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Biomedical subjects

C S Zee

Publications and source records attributed to C S Zee.

At least 55 records · Page 3Linked to original sources
PubMed1985

Computed tomography in the diagnosis of intracranial neoplasms in children.

The authors discuss their original observations using computed tomography (CT) in the diagnosis of posterior fossa neoplasms in children. The subject of CT diagnosis of childhood supratentorial tumors is also reviewed. However, despite the documented value of CT, the authors believe that magnetic resonance imaging (MRI) will eventually offer certain advantages that will make MRI the primary imaging modality for intracranial neoplasms in children.

Astrocytoma↗
PubMed1985

Arteriography of the carotid bifurcation: oblique projections.

Atherosclerotic plaques may not be demonstrated adequately by standard anteroposterior (AP)-lateral projections of carotid arteriography. We evaluated selective carotid arteriography in oblique projections for 60 individual carotid arteries. Two neuroradiologists evaluated arteriograms in four separate sessions devoted to AP-lateral views alone and in combination with oblique projections. The lumen surface was characterized as "smooth," "irregular," or "ulcerated." When oblique projections were added to AP-lateral views, there was a significant shift of radiologic diagnosis from smooth to irregular or ulcerated. Addition of oblique projections to standard AP-lateral views increases the radiographic diagnosis of carotid artery lesions that may be the source of emboli.

Angiography↗
PubMed1985

Evaluation of cerebrospinal fluid rhinorrhea by metrizamide computed tomographic cisternography.

Seven interesting and instructive cases of cerebrospinal fluid rhinorrhea evaluated by metrizamide computed tomographic cisternography are presented. The rhinorrhea was spontaneous in three patients and was related to previous head trauma or surgical procedures in four patients. The anatomical site and the extent of the fistula were demonstrated precisely by directly showing metrizamide passing through the bony defect. A combination of bone dehiscence and metrizamide within the adjacent paranasal sinuses or the nasal cavity is also useful in localization. Distortion of the interhemispheric fissure, sylvian fissure, or basal sulci indicates the probability of brain herniation through the defect.

Adolescent↗
PubMed1984

Surgical considerations in treatment of intraventricular cysticercosis. An analysis of 45 cases.

Infestations of the human brain with the larval stage of Taenia solium, once an infrequent diagnosis in the United States, is now a more frequently encountered clinical entity especially in population centers with high immigrant flux. During a recent 5-year period 45 cases of intraventricular cysticerosis have been evaluated and treated. Modes of involvement included isolated cyst formation, ependymitis, or combinations of both. Evidence of associated parenchymatous involvement was present in 20% of cases. Sites of infestation included the lateral ventricle (five cases), third ventricle (12 cases), Sylvian aqueduct (four cases), and fourth ventricle (24 cases). Mean post-therapy follow-up periods for this series exceed 36 months. This experience indicates that direct excision is the treatment of choice for ventricular cystic lesions, but that management, operative planning, and expectations should be influenced by considerations of: 1) the potential for acute clinical deterioration (38%); 2) the potential for cyst migration; 3) attendant ependymitis, defined by computerized tomography or verified at surgery; 4) the potential for increase in cyst volume with local mass effect; 5) selection and institution of corridors of surgical access that establish alternative routes of cerebrospinal fluid flow; and 6) the possibility of cyst excision by a stereotaxic endoscopic procedure.

Adolescent↗
PubMed1983

Computed tomography of posterior fossa ependymomas in childhood.

In reviewing 10 children with surgically proven posterior fossa ependymomas, various computed tomographic representations were seen. Calcification, seen in 50% of the cases, was the single most important finding suggesting the diagnosis of ependymoma. The appearance of two of our ependymomas mimicked the "typical" appearance of medulloblastomas. A case of calcified brainstem ependymoma is presented, to our knowledge, the first such case studied with computed tomography.

Adolescent↗
PubMed1983

Intracranial metastatic Wilms' tumor in children: a report of two cases.

Two cases are presented of children with intracranial metastasis from Wilms' tumor. Both patients had undergone nephrectomies for Wilms' tumor, one 19 months and the other 32 months prior to clinical presentation of intracranial metastasis. Computed tomographic examination in both cases demonstrated lesions that did not have any particularly unique features. Subsequent craniotomy and removal of the tumor in one case confirmed metastatic intracranial Wilms' tumor.

Brain Neoplasms↗
PubMed1983

Radiologic considerations in neurocysticercosis.

Radiologic imaging techniques play an important role in the diagnosis and management of neurocysticercosis. Cysticercal involvement of the central nervous system can be classified as parenchymal, ventricular, meningo-cisternal, spinal, and mixed, depending upon the site of involvement. Computerized tomographic scanning has replaced most of the previously used techniques for assessing parenchymal disease and diagnosis has been greatly improved. Ventriculography and myelography are still useful in cases of intraventricular and spinal disease respectively.

Adolescent↗
PubMed1982

Cysticercosis cerebri. Review of 127 cases.

We reviewed the clinical features, diagnosis, and treatment in 127 cases of cysticercosis cerebri. The chief syndromes were seizures (55.1%), hydrocephalus (37.8%), and stroke (11.8%). Serum or CSF indirect hemagglutination titers, determined in 101 patients, were positive in 84.1% of those with CSF pleocytosis but in only 42.1% of those without. Computed tomography (CT), employed in 85 patients, showed typical multiple calcifications in 64.7%. The CT scans were most useful in the surgical treatment of ventriculomeningeal infestation. Ventricular shunt implantation was performed in 40 patients with hydrocephalus and produced marked improvement in 32. Cyst resection was necessary only for patients with rapidly enlarging fourth ventricle cysts.

Adolescent↗
PubMed1982

Computed tomographic observations pertinent to intracranial venous thrombotic and occlusive disease in childhood. State of the art, some new data, and hypotheses.

Selected topics are discussed and new observations recorded regarding computed tomographic (CT) evaluation of intracranial venous thrombotic and occlusive disease in childhood. High density of the vein of Galen and adjacent venous sinuses (relative to brain) can be seen normally in children. A number of potential pitfalls in the diagnosis of superior sagittal sinus thrombosis are also disclosed. A case of cavernous sinus thrombosis with abnormal CT changes in included. In addition, the normal CT appearance of the cavernous sinus is described. In some cases, filling defects occur which appear to correlate with normal cranial nerves. An unusual case of venous sinus occlusion by neoplasm (sarcoma) is presented. Finally, new findings in the Sturge-Weber syndrome are analyzed. Enhancement of the brain in this condition may have its basis in altered circulation resulting from fundamental venous abnormalities.

Adolescent↗
PubMed1982

Transcallosal, interfornicial approaches for lesions affecting the third ventricle: surgical considerations and consequences.

A group of 11 patients with a variety of lesions affecting the 3rd ventricle have been treated using a direct transcallosal interfornicial approach to the region. In 3 patients, no attendant hydrocephalus was present. In an effort to minimize potential cortical injury related to the approach, we studied the venous anatomy in the region of the coronal suture. Based on this study, appropriate flap placement and interhemispheric entry points were defined. Although no lasting, clinically apparent morbidity was observed in any of the 11 cases, we performed more sophisticated studies of the interhemispheric transfer of somesthetic and perceptual motor tasks, as well as psychometric testing related to parameters of intelligence and memory, 3 to 8 months postoperatively in 6 cases. The results and clinical material indicate that this surgical technique is a safe, feasible alternative in the management of a wide spectrum of pathological lesions within this region. A transcallosal, interfornicial approach offers excellent visualization of the entire 3rd ventricle without the dependence on hydrocephalus or an extensive extra-axial mass to enhance the exposure. With proper planning and technique, it may be accomplished with a minimum of physiological consequence.

Brain Diseases↗
PubMed1982

Inconsistent venous opacification: a pitfall of epidural venography.

The lumbar epidural venograms of 45 consecutive patients with prior normal or equivocal myelographic examinations were reviewed. Each venographic injection was performed using transfemoral double-catheter technique, abdominal compression, Valsalva maneuver, and serial filming for 12 sec. There was a 30% incidence of false "occlusions" of epidural veins suggestive of compression by a herniated intervertebral disk. These false venous occlusions were demonstrated to be such by both subsequent opacification of previously nonopacified veins and lack of opacification of previously opacified veins during repeat venography. In view of the significant incidence of spurious venous occlusions in this series, It is recommended that epidural venography with single injection should be interpreted with caution except for normal studies.

Catheterization↗