PubMed Health⌕ Search

Biomedical subjects

U Batzdorf

Publications and source records attributed to U Batzdorf.

At least 19 recordsLinked to original sources
PubMed1992

Ependymoma of the cauda equina region: diagnosis, treatment, and outcome in 15 patients.

New diagnostic imaging techniques make possible a reappraisal of current diagnostic, therapeutic, and management strategies for certain rare lesions of the central nervous system. With this in mind, we have reviewed our experience with ependymoma of the filum terminale and cauda equina region. Fifteen patients with this tumor have been treated since 1955. Typical presentations included pain, lower extremity weakness, and, occasionally, bladder dysfunction. Delays in arriving at the proper diagnosis have been the rule; however, we have noted a substantial increase in the number of these tumors referred to us since the advent of magnetic resonance imaging. Treatment includes surgical resection to the extent consistent with preservation of neurological function; postoperative irradiation appears to be of benefit in controlling recurrence except in those patients whose well-circumscribed tumors have been removed completely. Presence of urinary difficulties at the time of diagnosis is a relatively poor prognostic sign, and a more liberal use of magnetic resonance imaging in cases of persistent or recurrent low back and radicular pain unresponsive to conservative therapy may help to achieve earlier diagnosis. Because of the possibility of late recurrence, prolonged follow-up is mandatory for all patients, and magnetic resonance imaging is the diagnostic tool of choice.

Adolescent↗
PubMed1991

Surgical decompressive procedures for cervical spondylotic myelopathy. A study using magnetic resonance imaging.

Twenty-two patients who underwent a surgical decompressive procedure for cervical spondylotic myelopathy were studied with magnetic resonance imaging to evaluate the effectiveness of their decompressive procedures. Twelve patients were judged as adequately decompressed by magnetic resonance imaging criteria. Ten patients exhibited evidence of residual cord indentation. This along with cord atrophy, gliosis, and abnormal spine curvature presumably contributed to residual deficit in several patients. One patient underwent a second decompressive procedure for residual cord indentation, which subsequently improved, as seen on his second postoperative magnetic resonance image. Magnetic resonance imaging was useful in distinguishing mechanical problems from intrinsic cord damage or atrophy. Magnetic resonance imaging should be used after operation in patients with residual deficit to detect patients who may be considered for a second decompressive procedure.

Cervical Vertebrae↗
PubMed1989

Grisel's syndrome. Cervical spine clinical, pathologic, and neurologic manifestations.

Grisel's syndrome involves the subluxation of the atlantoaxial joint from inflammatory ligamentous laxity following an infectious process. Even though it was first described in 1830, it is a rare disease usually affecting children, but infrequent adult cases do occur. Patients generally seek treatment for progressive unrelenting throat and neck pain followed by torticollis and subluxation. Neurologic complications occur in approximately 15% of cases and can range from radiculopathy to myelopathy and even death. Principles of management include bacteriologic cure and correction of bony deformity and neurologic protection. The authors present two adult patients with Grisel's syndrome. The first illustrates the permanent spinal deformity that can occur if the disease remains unrecognized for a prolonged period of time. The second case demonstrates a delayed neurologic complication in an adult who had Grisel's syndrome in childhood. It is hoped that these two examples, together with a detailed discussion of the literature, will inform physicians of an unusual but important condition to be considered in the differential diagnosis of any patient complaining of neck pain.

Adult↗
PubMed1988

Analysis of cervical spine curvature in patients with cervical spondylosis.

Computer-aided design techniques were used to analyze the degree of spinal curvature shown on cervical spine radiograms of 28 patients. On films standardized as to size, a geometrical chord was constructed from the 2nd to the 7th cervical vertebrae (C2 to C7), and an arc was drawn along the posterior margin of the vertebrae. The resulting area was used as an index of curvature, and the spinal canal diameter was measured. Severity of myelopathy as well as clinical improvement was related to the geometrical data. There was no clear correlation between severity of the preoperative myelopathy and degree of curvature. Severe myelopathy was seen in association with straight, lordotic, and hyperlordotic spines. Neck pain was most severe in patients with reversed cervical curvature. The degree of curvature, however, seems to relate to the postoperative clinical outcome. Patients with relatively normal curvature showed the greatest improvement in symptoms and signs. Postoperative magnetic resonance scanning confirms that posterior migration of the spinal cord after laminectomy may be inadequate to clear osteophytes in patients with straightened or reversed curvature of the cervical spine. Spinal geometry should be considered in the selection of the best surgical procedure and the extent of laminectomy for patients with spondylotic myelopathy. Significant abnormalities of spinal curvature may account for some instances of poor outcome after laminectomy.

Aged↗
PubMed1988

Chiari I malformation with syringomyelia. Evaluation of surgical therapy by magnetic resonance imaging.

Five patients with a Chiari I-syringomyelia complex of adult onset were evaluated by magnetic resonance (MR) imaging. All patients underwent suboccipital craniotomy with upper cervical (C-1 and part of C-2) laminectomy, arachnoid retraction, and duraplasty. Postoperative MR studies of four patients disclosed collapse of the syringomyelic cavity, even when the cavity extended into the thoracic region. This appeared to be a progressive process taking place over several weeks. Operative complications are noted and physiological implications are discussed.

Adolescent↗
PubMed1988

Posttraumatic syringomyelia.

Posttraumatic syringomyelia is becoming increasingly recognized as a sequel to major and minor spinal cord injury, paralleling the development and widespread availability of magnetic resonance imaging as a diagnostic modality for evaluating possible spinal pathologic lesions. Delayed, subacute, or progressive neurologic deterioration in victims of traumatic spinal injury with "fixed deficits" should raise the suspicion of posttraumatic syringomyelia. Alternatively, it may present as sensory or motor complaints occurring on a delayed basis after minor spinal trauma causing no initial neurologic impairment. At our institution, we have treated six of eight patients with this condition by shunting fluid from the intramedullary cyst to the peritoneal cavity by means of a simple valveless shunt, resulting in sustained neurologic improvement in five patients.

Adolescent↗
PubMed1987

MR imaging of the cervical spine: neurovascular anatomy.

High-resolution surface-coil MR imaging reveals intricate anatomic detail of the cervical spinal canal and its neurovascular contents. Appreciation of the normal neurovascular anatomy provides a scientific foundation for the detection of disease. Sagittal, axial, and oblique MR images of normal subjects were correlated with comparable anatomic sections obtained with a cryomicrotome whole-organ sectioning technique. The anterior epidural venous plexus is a prominent structure in the cervical spinal canal and was consistently identified both with cryomicrotomy and with MR in sagittal and axial planes. Epidural veins can be displaced and distorted in patients with cervical disk disease. Nerve roots including dorsal and ventral rootlets were consistently identified on axial images coursing through the subarachnoid space. Oblique-plane imaging showed nerve roots "en face" in their respective foramina; this may be a useful imaging technique in the diagnosis of nerve root impingement.

Cadaver↗
PubMed1986

Sphenoid sinus mucocele (anterior clinoid variant) mimicking diabetic ophthalmoplegia and retrobulbar neuritis.

Two patients (two men, 56 and 59 years old) had sphenoid sinus mucocele originating in the anterior clinoid process. In one case the mucocele initially mimicked diabetic ophthalmoplegia with pupil-sparing palsy of the oculomotor (third) nerve. After resolution of the palsy, severe visual loss developed with minimal recovery of vision after surgery. The second patient had recurrent episodes of retrobulbar optic neuropathy with optic atrophy and decreased vision. Visual loss from sphenoid sinus mucoceles is usually associated with a poor prognosis if surgical treatment is delayed more than seven to ten days.

Diabetes Complications↗
PubMed1986

Relationship between arterial blood pressure and plasma norepinephrine levels in a patient with neurogenic hypertension.

This study examined the relationship between arterial blood pressure and plasma norepinephrine levels during 12 hours of monitored sleep in a 35-year-old man in whom neurogenic hypertension developed immediately after surgical removal of a large hemangioblastoma at the obex region of the cervical-medullary junction. Plasma norepinephrine levels throughout the 12-hour sampling period correlated (r = 0.81, p less than 0.01) with mean arterial blood pressures, suggesting that sleep-related changes in blood pressure were dependent on associated changes in sympathetic nervous system activity in this patient with neurogenic hypertension.

Adult↗
PubMed1984

Carotid-cavernous fistula following nasopharyngeal biopsy.

A middle-aged man with a cervical lymph node metastasis underwent nasopharyngeal biopsy in search of the primary tumor. Following biopsy his eye became swollen and painful with unilateral loss of vision. A carotid-cavernous fistula was demonstrated, as was deficient ossification at the base of the skull. The fistula was successfully treated with balloon embolization.

Arteriovenous Fistula↗
PubMed1983

Surgical exposure of the high cervical carotid artery: experimental study and review.

Difficulty in gaining access to the high cervical internal carotid artery (ICA) has thus far prevented effective operation for intimal repair and treatment of aneurysms at this level. Mobilization of the angle of the mandible by means of mandibular osteotomies considerably improves exposure to the high cervical ICA. This procedure has been performed in rhesus monkeys and in human cadavers. In monkeys, retromandibular external carotid artery-ICA anastomoses were carried out with no problems (neurological, wound healing, or other). This new technique should be considered for the management of some high cervical ICA lesions, particularly those occurring after closed cervical trauma.

Animals↗
PubMed1983

Successful treatment of spinal arachnoiditis due to coccidioidomycosis. Case report.

An unusual case is reported of a patient with spastic paraparesis who was found to have severe spinal arachnoiditis due to Coccidioides immitis. Despite an obstructive hydrocephalus and a spinal subarachnoid block, the patient was treated effectively with surgery (shunting) and antifungal therapy (amphotericin and ketoconazole). He remains asymptomatic 3 years after diagnosis. Aggressive surgical and medical treatment of coccidioidal infection of the central nervous system can be beneficial, even in patients with the worst prognosis.

Adult↗
PubMed1983

Use of metrizamide for percutaneous cordotomy. Technical note.

Demonstration of the anterior surface of the spinal cord is an important step in performing a percutaneous cordotomy. Metrizamide has been found to be a superior agent for this purpose, permitting visualization of the cord shadow in the anteroposterior as well as the lateral projection, and thereby also enabling the surgeon to visualize displacement of the spinal cord during the procedure. Tissue impedance and spinal cord stimulation techniques are used in conjunction with metrizamide. No adverse effects have resulted from the use of this technique.

Humans↗
PubMed1983

Comparisons of carmustine, procarbazine, and high-dose methylprednisolone as additions to surgery and radiotherapy for the treatment of malignant glioma.

Within 3 weeks of definitive surgery, 609 patients with histologically demonstrated, supratentorial malignant glioma were randomized to receive, in addition to 6000 rads of radiotherapy, one of four treatment regimens: carmustine (BCNU), high-dose methylprednisolone, procarbazine, or BCNU plus high-dose methylprednisolone. We analyzed the data for the total randomized population and for the 527 patients (87% with glioblastoma multiforme) in whom the initial protocol specifications were met (the valid study group). Significantly longer survival was experienced by patients receiving procarbazine or BCNU alone compared to those receiving only high-dose methylprednisolone. No other pairwise comparisons demonstrated differences significant at the 0.05 level. However, the combination of BCNU plus high-dose methylprednisolone tended to be less effective than BCNU alone in patients with poor prognosis. This study indicates that BCNU and procarbazine are moderately useful agents in conjunction with radiotherapy for patients with malignant glioma. In addition, future protocols may allow use of corticosteroids in conventional dosages for treating cerebral edema and controlling symptoms; conclusions based on survival as the endpoint are unlikely to be affected by administering steroids at somewhat greater than the usual dose. More effective regimens for the treatment of malignant glioma should be sought.

Adolescent↗
PubMed1979

Blunt trauma to the high cervical carotid artery.

Closed injuries to the neck, occasionally associated with mandibular fractures, can result in trauma to the internal carotid artery at the high cervical level opposite the uppermost cervical vertebrae. Such arterial injuries range from spasm to intimal tear with thrombus formation, medial tear, and aneurysm formation. These types of lesions may overlap. Ten patients are presented, five with traumatic carotid occlusions and five with traumatic aneurysms. The clinical diagnosis of traumatic cervical carotid occlusion may be difficult because of the absence of physical trauma to the neck. The diagnosis of aneurysm poses fewer problems. Oculopneumoplethysmography, computerized tomographic head scanning, and carotid arteriography with cross compression are the most useful diagnostic techniques. Thrombectomy should be carried out early, particularly in the presence of fluctuating neurological signs. Aneurysms that cannot be approached directly may necessitate carotid ligation.

Adult↗