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Biomedical subjects

B E Kendall

Publications and source records attributed to B E Kendall.

At least 163 records · Page 9Linked to original sources
PubMed1985

Post-traumatic cystic and non-cystic myelopathy.

Sixty-four patients with suspected cystic myelopathy following spinal cord trauma were examined radiologically. In twenty-seven of these, spinal cord cysts were confirmed at surgery; in five, cysts were excluded by surgery and/or autopsy; the rest were unconfirmed. In water soluble myelography the most frequent sign in those with confirmed cysts was distention of the involved segments of the spinal cord. A less frequent but reliable sign was variation in cord size with position in a paradoxical fashion to the well established changes which occur with air myelography. Focal concentrations of contrast medium were visible within cord substance at CT in two of the patients in whom no cyst was found at surgery or autopsy. Some correlations between clinical features, including rate of progression and results of surgery, and radiological findings are unexpected on the basis of existing theories on pathogenesis.

Cysts↗
PubMed1985

Surgical treatment of cervical cord compression in rheumatoid arthritis.

Cervical myelopathy is a rare but potentially dangerous complication of rheumatoid arthritis and presents considerable therapeutic problems. A conservative approach carries high mortality and surgical intervention is not without serious risks. Reduction of subluxation and posterior fusion is widely practised but may require prolonged bed rest and continuous skull traction, sometimes for many weeks. When anterior decompression has been attempted prolonged immobilisation and external fixation have created problems. In this series 23 rheumatoid patients with cervical myelopathy were investigated over a four-year period. Seventeen underwent anterior decompression of the cervical cord, of whom 14 had a transoral removal of the odontoid peg and pannus and posterior occipitocervical fusion during the same anaesthetic without mortality or serious postoperative complications; all but one have improved. The authors believe that early mobilisation after a combined cord decompression and internal fixation has reduced the mortality and morbidity. Management of cervical myelopathy in rheumatoid arthritis and indications for operation are discussed.

Adult↗
PubMed1985

Germinoma of the pituitary gland; a report of two cases.

Intracranial germinomas are usually situated in the pineal, but sometimes they arise in the infundibular region of the third ventricle (ectopic pinealoma) and may rarely extend down into the pituitary fossa. Two cases of germinoma arising within the pituitary gland and presenting with hypopituitarism, are described; no report of any similar cases could be found.

Adolescent↗
PubMed1984

Radiology of intracranial empyemas, with special reference to computed tomography.

Intracranial empyemas are collections of pus, which usually develop in the subdural or extradural space; the former is more frequent. They are not common lesions, forming about one fifth to one third of reported series of intracranial abscesses [1, 2]. In the preantibiotic era, they were commonly fatal [3], but a review of series reported since widespread use of antibiotics indicated a continuing mortality rate of 25% [4]. Their radiological interest resides not only in their importance, but also in the problems of early diagnosis. Negative results have been reported with a number of techniques, including radionuclide imaging [5], computed tomography (CT) [2, 4, 6, 7] and cerebral angiography [8, 9]. A recent neurosurgical review concluded balefully that "no reassurance can be obtained from negative investigations". The present study is an examination of the possible ways in which such negative studies, particularly CT, can be avoided.

Adolescent↗
PubMed1984

Radiological features of subependymoma with emphasis on computed tomography.

The features of 17 symptomatic subependymomas on X-ray computed tomography are described. Thirteen were reviewed from isolated case reports and 4 were original material. Over half were entirely intraventricular, 6 extended into brain substance and 2 into subarachnoidal cisterns. Twelve were isodense, 15 showed diffuse but irregular enhancement, and 5 contained nodular calcification. Large low density cysts, intratumoural haemorrhage and brain oedema were found almost exclusively in lesions extending into brain substance. It is concluded that subependymomas resemble ependymomas too closely on CT to be distinguished radiographically from them as a separate group. However subependymomas contain calcification slightly less frequently, and usually appear as mainly intraventricular lesions even when they occur above the tentorium.

Adolescent↗
PubMed1984

Intracranial tumors in neonates: a report of seventeen cases.

Seventeen patients with intracranial neoplasms that were symptomatic within the first 2 months of life were studied. Macrocrania was the commonest clinical feature, and radiologic studies including computed tomographic examination in five of the patients, showed that the tumors tended to be large, rapidly growing, and located along the neural axis. The outlook was poor, with a high operative and case mortality. The risks of irradiating young infants are discussed, and a conservative surgical approach with careful case selection is advocated.

Brain Neoplasms↗
PubMed1983

Observation on peritumoural oedema in meningioma. Part I: Distribution, spread and resolution of vasogenic oedema seen on computed tomography.

The distribution of oedema detected by computed tomography in 46% of 160 patients with cerebral meningiomas was studied. Oedema occurred most frequently in the centrum semiovale and deep white matter around the ventricular trigones and frontal horns, the distribution reflecting mainly the size of the interstitial spaces adjacent to the tumour. Other theoretically relevant factors such as hydrocephalus and cerebral atrophy did not influence oedema distribution. Cyst like spaces of various types were observed in 20% and their aetiology is discussed. Oedema usually resolved after surgery, but in at least 13% it persisted after 3 months. Atrophy related to tumour size and not to presence or extent of oedema. Increased oedema after surgery was never of vasogenic type and could nearly always be ascribed to a definable complication.

Brain Diseases↗
PubMed1983

Observations on peritumoral oedema in meningioma. Part II: Mechanisms of oedema production.

Meningiomas occurring in 160 patients were studied in relation to oedema production using computerised tomography. Statistically significant positive correlations with oedema production were found with tumours of large surface area, anterior parasagittal position, prominent vascularity, involving dural sinuses, and with short clinical history. Significant negative correlations were found with small tumour size and the presence of calcification. It is considered that hydromechanical factors predominate in oedema production with meningioma.

Blood-Brain Barrier↗
PubMed1983

Dysgenesis of the corpus callosum.

The embryology of the corpus callosum is briefly reviewed in relation to dysgenesis and associated malformations. The morphology, etiology, clinical and radiological features of such malformations are discussed and illustrated.

Abnormalities, Multiple↗
PubMed1983

Involvement of the central nervous system in congenital muscular dystrophies.

Three children, two siblings and one unrelated child, with congenital muscular dystrophy with central nervous system (CNS) involvement are discussed. The siblings appeared to suffer from a relatively mild myopathy with progressive brain disease, of which brain biopsy in one showed astrocytic proliferation in the white matter. In the patient with severe muscle disease, autopsy showed widespread patchy demyelination in the white matter and developmental abnormalities in the cerebral and cerebellar cortex. These patients differ from the Japanese (Fukuyama) cases of CMD in the severity of the changes in the cerebral white matter, and from Santavuori's cases in the absence of ocular abnormalities and hydrocephalus. Their unique nosology is discussed.

Adolescent↗
PubMed1983

Computed tomography in non-specific mental retardation and idiopathic epilepsy.

In 29 children with mental retardation and infantile spasms, cranial computed tomography findings were abnormal in 75% and this finding may lead to modification of treatment or influence genetic counseling. In 41 children with mental retardation and other forms of epilepsy abnormal computed tomography findings were much less frequent and were not relevant to treatment.

Adolescent↗
PubMed1983

Neurological features and computed tomography of the brain in children with ornithine carbamoyl transferase deficiency.

The clinical features and the computed tomographic appearances of the brain in seven children with ornithine carbamoyl transferase deficiency are described. Episodic vomiting and drowsiness, acute encephalopathy, failure to thrive and developmental retardation were common, but focal neurological symptoms and signs were also observed. The CT appearances were non-specific with generalised or focal changes. They were related to the severity, the duration and the age of onset of the hyperammonaemia. Since the CT changes may suggest conditions other than metabolic disease, the emergency investigation of a child with an encephalopathy should include the estimation of plasma ammonium and, if elevated, the appropriate investigations to establish the cause.

Amino Acid Metabolism, Inborn Errors↗
PubMed1983

Computerized axial tomography and diagnosis of multiple sclerosis.

Computed axial tomography (C.T.) findings are illustrated in 3 patients who presented with C.T. changes suggesting respectively chronic M.S., acute M.S., and an appearance simulating a malignant tumour. Review of the literature shows that the chronic form with cerebral atrophy and low density lesions in the hemispheres is common in patients with a long history and is unlikely to cause diagnostic difficulty. The acute presentation is less common and could be confused with a variety of causes of multiple low density enhancing lesions. The C.T. diagnosis of M.S. is more difficult in rare cases in which plaques cause mass effect and show ring enhancement; all 3 such cases in the literature were subjected to cerebral biopsy.

Adult↗
PubMed1983

Diagnosis and management of pineal tumors.

The management of pineal region tumors remains controversial. Advocates of a conservative approach emphasize the excellent results of radiotherapy, particularly with germinomas, while a number of recent reports have demonstrated the safety of direct surgery. In order to improve treatment planning, attempts have been made to distinguish the various tumor types by computerized tomography (CT) and by the use of markers for germ-cell tumors. This paper reports a study of 35 patients with pineal tumors including two ectopic germinomas. Pretreatment CT was performed in all 35 patients, and human chorionic gonadotropin and alpha-fetoprotein levels were assayed in 11. Histological verification was available for 33 tumors; the other two were characterized by clinical and CT features plus tumor markers. Of the 27 tumor operations, 21 were for a pineal mass and six for ectopic germinoma or metastasis. There was no operative mortality. Morbidity was minimal, and surgery did not increase the incidence of subarachnoid seeding. Each histological type of tumor has a typical appearance on CT scanning, although, in the individual case, a firm diagnosis is not always possible. However, consideration of CT scans together with the clinical features, cerebrospinal fluid cytology, tumor markers, and (if there is still doubt) response to a small dose of irradiation will generally allow a specific diagnosis with a high degree of probability. In this way, germinomas may be selected for radiotherapy and the tumors less likely to respond may be subjected to primary surgery.

Adolescent↗