PubMed Health⌕ Search

Biomedical subjects

T C Kriss

Publications and source records attributed to T C Kriss.

14 recordsLinked to original sources
PubMed2000

Sonographic appearance of the ventriculus terminalis cyst in the neonatal spinal cord.

The ventriculus terminalis or "fifth ventricle" is an ependyma-lined residual lumen of the caudal portion of the spinal cord (the conus medullaris). We present the cases of three neonates with asymptomatic cystic dilatation of the ventriculus terminalis as seen on spinal sonography. Over a 4 year period (1996-1999), we prospectively found three cases in which spinal sonograms demonstrated cystic dilatation of the ventriculus terminalis of the conus medullaris in normal term neonates. Sonograms of the lumbosacral spine of two of the infants demonstrated cystic dilatation of the ventriculus terminalis of the conus medullaris. The third infant had cystic dilatation at the distal tip of the conus medullaris at the origin of the filum terminale. No other abnormalities were noted. The three infants have remained asymptomatic during clinical follow-up periods of up to 3 years. Cystic dilatation of the ventriculus terminalis is an unusual but normal anatomic variant of the conus medullaris that can be visualized on spinal sonograms in neonates.

Cysts↗
PubMed2000

Neck pain. Primary care work-up of acute and chronic symptoms.

Acute or chronic neck pain can arise from degenerative processes, musculoskeletal trauma, or structural changes. For all patients presenting with neck pain, determining the presence of radiculopathy or myelopathy is an important step in initial assessment. Depending on the duration of pain, the work-up should include appropriate use of traditional and advanced imaging studies. For cases that do not suggest traumatic, structural, or rheumatologic origins, alternate considerations should include stress, depression, and--because of its increased incidence in older persons--cancer. Nonsteroidal anti-inflammatory agents, mild oral analgesics, and short-term corticosteroid therapy are the mainstays of treatment, although physical therapy and traction can be helpful for some patients. The presence of a herniated disk, cord compression (severe stenosis), tumor, or other structural lesion may require surgical decompression.

Acute Disease↗
PubMed1998

History of the operating microscope: from magnifying glass to microneurosurgery.

The advent of the microscope in the operating room revolutionized neurosurgery. We traced the origin and evolution of this important invention from the first magnifying lens to its practical application in neurosurgery. The concept of magnification evolved from unexplained observations in ancient times to the invention of the microscope by the late 16th century. In the subsequent 3 centuries, scientists made technical advances that greatly improved the power and utility of the microscope. By the early 20th century, otolaryngologists became the first surgeons to use the microscope in clinical surgery. After World War II, ophthalmologists and vascular and plastic surgeons began using the microscope in the operating room, making further technical improvements. It was a relatively small group of pioneering neurosurgeons in the late 1950s and 1960s who transformed microneurosurgery from a revolutionary and unorthodox "experiment" into the standard of care in much of modern neurosurgery.

Equipment Design↗
PubMed1997

Symptomatic spinal intradural arachnoid cyst development after lumbar myelography. Case report and review of the literature.

STUDY DESIGN: This case report describes the unique occurrence of acquired intradural spinal arachnoid cyst after lumbar puncture, which was proven radiographically and surgically. OBJECTIVES: To review and explore complications of lumbar puncture in the context of subsequent cyst development and to review the incidence, presentation, pathogenesis, and management of spinal intradural arachnoid cysts. SUMMARY OF BACKGROUND DATA: The etiology of the spinal intradural arachnoid cyst remains obscure; some such cysts are ascribed anecdotally to previous trauma or arachnoiditis, whereas the majority are idiopathic and assumed by many authors to be congenital. METHODS: A 20-Year-old woman with back and leg pain underwent lumbar myelography that yielded normal results with no evidence of arachnoid cyst at that time. Within 5 months, clinical symptoms of cauda equina compression and an S1 radiculopathy developed. Subsequent myelography and magnetic resonance imaging revealed a lumbar spinal arachnoid cyst. There was no history of intervening trauma or arachnoiditis. The lumbar puncture was thought to be the cause of the arachnoid cyst. RESULTS: A laminectomy was performed with complete excision of the arachnoid cyst. The patient had an unremarkable postoperative course with excellent relief of her symptoms. CONCLUSIONS: This case provides supporting evidence for the traumatic etiology of spinal intradural arachnoid cyst. The development of an intradural spinal arachnoid cyst should be included as a possible complication of lumbar puncture.

Adult↗
PubMed1997

Equine-related neurosurgical trauma: a prospective series of 30 patients.

Thirty million Americans ride horses; 50,000 of these riders are treated in emergency rooms annually. Equestrian activities are uniquely dangerous because the participant is unrestrained, often helmetless, and riding large, unpredictable animals capable of 40-mph speeds and kicking with up to 1 ton of force. Neurologic injuries in equestrians constitute the majority of severe injuries and fatalities. We prospectively studied all patients admitted to the University of Kentucky Medical Center with equine-related neurosurgical trauma from July 1992 to January 1996. Eighteen of 30 patients were male. Age ranged from 3 to 64 years. Five patients died (17%), and two suffered permanent paralysis. There were 24 head injuries (80%) and 9 spinal injuries (30%). The majority of injuries (60%) were caused by ejection or fall from the horse. Twelve patients (40%) were kicked by a horse, and four patients sustained crush injuries. Six patients underwent craniotomy, three had operative spinal stabilization, and five required ventriculostomy. Eleven patients (37%) were professional riders. Twenty-four patients (80%) were not wearing helmets, including all fatalities and craniotomy patients. Our data show that equine-related neurosurgical injuries can be severe and fatal because of the significant size, force, and unpredictability of these animals as well as the lack of proper headgear. We recommend that helmets be worn at all times around horses because a significant number of our patients (33%) were injured as bystanders. Risk of serious injury appears to be a function of cumulative exposure to horses, not level of expertise. Experience is not protective; helmets are.

Adolescent↗
PubMed1996

Cavernous sinus thrombophlebitis: case report.

OBJECTIVE AND IMPORTANCE: Cavernous sinus thrombophlebitis is a rare, dangerous, and historically difficult condition to diagnose and treat. Knowledge of the imaging findings and the importance of early diagnosis and treatment are emphasized. CLINICAL PRESENTATION: We present a case of cavernous sinus thrombo-phlebitis caused by sphenoid sinusitis. Previously undescribed magnetic resonance imaging findings of cavernous sinus thrombophlebitis include enlargement of the cavernous sinus, abnormal enhancement and increased T2 signal of the petrous apex and clivus, and marked narrowing of the cavernous portion of the internal carotid artery. Resolution of cavernous sinus thrombophlebitis is also documented by magnetic resonance imaging. INTERVENTION: The anatomy of the cavernous sinus dictates the natural history and diagnosis of cavernous sinus thrombophlebitis. We review the literature regarding the clinical diagnosis, differential diagnosis, and treatment of cavernous sinus thrombophlebitis. CONCLUSION: We emphasize the importance of a high index of suspicion, the potentially rapid and fatal course of the disease process, and the subsequent need for antibiotic therapy and selective surgery.

Cavernous Sinus↗
PubMed1996

SCIWORA (spinal cord injury without radiographic abnormality) in infants and children.

We review the biomechanics of the pediatric cervical spine and the clinical findings that pertain to SCIWORA (spinal cord injury without radiographic abnormality) in order to provide a more thorough understanding of this pediatric phenomenon of closed spinal trauma with significant neurologic sequelae but without bony injury. The unique hypermobility and ligamentous laxity of the pediatric bony cervical and thoracic spine predispose to a SCIWORA-type injury. In SCIWORA, the unusually elastic biomechanics of the pediatric bony spine allow deformation of the musculoskeletal structures beyond physiologic extremes, permitting direct cord trauma followed by spontaneous reduction of the bony spine. Potential mechanisms of the SCIWORA include hyperextension/flexion, longitudinal distraction, and ischemic injury of the spinal cord.

Age Factors↗
PubMed1996

Doppler sonographic confirmation of thalamic and basal ganglia vasculopathy in three infants with trisomy 13.

A prospective review of 1746 head sonographic examinations performed from July 1993 to December 1995 revealed three scans that demonstrated a linear, branching echogenic pattern within the thalamus or basal ganglia. All three of these patients had trisomy 13. This finding has been described previously and is presumed to be of vascular causation. Doppler evaluation of the thalamus and basal ganglia in our three cases confirmed the vascular nature of the echogenic, branching pattern.

Basal Ganglia↗
PubMed1995

Occult spinal dysraphism in the infant.

The progressive neurologic dysfunction caused by occult spinal dysraphism can be prevented with early clinical recognition, radiographic diagnosis, and neurosurgical treatment. However, detection of occult spinal dysraphism in the infant is difficult because neurologic symptoms often are not apparent until the child becomes ambulatory. Occult spinal dysraphism, however, can be suspected in the asymptomatic neonate when cutaneous stigmata, such as hemangiomas, hairy patches, deep and/or eccentric dimples, or subcutaneous masses are seen over the lumbosacral spine. Because of the serious, often irreversible, sequelae of a delayed diagnosis, spinal sonography of high-risk infants with midline, lumbosacral, cutaneous stigmata should be considered as an effective, noninvasive screening method.

Humans↗
PubMed1995

The ventriculus terminalis of the spinal cord in the neonate: a normal variant on sonography.

OBJECTIVE: The ventriculus terminalis, or fifth ventricle, is an ependymal-lined residual lumen of the caudal most portion of the spinal cord (the conus medullaris). We describe five neonates in whom this normal variant was depicted on sonography. MATERIALS AND METHODS: Screening lumbosacral spinal sonograms are performed at our institutions on neonates with lumbosacral cutaneous stigmata. Over a 2-year period (1993-1995), we prospectively found five cases in which spinal sonograms showed the ventriculus terminalis of the conus medullaris in term neonates. Two of the five received follow-up spinal sonograms at the age of 3 months. RESULTS: Sonograms of the lumbosacral spine of these five neonates showed an unusual hypoechoic or split appearance of the central echo complex of the conus medullaris. No other abnormalities were noted, and the finding was unchanged on the follow-up sonograms performed on two of the infants at the age of 3 months. These infants have remained asymptomatic during clinical follow-up periods of up to 2 years. CONCLUSION: The ventriculus terminalis is a normal anatomic variant of the conus medullaris that can be visualized on spinal sonograms in neonates.

Follow-Up Studies↗
PubMed1994

Cervical paraspinous desmoid tumor in a child: case report.

Desmoid tumors are uncommon fibroblastic proliferative lesions usually occurring in the abdominal wall of adults. We report an unusual case of such a tumor presenting as a rapidly growing cervical paraspinous mass in a 19-month-old girl. After surgical resection without adjuvant therapy, the child is recurrence free after 17 months. The primary treatment of these lesions is surgical resection. We found magnetic resonance imaging to be the best imaging method for evaluation, because it was able to distinguish the tumor from the surrounding muscle. Careful postoperative surveillance is warranted, because these tumors have a high rate of recurrence. Although rare, desmoid tumor should be considered in the differential diagnosis of a paraspinous soft tissue tumor in a pediatric patient.

Cervical Vertebrae↗