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Biomedical subjects

A L Day

Publications and source records attributed to A L Day.

67 records · Page 4Linked to original sources
PubMed1980

Cervical carotid dissecting aneurysms.

Thirteen cases of cervical carotid dissecting aneurysm have been seen at the University of Florida during the past 3 years. In our experience, two groups of patients with this disease can be distinguished clearly by either clinical or angiographic criteria. One group of cervical carotid dissecting aneurysms is characterized by spontaneous onset, unilaterality, and the absence of pseudoaneurysm formation. These lesions have a strong tendency to resolve with appropriate medical therapy. The other group is characterized by an association with obvious predisposing factors, such as fibromuscular dysplasia, angiography, or trauma. These lesions are often associated with pseudoaneurysms and rarely resolve spontaneously. These two groups of lesions probably represent a spectrum of the same basic disease process. The natural history of patients who survive a cervical carotid dissection is usually one of stability or improvement. A trial of medical therapy (to prevent embolic symptoms) and repeat arteriography are indicated before the consideration of surgical therapy.

Adult↗
PubMed1979

Fracture and complete dislocation of the thoracic or lumbosacral spine: report of three cases.

Severe fracture/dislocation of the thoracic (T) or lumbar (L) spine is usually associated with complete neurological dysfunction below the level of injury. Three cases of severe spinal fracture/dislocation are presented in this report. Two of these patients suffered only partial neurological deficit, which improved after open reduction, internal fixation, and bone fusion. Severe fracture/dislocation of the T or L spine may be quite obvious on lateral roentgenograms. Occasionally, however, the fracture site may be obscured by the overlying shoulders, hips, or soft tissues. If no lateral displacement is evident on anteroposterior (AP) films, a false impression of normal alignment may be given, as was the case in two of our patients. A careful interpretation of the AP view will provide the diagnosis in such cases. The subtle AP radiographic changes suggesting fracture/dislocation of the T or L spine are detailed. The mode of injury, physical findings, prognosis, and surgical treatment of such severe injuries are also briefly reviewed.

Adolescent↗
PubMed1979

Angiographically cryptic cerebrovascular malformations.

Three cases of angiographically cryptic cerebrovascular malformations are presented and a review of the cases in the English literature is tabulated. The typical patient is a 30- to 40-year-old woman with a history of seizures and headache. There is no antecedent history suggesting hemorrhage. On nonenhanced computerized tomographic scans, these lesions are denser than normal brain. They enhance with contrast administration. The angiogram demonstrates an avascular mass. The history, physical findings, and radiographic studies suggest brain tumor. An accurate diagnosis requires operation and pathological examination of the lesion.

Cerebral Angiography↗
PubMedDate not supplied

Resolving siphon stenosis following endarterectomy.

Tandem arteriosclerotic lesions of the carotid sinus and siphon increase the risks of carotid endarterectomy; when the siphon is severely stenotic, a microvascular bypass may be the preferable procedure. Two patients, each with severe siphon stenosis and significant sinus lesions, however, were subjected to carotid endarterectomy as their initial surgical procedure. The postoperative arteriogram showed resolution of the siphon stenosis in both patients. The identification of an associated extracranial lesion, or the presence of a lesion located more distal in the siphon than atheroma usually occur, should alert the surgeon that the intracranial obstruction may be due to embolism. In patients with these tandem lesions, therefore, a repeat arteriogram, performed several weeks after endarterectomy of sufficient medial treatment interval, may show resolution of the intracranial lesion, and may avoid an unnecessary bypass procedure.

Aged↗
PubMedDate not supplied

Laser endarterectomy: a comparison of thrombotic potential following CO2 laser vs surgical endarterectomy.

Although laser endarterectomy has recently been suggested as useful in the treatment of arteriosclerotic obstructions, the "in vivo" clotting effects have not been well delineated. In this study, the common carotid and femoral arteries of ten mongrel dogs were exposed, and alternating 1 cm segments of each artery were treated with surgical endarterectomy and low-powered CO2 laser endarterectomy. Segments were then harvested, and subjected to histologic examination and vascular prostacyclin synthesis determinations, as measured by 6-keto PFG1a radioimmunoassay. Gross examination and light and scanning electron microscopy showed increased platelet aggregation and more extensive damaging of the underlying media of the laser compared to the surgical segments. Six-keto PFG1a levels were significantly lower (p = 0.001) in the laser compared to surgical sites (mean 232 +/- 72 pg/mg vs 515 +/- 144 pg/mg), or controls (895 +/- 337 pg/mg). These findings suggest that laser endothelial evaporation leads to increased thrombotic potential in the early post-operative period in comparison to surgical endarterectomy.

6-Ketoprostaglandin F1 alpha↗
PubMedDate not supplied

Observations on the treatment of lumbar disk disease in college football players.

Over a 4 year period, 12 college players were treated for diskogenic injury. The most common position affected was down-lineman. Symptoms consisted of low back and/or radicular pain. No players could recall the onset of symptoms relative to football activity; weightlifting was associated with symptoms in three cases. Tentative clinical diagnosis was herniated disk disease. Method of diagnosis in the athletic population is presented along with results of surgical treatment. Percutaneous diskectomy appears to be successful for disk herniations occurring at the L4-5 space or higher.

Athletic Injuries↗