[Hyperdense areal in the putamen after intra-arterial medialysis: contrast media extravasation or hemorrhage?].
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Aged↗
Biomedical subjects
W Möller-Hartmann
Publications and source records attributed to W Möller-Hartmann.
Metabolic and electrophysiological validation of functional MRI.
OBJECTIVES: Although functional MRI is widely used for preoperative planning and intraoperative neuronavigation, its accuracy to depict the site of neuronal activity is not exactly known. Experience with methods that may validate fMRI data and the results obtained when coregistering fMRI with different preoperative and intraoperative mapping modalities including metabolically based (18)F-fluorodeoxyglucose PET, electrophysiologcally based transcranial magnetic stimulation (TMS), and direct electrical cortical stimulation (DECS) are described. METHODS: Fifty patients were included. PET was performed in 30, TMS in 10, and DECS in 41 patients. After coregistration using a frameless stereotactic system, results were grouped into overlapping (<1 cm distance), neighbouring (<2 cm), or contradictory (>2 cm). RESULTS: Comparing fMRI with PET, 18 overlapping, seven neighbouring, and one contradictory result were obtained. In four patients no comparison was possible (because of motion artefacts, low signal to noise ratio, and unusual high tumour metabolism in PET). The comparison of TMS and fMRI showed seven overlapping and three neighbouring results. In three patients no DECS results could be obtained. Of the remaining 38 patients, fMRI hand motor tasks were compared with DECS results of the upper limb muscles in 36 patients, and fMRI foot motor tasks were compared with DECS results of the lower limb on 13 occasions. Of those 49 studies, overlapping results were obtained in 31 patients, and neighbouring in 14. On four occasions fMRI did not show functional information (because of motion artefacts and low signal to noise). CONCLUSIONS: All validation techniques have intrinsic limitations that restrict their spatial resolution. However, of 50 investigated patients, there was only one in whom results contradictory to fMRI were obtained. Although it is not thought that fMRI can replace the intraoperatively updated functional information (DECS), it is concluded that fMRI is an important adjunct in the preoperative assessment of patients with tumours in the vicinity of the central region.
Adult↗
Brain abscess decades after a penetrating shrapnel injury.
We describe a patient who developed a brain abscess 52 years after sustaining a penetrating craniocerebral shrapnel injury. For 10 years he had suffered from diabetes mellitus, a disorder known to predispose to infections from a diminished body defence. The treatment and aetiology of this rare occurrence is discussed.
Aged↗
Acute necrotising encephalopathy of childhood after exanthema subitum outside Japan or Taiwan.
Acute necrotising encephalopathy of childhood (ANE) is an uncommon disease which predominantly affects infants and young children living in Japan and Taiwan. A multifocal encephalopathy with symmetrical lesions in the thalamus, tegmentum of the brain stem, cerebral periventricular white matter and cerebellar medulla is characteristic. We present the imaging features in a 4-year-old Japanese boy who had been living in Germany for 2 1/2 years before presentation.
Brain↗
[Circular dissection of the ascending aorta with intimo-intimal invagination. CT diagnosis of a rare form of aortic dissection].
Intimointimal intussusception is a rare type of aortic dissection. The intimal tear occurs circumferentially with intussusception of the intimal flap downstream into the aortic arch causing obstruction of the great supraaortic vessels. A CT diagnosis has only once been reported. CT and angiographic findings of this rare complication of aortic dissection are described.
Aortic Dissection↗
[Abdominal involvement in neurofibromatosis type 1].
Neurofibromas are benign tumours that arise from neuroectodermal tissues. They may occur as solitary lesions, or multiple, then referred to as neurofibromatosis, or von Recklinghausen's disease. We report on a 27-year old patient with large involvement of many nerve trunks and plexus (elephantiasis nervosa), responsible for bowel obstruction and anuria.
Abdominal Neoplasms↗
[Emboliform sarcoma of the right pulmonary artery].
Sarcoma of the pulmonary artery is a rare tumor. The histopathologic features of these tumors differ widely, with leiomyosarcomas representing less than 20% of all pulmonary sarcomas. Diagnosis is very difficult because most of the cases have no specific clinical signs: the major differential diagnosis is that of pulmonary thromboembolism. We report the case of a 45-year-old woman, who was first treated for pulmonary thromboembolism until the diagnosis of an intravascular growing tumor was made by means of computed tomography, pulmonary angiography and nuclear magnetic resonance tomography. The patient underwent right pneumonectomy and microscopically a leiomyosarcoma of the right pulmonary artery was found.
Diagnosis, Differential↗
[Unusual calcinosis of tibial muscles. Myonecrosis calcificans of the tibial muscles].
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Aged↗
[Diagnosis of a left-sided cervical aortic arch with nuclear magnetic resonance tomography].
Aortic arch anomalies are rare. They arise as a failure of the normal development of the left fourth dorsal arch. Cervical aortic arches are believed to result from persistence of the third dorsal arch, which re-routes the aortic arch in the cervical region. We describe a case of a left-sided cervical aortic arch in which the diagnosis was confirmed, and the anatomy defined, using magnetic resonance tomography.
Angiography, Digital Subtraction↗
[Focal meningoencephalitis as initial manifestation of Actinobacillus actinomycetem comitans endocarditis].
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Actinobacillus Infections↗
Nephrotoxicity of paracetamol in the rat--mechanistic and therapeutic aspects.
Besides hepatotoxicity, paracetamol may exert nephrotoxic effects in experimental animals and patients. The present study in rats shows that antidotes known to protect against hepatotoxicity, such as methionine or N-acetylcysteine, are not effective in preventing paracetamol-induced kidney damage. Only diethyldithiocarbamate, an inhibitor of microsomal monooxygenases, provided complete protection against both hepato- and nephrotoxicity. While a marked depletion of glutathione was observed in the liver, no such effect was seen in the kidney. These data suggest that the mechanism of paracetamol nephrotoxicity seems to be quite different from that responsible for the hepatotoxicity. The hypothesis that a C-S-lyase-mediated final metabolism of paracetamol-S conjugates in the kidney might be responsible for nephrotoxicity needs support by further experimental investigations.
Acetaminophen↗
Cholestyramine as an antidote against paracetamol-induced hepato- and nephrotoxicity in the rat.
Besides hepatotoxicity, paracetamol may exert nephrotoxic effects in experimental animals and man. The present study in rats shows that cholestyramine given 4 and 24 h after paracetamol provided protection against both hepato- and nephrotoxicity; this was evidenced by reduced increments in plasma enzyme activities (SDH, GPT), indicating liver damage, and diminished retention of plasma and creatinine, indicating renal failure. The recovery of paracetamol and its conjugates in urine was markedly reduced by cholestyramine at 24-48 h after treatment. The protective effects of cholestyramine are explained by adsorption of paracetamol and conjugates in the intestine undergoing biliary excretion and enterohepatic circulation.
Acetaminophen↗