographic findings, prognosis, survival, and associated genetic abnormalities.

Brain

Common congenital brain anomalies.

Craniocerebral malformations remain enigmas to many radiologists because their pathogeneses are obscure, noninvasive imaging modalities could not display them in detail until recently, and concise classifications have been lacking. In this article the MRI findings of the most common congenital brain malformations are presented with an emphasis on the characteristic features of each malformation and the clinical symptoms and course.

Abnormalities, Multiple

Epidural morphine and methylprednisolone. New therapy for recurrent low-back pain.

Twenty patients with intractable, postoperative, recurrent low-back pain were treated with a sequential, epidural injection of morphine (8 mg) and methylprednisolone acetate (80 mg). Concomitantly administered, these drugs provided 50-100% pain relief lasting 6-24 months and elicited prolongations of mood elevation and morphine-induced side effects. Evidence from computed tomography and electromyography, however, indicated no amelioration of pre-existing pathologies.

Adult

The radiographic evaluation of the symptomatic postoperative lumbar spine patient.

The diagnostic evaluation of patients with previous lumbar surgery presents a problem clinically and radiographically. The authors evaluated radiographically 75 patients with previous lumbar surgery who had persistent lumbar symptomatology. From their series, they found that a combination of two modalities (1) plain radiographs of the lumbar spine and (2) CT with intrathecal metrizamide and/or intravenous contrast provided the most complete and useful diagnostic information. The findings are presented with an emphasis on the pathologic changes demonstrated on the CT scans of the lumbar spine of which the most persistent findings were granulation tissue at the surgical site, lumbosacral spondylosis, recurrent or residual herniated disc, and arachnoiditis.

Adult

The computed tomographic spectrum of cerebral cysticercosis.

A review of the disease cerebral cysticercosis is presented. The pathogenesis, symptomatology, diagnosis, and treatment of this disease is discussed with an emphasis on the role of computed tomography in the diagnosis of cerebral cysticercosis.

Adolescent

Computed tomography in the evaluation of encephaloceles in infants and children.

Computed tomography (CT) is an accurate diagnostic modality in the evaluation of encephaloceles. The axial and coronal planes, contrast enhancement attenuation measurement of the contents of the encephalocele, and the use of the standard and reverse modes for viewing the CT images are all valuable in this evaluation.

Child