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Biomedical subjects

B Liliequist

Publications and source records attributed to B Liliequist.

At least 19 recordsLinked to original sources
PubMed1988

Discrepancies between CT and EEG findings after acute cerebrovascular disease.

Combined EEG and brain CT examinations were performed in 33 patients during the 1st and 2nd week after stroke. CT was abnormal in 17 patients (51%) and EEG was abnormal in 24 patients (72%). In 17 patients CT and EEG showed conflicting results; in 5 patients with normal EEG findings CT was pathological, and 12 patients had normal CT but pathological EEG findings. In this latter group, there were 5 particularly interesting cases with normal CT and a prominent unilateral EEG abnormality. Recently patients with this combination of findings have been described where further investigations disclosed internal carotid occlusion, which could be treated surgically. It is suggested that EEG should be more extensively used when CT findings are negative after stroke, and if a major unilateral EEG abnormality is encountered in such cases, further investigations with angiography should be considered in order to exclude surgically treatable internal carotid occlusion.

Aged↗
PubMed1985

An adapter for computed tomography-guided stereotaxis.

A new, versatile adapter for computed tomography-guided stereotaxis is presented. The instrument consists of a light aluminum frame, which by means of a nasion support and two ear plugs is fixed to the patient's head. Reproducibility of repeated fixations is very high. The adapter is fitted to most stereotactic frames and can be used in all adult patients. Comparison between computed tomography- and ventriculography-guided determinations of thalamic targets showed a mean difference of 0.6 and 0.7 mm for the x and y coordinates, respectively. The z coordinates seldom showed any measurable difference. We now perform all types of stereotactic neurosurgery (tumor biopsy, implantation of depth electrodes, thalamotomy, dentatotomy, cingulotomy, etc.) with computed tomography guidance only. The short-term results in a small number of patients have been at least as good as after conventional ventriculography-guided surgery. In addition to open stereotactic surgery, the adapter is also suitable for external stereotactic irradiation of intracranial targets with a linear accelerator.

Brain↗
PubMed1984

Effect of cranioplasty on cerebrospinal fluid hydrodynamics in patients with the syndrome of the trephined.

Forty patients with cranial bone defects after craniectomy underwent extensive cerebrospinal fluid (CSF) hydrodynamic investigations by means of a CSF infusion test before and after cranioplasty. The results of these investigations were related to the clinical signs of the patients before and after cranioplasty and to the size and location of the skull bone defect. Twenty-two patients were considered to have "the syndrome of the trephined" (ST). The remaining patients were either free of symptoms or had symptoms not related to ST. CSF hydrodynamic variables that were changed before and normalized after cranioplasty include the following: Resting pressure, sagittal sinus pressure, buffer volume, elastance at resting pressure and pulse variations at resting pressure. The changes were statistically significant mainly in ST patients who were also relieved of their symptoms after cranioplasty.

Adult↗
PubMed1983

Treatment of spontaneous intracerebral haemorrhage. A retrospective analysis of 74 consecutive cases with special reference to computertomographic data.

The surgical treatment of spontaneous intracerebral haemorrhage (SIH) is still a matter of controversy, although most Neurosurgeons agree that surgery is indicated in selected cases. The introduction of computer tomography (CT) permits a more accurate determination of the localization, size and expansion of an intracerebral haemorrhage. The aim of this study is to evaluate the results of surgical and conservative therapy in selected cases and to search for parameters that could help to predict the outcome and facilitate the decision between surgery and conservative therapy. Seventy-four patients treated following SIH during the years 1976-1980 were analyzed. The decision for surgical treatment was made on the basis of the patient's conditions and the findings in the CT scan. Thirty-nine patients with mainly medium-sized haemorrhages underwent surgery and 35 were conservatively treated. The mortality after three months was 5/39 (13%) in the surgical and 7/35 (20%) in the conservative group. The volume of haemorrhage was significantly larger in the patients who died and 9/10 patients with a haematoma volume above 80 ml died. Five of these 10 were operated and the other 5 not and surgery seemed to be of little benefit to this group. Dilatation of the contralateral ventricle is another indicator of a bad prognosis. Long-term follow-up investigation was carried out 4-38 months after the initial treatment. Total mortality was 19 out of 68 patients that could be reached for late follow-up. Eleven patients (29%) were fully recovered and 16 had minor neurological deficits. There was no difference in late results between the surgical and the conservative groups, but the patients in the surgical group were generally in a worse condition and had larger haemorrhages that the others. The fact that the total mortality in this material is lower than in other conservatively treated series favours surgery in selected cases of SIH. The use of CT gives valuable information as to the prognosis and especially the volume of haemorrhage seems to be a good prognostic factor.

Adolescent↗
PubMed1983

Sexuality after stroke with hemiplegia. I. Aspects of sexual function.

In a consecutive series of 51 one-stroke hemiplegics some aspects of sexuality were investigated using structured interviews. Findings were related to treatment with anti-hypertensive drugs. In most subjects the site of brain lesion was visualized by X-ray methods. Moreover, in a sub-sample of 15 consecutive males LH, FSH and prolactin were assessed using standard clinical radioimmunoassay techniques. Serum testosterone including response to HCG-stimulation was also measured. Both in males and females frequency of intercourse and durations of foreplay and of intercourse were markedly reduced. For the males erectile problems were rare before but occurred for the majority after stroke. For the females, but not for the males, orgastic dysfunction was relatively common pre-stroke. After the stroke such dysfunction occurred for 75% of the females and 64% of the males. Partnership sexual drive also decreased. Each of the 15 males hormonally screened had values within the predicted normal and responses to HCG-stimulation were also adequate. Moreover, actual levels of hormones were associated neither with change in sexual function nor with the sexual function per se at the time of the investigation. Thus, in this sample hormonal disarrangement did not appear to be the cause of sexual dysfunction. Surprisingly, no association between erectile dysfunction and use of anti-hypertensive drugs occurred. We believe that sexual dysfunctions in hemiplegics may rather be explained in terms of coping than by endocrine deficits or by anti-hypertensive treatment.

Cerebrovascular Disorders↗
PubMed1981

Antifibrinolysis with tranexamic acid in aneurysmal subarachnoid hemorrhage: a consecutive controlled clinical trial.

A randomized controlled clinical trial was carried out to study the effect of tranexamic acid (AMCA, Cyklokapron; AB Kabi, Stockholm, Sweden) in the prevention of early rebleeding after the rupture of an intracranial aneurysm. The incidence of vasospasm, hydrocephalus, cerebral ischemic and thromboembolic complications, morbidity, and mortality was also evaluated. The series comprises 59 patients, 30 treated with tranexamic acid and 29 controls. The treatment was stopped if there was rebleeding, operation, or discharge from the hospital. There were 6 recurrent hemorrhages in 6 patients in the tranexamic acid-treated group and 11 recurrences in 7 patients in the control group. Recurrent hemorrhages occurred later in tranexamic acid-treated patients than in controls. Five patients in each group died from rebleeding. Five additional treated patients and 2 controls died from cerebral ischemic dysfunction. The results suggest that tranexamic acid may protect patients with ruptured aneurysms from rebleeding for 1 or 2 weeks, but that it also may produce cerebral ischemic complications.

Adult↗
PubMed1981

Diaphanoscopy and diaphanography for breast cancer detection in clinical practice.

Transillumination of the female breast has during the past few years been reintroduced as an aid in the diagnosis of breast lesions. A series of 259 women with symptoms from the breast were examined by mammography, clinical examination by two independent surgeons, diaphanoscopy by one of the surgeons, diaphanography, and fine needle aspiration biopsy of material taken from palpable tumours. The results were evaluated in order to ascertain the contribution made by transillumination procedures to the diagnosis of malignancy. Carcinoma of the breast was confirmed in 26 women. The malignancy was correctly suggested in 21 and 23 women, respectively, at clinical examination, in 19 by mammography, in 20 by diaphanoscopy, in 16 by diaphanography and in 20 by aspiration cytology. The number of false positive cases was high, especially with the transillumination procedures. All malignancies detected by diaphanoscopy were also believed to be carcinoma at the clinical examination. The three cancers falsely classified as benign at clinical examination were correctly identified as malignant only by mammography or cytology or both.

Adult↗
PubMed1980

Computer tomography in the evaluation of subarachnoid hemorrhage.

Repeat CT scanning and cerebral angiography has been performed in 68 consecutive patients with subarachnoid hemorrhage. Blood in the subarachnoid cisterns could be discerned in 27 of 32 patients provided the examination was performed within 2 days of the bleeding. The distribution of cisternal blood can be identified which, in combination with the localization of a possible intracerebral hematoma, yields a rather good predictability as to the site of the ruptured aneurysm. The subsequent angiography can thus be directed to the relevant vessel in most cases. Repeat CT scanning can replace angiography in the evaluation of patients with deterioration of the clinical condition.

Adult↗
PubMed1979

Assessment of posterior fossa tumors in infants and children by means of computed tomography.

The attenuation profiles before and after contrast enhancement were examined in 18 infants and children with posterior fossa tumors: eight cerebellar astrocytomas, six medulloblastomas, and four brainstem tumors. The astrocytomas, with one exception, had characteristic patterns, and all could be distinguished from the medulloblastomas, which have a distinct pattern of their own. The brainstem tumors had varying appearances, and were entirely low-attenuating, high-attenuating or had a ring shadow after enhancement. The nature of a posterior fossa tumor in a pediatric patient can usually be predicted fairly satisfactorily from a computed tomogram.

Adolescent↗
PubMed1979

Spontaneous thrombosis of ruptured intracranial aneurysms during treatment with tranexamic acid (AMCA). Report of three cases.

Radiographically verified spontaneous disappearance of medium-sized arterial cerebral aneurysms is seldom reported, and only three times in connection with antifibrinolytic therapy (EACA). In our clinic repeat angiograms have shown non-filling of the aneurysms in three patients during treatment with tranexamic acid (AMCA) two, three, and four weeks respectively after primary bleeds. Initially, all three patients had severe radiological vasospasm associated with neurological deterioration. Follow-up angiograms have demonstrated partial reappearance of the aneurysm after one month in one patient and complete disappearance of the aneurysms in the other two patients after 9 and 22 months respectively. In two cases occlusion of cerebral arteries occurred. With regard to the higher risk of severe vasospasm and occlusion of cerebral arteries in our opinion it should not be a therapeutic goal to try to achieve a thrombosis of a ruptured aneurysm with antifibrinolytic drugs. The reason for spontaneous aneurysm thrombosis during treatment with AMCA may be a local inhibition of plasminogen activators in and around the aneurysm wall. It may also be related to the sympathomimetic property of the drug, with vasospasm and a subsequent flow-reduction inside the aneurysm or a possible interaction with other drugs and substances.

Adult↗
PubMed1979

Bone mineral content in the proximal tibia measured by computer tomography.

With a slight modification of the EMI MK1 scanner a sensitive method for examination of the bone mineral content in the proximal tibia was achieved. The method allows an estimation of the amount of trabecular and cortical bone as well as their mineral content. The anatomic structure of the bone substance is demonstrated, differing in osteoporosis and osteomalacia. The reproducibility is acceptable.

Bone and Bones↗
PubMed1978

Quantitative estimation of tumor volume on computer assisted tomography.

With the use of computer assisted tomography (CAT), the volume of intracranial hemorrhages can be calculated. The present work outlines a method that, based on EMI scan printouts, makes possible a calculation of the volume of hemorrhages, tumors, or other pathological changes detectable on CAT with a high degree of accuracy, even when the pathological changes are irregular in shape. Thus, there have been divergences between the estimations of volume of meningiomas using this method and the measure of the volume of the enucleated meningiomas within the range of 0 to +5%. An example of such a meningioma, and the calculation of its volume, is presented.

Brain↗
PubMed1978

Computed tomography of the paranasal sinuses.

The diagnostic value of computer tomography in lesions of the paranasal sinuses has been investigated in three cases with maxillary carcinoma and in five cases with fractures of the facial bones. In most of the cases, particularly in carcinoma, computer tomography was found to provide additional information to that obtained with conventional X-ray techniques. In fractures, however, a supplementary plain film examination was found to be indispensable.

Facial Injuries↗