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Biomedical subjects

A H Kaye

Publications and source records attributed to A H Kaye.

88 records · Page 5Linked to original sources
PubMed1984

Intracranial extension of inflammatory pseudotumor of the orbit. Case report.

Orbital pseudotumors are inflammatory lesions of the orbit of unknown etiology, which initially mimic an orbital neoplasm. Involvement of the other orbit is uncommon, and extension into the paranasal sinus rare. Intracranial extension of pseudotumor of the orbit is previously unreported. This is a case report of a patient with pseudotumor of the orbit with intracranial extension. The literature of the subject is reviewed.

Aged↗
PubMed1984

CSF smooth-muscle constrictor activity associated with cerebral vasospasm and mortality in SAH patients.

Cerebrospinal fluid (CSF) was collected preoperatively (by lumbar puncture) or perioperatively (by lumbar or ventricular drain) from 32 patients with subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms. Samples were also obtained from six control patients without evidence of subarachnoid blood. Smooth-muscle constrictor activity in the CSF was measured by bioassay using the isolated rat stomach fundus preparation. Concentrations of unidentified smooth-muscle constrictor substances were considerably greater in CSF from a group of seven patients with evidence of severe angiographic vasospasm and/or delayed ischemic deficits who died (73.8 +/- 39.7 nmol/liter prostaglandin E2 (PGE2) equivalents), as compared to 25 other SAH patients who survived (6.5 +/- 1.4 nmol/liter PGE2 equivalents), and six control patients (1.17 +/- 0.34 nmol/liter PGE2 equivalents). The data suggest that there is a relationship between smooth-muscle constrictor substances in the CSF after SAH and both the degree of angiographic vasospasm and the outcome. It is possible that this relationship might be exploited clinically.

Humans↗
PubMed1984

Jugular foramen schwannomas.

Thirteen patients with schwannomas of the jugular foramen were operated on at the Cleveland Clinic between 1974 and 1983. The authors' experience in managing these rare tumors is presented. Three major growth patterns of jugular foramen schwannoma were seen, and it is postulated that the position of the tumor depends on its point of origin from the nerves as they pass through the pars nervosa of the jugular foramen. The more distal lesions will expand inferiorly out of the base of the skull, and the more proximal lesions will enlarge into the posterior fossa. Tumors in the mid region will tend to expand primarily into bone. The schwannoma was primarily intracranial in six patients. In five patients the tumor expanded the bone at the base of the skull, with only a small intracranial component, and in two patients the tumor was primarily extracranial, with a small extension into the bone or posterior fossa. The presentation of the patients varied according to the tumor growth pattern. Deafness, vertigo, and ataxia were present in all patients with a major intracranial component, and in most of these there were only minimal deficits of the jugular foramen nerves. By contrast, lower cranial nerve involvement, including hoarseness and weakness of the trapezius and sternocleidomastoid muscles, occurred in patients in whom the tumor was primarily, within the bone or extracranial. Three of the five patients with the major component of the schwannoma within the bone also had deafness. Symptomatic history was longest in those with tumor mainly involving the bone at the base of the skull, and shortest in patients with entirely extracranial tumor. Surgical resection was accomplished with a joint neurosurgical-otological approach, usually combining a posterior fossa exploration with either a translabyrinthine transcochlear or infralabyrinthine procedure. The exact nature of the operation depended upon the presence of intracranial tumor and on the extent of bone or extracranial involvement. Total excision was performed in all cases. There was no operative mortality, and surgery resulted in loss of function of the ninth, 10th, and 11th cranial nerves in most patients. The major postoperative morbidity consisted of swallowing difficulties and sputum aspiration.

Adult↗
PubMed1983

The 5-hydroxytryptamine antagonist ketanserin inhibits the vasoconstrictor activity of per-operative CSF, from subarachnoid haemorrhage patients, on isolated tissues.

Peri-aneurysmal CSF was obtained at operation from 13 patients with subarachnoid haemorrhage from ruptured intracranial aneurysms. The 5-hydroxytryptamine antagonist ketanserin inhibited contractions of isolated human intracranial arteries, elicited by this CSF. The presence of 5-HT in CSF was confirmed by high performance liquid chromatography. The use of ketanserin in the therapy of postoperative cerebral vasospasm is discussed.

Adult↗
PubMed1983

Intravenous digital subtraction angiography in the assessment of patients for carotid endarterectomy.

Preoperative intravenous digital subtraction angiography (IV DSA) was compared with the operative findings in 54 patients who underwent a total of 57 carotid endarterectomies, to evaluate the accuracy of preoperative IV DSA in predicting the lesion found at surgery. Four studies early in the series were technically unsatisfactory, leaving 50 patients with 53 procedures for evaluation. Severe carotid artery stenosis was accurately predicted in all cases. Deep ulceration in the absence of severe carotid stenosis was reliably shown by IV DSA, although it was not reliably demonstrated by either IV DSA or carotid angiography if severe stenosis was also present. As severe carotid stenosis or deep ulceration are the major radiological indications for carotid endarterectomy, the authors have found that technically satisfactory IV DSA is an adequate preoperative imaging technique.

Arterial Occlusive Diseases↗
PubMed1982

The treatment of trigeminal neuralgia by posterior fossa microsurgery.

Between 1972 and 1981 57 patients underwent posterior fossa exploration in Oxford by a single surgeon for the treatment of trigeminal neuralgia. Fifty-four of these had either partial or total section of the trigeminal sensory root, 2 had microvascular decompression operations and one had both a partial sensory root section and microvascular decompression. There was no mortality and no significant morbidity. Fifty-four patients were followed up for a mean period of 4 . 5 years. Fifty-two patients (96%) had either no further pain or only minor twinges requiring no further treatment. Two other patients who had partial sections suffered no further trigeminal neuralgia after subsequent total sections. One patient who had a partial root section developed anaesthesia dolorosa and one who had a microvascular decompression developed painful dysaesthesia. All patients having partial root sections retained previously intact corneal responses--the sensory impairment in the face corresponded to the appropriate part of the portio major cut. Only 11% of patients were found to have a vascular abnormality.

Adult↗
PubMed1982

Intracranial pressure in patients with the empty sella syndrome without benign intracranial hypertension.

The intracranial pressure was monitored continuously for at least 48 hours in five patients with empty sella syndrome, who did not have clinical benign intracranial hypertension (BIH). It has been suggested that the empty sella syndrome is a result of chronically elevated intracranial pressure in the presence of a congenitally deficient diaphragma sellae. However, whilst the intracranial pressure in two of the five patients was abnormally high, in three patients in whom it was monitored, the CSF pressure was normal. Although these cases may represent "burnt out" forms of intracranial pressure problems, it might be that the normal pulsations of CSF are sufficient to produce the empty sella in the presence of a deficient diaphragma sella.

Adult↗
PubMed1982

Dangers of collapsible ventricular drainage systems. Technical note.

Ventricular drainage systems employing a collapsible plastic bag for fluid collection were postulated to cause an increasing back-pressure produced in part by the elasticity of the bag. This postulate was shown to be correct in an experimental situation. There was a logarithmic rise in cerebrospinal fluid pressure as the bag filled. By increasing the size of the bag, the problem was overcome.

Cerebral Ventricles↗
PubMed1981

Hemifacial spasm: a long term follow-up of patients treated by posterior fossa surgery and facial nerve wrapping.

Sixteen patients with hemifacial spasm were treated by posterior fossa surgery and wrapping of sponge around their facial nerve. A good or excellent result has been obtained in fourteen of the sixteen cases, and in seven cases followed by four years or longer. Two patients had a mild recurrence of their hemifacial spasm after a cessation of their spasm for eighteen months and two years following surgery. Contrary to the experience of other authors a definite vascular abnormality was found in only four cases. In the other twelve cases circumferential fibrosis about the nerve is again proposed as a mechanism for the effectiveness of the procedure.

Adult↗
PubMed1981

Postoperative intracranial pressure in patients operated on for cerebral aneurysms following subarachnoid hemorrhage.

The postoperative intracranial pressure (ICP) in 36 patients operated on for cerebral aneurysm following subarachnoid hemorrhage was studied. Not only was the baseline ICP significantly lower in patients whose outcome was assessed as "good" as compared with those patients with a worse outcome at 1 month after surgery, but also the height of the plateau waves and B-waves was significantly less in the patients who did well. The baseline ICP and the height of the B-wave formation were unrelated to the position of the aneurysm. Plateau waves were marginally significantly higher in aneurysms of the anterior communicating artery complex. Neither preoperative hypertension nor the use of antifibrinolytic agents made any difference to postoperative ICP. In patients with cerebral arterial vasospasm found preoperatively on the angiograms, the ICP tended to be lower in the postoperative period than in those without spasm.

Cerebral Arteries↗
PubMed1978

Local excision of carcinomas of the rectum, anus, and anal canal.

Local resection has a place in the treatment of selected patients with carcinoma of the rectum, anus and anal canal. Selection depends on the ability of the surgeon to assess accurately the stage of the tumour. Favourable lesions are those which are small, exophytic, and mobile on the surrounding tissues. A transphincteric approach has been advocated for these tumours, but this seems unnecessarily destructive. The present series consists of 18 highly selected patients who were treated by transanal local removal. There have been two recurrences, one of which has been treated by abdominoperineal resection and the other by further local excision. All of these patients were diagnosed clinically as suffering from carcinoma before operation. Patients who had a preoperative diagnosis of carcinoma and were later found to have benign adenomas, and patients who were diagnosed as benign and later found to have histological malignancy, have been excluded.

Adenocarcinoma↗
PubMed1975

Letter: Sinutab.

Explore the source record for details and available documents.

Acetaminophen↗
PubMedDate not supplied

Photodynamic therapy of brain tumors.

Photodynamic therapy (PDT) is a binary treatment modality suitable for various malignant tumors including brain. It involves the selective uptake of a photosensitizer into tumor followed by intraoperative irradiation of the tumor with light of an appropriate wavelength to cause activation of the sensitizer and subsequent selective tumor destruction. PDT has been extensively investigated in laboratory studies and has been used in clinical trials to treat a variety of brain tumors, particularly gliomas. The main advantage of PDT lies in its ability to select out infiltrating tumor cells that are responsible for local tumor recurrence. The therapy has been shown to be safe clinically but adequate trials have yet to be undertaken to prove its efficacy and much work remains to be done to optimize treatment. The biological basis, laboratory studies, and clinical trials involving PDT in the treatment of cerebral tumors are discussed.

Animals↗