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Biomedical subjects

A B Dublin

Publications and source records attributed to A B Dublin.

At least 37 records · Page 2Linked to original sources

Computed tomography of disseminated coccidiodomycosis.

Fifteen cases of disseminated cerebral coccidioidomycosis (DCC) were evaluated by computed tomography (CT). Of the 14 patients with abnormal CT scans, all but 2 showed definite evidence of hydrocephalus. Abnormalities of the basal cisterns were present on non-contrast scans in 8 cases (53%). Ten (67%) demonstrated abnormal contrast enhancement of basal cisterns and other cerebrospinal fluid (CSF) spaces. White-matter lesions were detected in 6 cases (40%). Hydrocephalus usually follows abnormal enhancement of basal cisterns. A consistent relationship between active disease (as diagnosed by CSF complement fixation titers) and contrast enhancement could be demonstrated only in the first weeks of the illness.

Adolescent↗

Diagnostic image evaluation of hydranencephaly and pictorially similar entities, with emphasis on computed tomography.

The radiographic evaluation of a spectrum of vascular cerebral damage is presented, ranging from simple porencephaly to the most severe form, classic hydranencephaly. With a combination of clinical materal and computed tomography, it is possible in most cases to arrive at a specific diagnosis of hydranencephaly or severe bilateral porencephaly. Pictorially similar entities, such as massive congenital subdural hematomas or hygromas, alobar holoprosencephaly, massive hydrocephalus, and massive postanoxic or infective encephalopathies, are discussed.

Anencephaly↗

Cerebral blood flow determination by video dilution technique in a patient with malignant chemodectoma.

Cerebral angiography performed on a patient with a preliminary diagnosis of jugular foramen syndrome revealed a highly vascular malignant chemodectoma supplied mainly by the left ascending pharyngeal artery. Blood flow was determined during angiography in the extracranial branches of the carotid arteries by video dilution technique. The decrease of blood flow after partial embolization of the left ascending pharyngeal artery was also quantified. The application and value of video dilution technique in blood flow determination, together with the angiographic findings are discussed.

Adult↗

Traumatic dislocation of the atlanto-occipital articulation (AOA) with short-term survival. With a radiographic method of measuring the AOA.

Three patients with traumatic atlanto-occipital articulation (AOA) dislocation are presented, and an additional 10 well documented cases are reviewed from the literature. Medulla oblongata and/or spinal cord deficits, and evidence of cranial nerve injuries were noted in eight patients. Angiographic evidence of vertebral occlusion or narrowing was demonstrated in four patients. One patient had systemic hypertension, presumably from bilateral traumatic ninth nerve injuries. Five patients ultimately died. A new method of measuring the AOA is introduced.

Adolescent↗

Cerebral aneurysmal rupture during angiography with confirmation by computed tomography: a review of intra-angiographic aneurysmal rupture.

Rupture of a cerebral aneurysm during angiography, with confirmation by computed tomography (CT), is described. A review of 30 additional reported cases demonstrates no unusual profiles, with the exception of the predominance of female patients (71%), and the presence of pre-angiographic arterial hypertension. Experimental and clinical evidence increasingly suggests that intravascular pressures are transiently elevated during cerebral angiography. These changes may be enhanced by increased flow rates of contrast media, smaller diameters of the catheters, and the presence of intracranial arterial spasm, the latter presenting as a very prominent feature in intra-angiographic arterial rupture. However, direct evidence of elevation of the intra-aneurysmal pressure has not been documented, and may have occurred in only a portion of the cases.

Adult↗

Statistical detection of nonvisible isodense subdural fluid collections.

An analytic method for detecting isodense subdural fluid collections from computed tomography (CT) scan pixel attenuation data is presented. Analysis of 44 CT scan levels from 8 patients with isodense subdural hematomas (ISDH) and 50 CT scan levels from 15 patients without ISDH indicates 6% false positive and 3% false negative errors if the analysis is restricted to noncontrast CT scans that demonstrate subcalvarial bilateral cortical attenuation symmetry in the pictorial display.

Atrophy↗

Fluid--fluid level in cystic cerebral metastatic melanoma.

Two cases of cystic metastatic melanoma are presented. The only reliable computed tomography sign of a true cystic lesion is the presence of an interface, such as between blood and tumor fluid. Differentiation of cystic metastatic melanoma from other cystic lesions of the brain is discussed.

Adult↗

The evaluation of seizure disorders by computerized tomography.

A series of 150 patients with seizure disorders was analyzed in detail. Older individuals (over the age of 65 years) with a short duration of seizure activity at the time of computerized tomography (CT) examination (less than 6 months), associated with specific neurological findings and focal seizures secondarily generalized, produced the highest number of intracranial CT abnormalities. Relationships between CT, electroencephalography (EEG), and other diagnostic procedures and pertinent historical and neurological findings are discussed.

Adolescent↗

Computer assisted ventriculography.

Computed tomography was performed following iothalamate meglumine (Conray) ventriculography in two cases of colloid cyst of the third ventricle. The application of this technique in the diagnosis of intraventricular mass lesions is discussed.

Adult↗

Cerebral pseudoatrophy and computed tomography: two illustrative case reports.

The detection of cerebral atrophy in the demented patient is best accomplished by computed tomography (CT). However, CT is a static tool in the evaluation of cerebral disease. Two cases of "pseudoatrophy", one secondary to malnutrition, the other secondary to communicating hydrocephalus, will illustrate the problems in the evaluation of "atrophic" change on the basis of one CT examination alone.

Aged↗

Computed tomography in head trauma.

Retrospective analysis of 200 cases of documented head trauma demonstrated an accuracy approaching 100% in the diagnosis of intra- and extracerebral collections of blood. Caution must be exercised in the evaluation of trauma 1 to 5 weeks old, since subdural hematomas have the same density as normal brain tissue, and angiography may be necessary. The clinical diagnosis of brainstem contusion is associated with a remarkably high level (54%) of surgically correctable lesions. The use of computed tomography in the evaluation of other traumatic intracranial lesions is discussed.

Brain Diseases↗

Computed tomography in the evaluation of herpes simplex encephalitis.

A case of newborn congenital herpes simplex type 2 viral infection is presented. Computed tomography (CT) revealed diffuse hydrocephalus, and confirmed the periventricular nature of the brain calcifications. The pathologic, radiographic, and CT findings are discussed.

Encephalitis, Arbovirus↗

Infantile chronic subdural hematoma of the posterior fossa diagnosed by computerized tomography. Case report.

A 9-week-old infant manifested continuous vomiting for 1 week accompanied by a tense fontanel, "sun setting" of the eyes, frequent opisthotonos, and hypertonicity. The head circumference was at the 50th percentile. Computerized tomography (CT) revealed acute hydrocephalus and a posterior fossa subdural hematoma. The brain stem and cerebellum were of greater density (54 Hounsfield units) than normal cerebral white matter (42 Hounsfield units) whereas the subdural hematoma was the same density as normal cerebral white matter ("isodense"). The cerebellum and brain stem became enhanced by contrast (68 Hounsfield units), but no enhancement occurred in the cerebral white matter or subdural hematoma. A shunt followed by occipital craniectomy resolved both the hydrocephalus and subdural hematoma. Repeat CT scan 15 days postoperatively disclosed continuing higher density of the cerebellum and brain stem (60 Hounsfield units) relative to cerebral white matter. Increased density of the infantile cerebellum has been noted previously but not to the same extent as in this patient.

Chronic Disease↗

The value of computerized tomography in the management of 1000 consecutive head injuries.

One thousand consecutive head injuries were evaluated in a 14-month period. Computerized tomography (CT) was performed in 316 patients and 200 (63%) were scanned within 72 hours of injury. Fifty-one percent of patients had abnormal scans. The yield of abnormal scans varied with the neurological state at the time of the scan: alert and normal neurologically, 13%; alert and focal deficit, 50%; impaired consciousness and no lateralizing findings, 35%; impaired consciousness and lateralizing findings, 85%; deep coma or posturing, 56%. Thirty-eight percent of patients had multiple lesions. Repeat scans were done in 103 patients, 52% developed new lesions or deterioration in known lesions, and 31% required subsequent surgery. Ten patients developed delayed onset subdural hygromas noted six to 46 days after injury. Two of eight operated patients improved markedly. The CT scan appearance of subdural lesions may be independent of the time from injury depending upon initial composition and rebleeding episodes. Thus, subdural lesions should not be labeled "acute," "subacute," or "chronic" on the basis of CT morphology alone. Seven patients had subdural lesions with the same density as brain (isodense). Arteriography aided diagnosis in six patients. The CT scan readily shows what proportion of a parenchymal lesion is intracerebral hematoma, contusion, or edema, rather than nonspecific arteriographic mass effect, and allows precise surgical decisions. Eighteen of 40 patients (45%) with "brain stem contusion" harbored surgical lesions, including five cases of delayed subdural hygroma.

Adolescent↗