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Biomedical subjects

C W Kerber

Publications and source records attributed to C W Kerber.

At least 55 records · Page 3Linked to original sources
PubMed1979

Calibrated leak balloon microcatheter: a device for arterial exploration and occlusive therapy.

In quest of an endarterial treatment for intracranial arteriovenous malformations and fistulas, a microcatheter which can be flow-guided into third- and fourth-order branches of the intracranial arteries was developed. This permits controlled deposition of a vascular occlusive polymer (isobutyl-2 cyanoacrylate). Goals and experimental techniques are reviewed and clinical experience on the first 25 patients is presented. Complications included one stroke and three catheters glued in place, but refinements in technique have permitted avoidance of complications over the 14 months before this report.

Animals↗
PubMed1979

Modification of cyanoacrylate for therapeutic embolization: preliminary experience.

Cyanoacrylate is a satisfactory material for therapeutic embolization, but it has the disadvantage of not being radiopaque and polymerizing within 1 sec after contact with ionic materials. Its behavior was modified with varying concentrations of iophendylate and were able to satisfactorily control its polymerization from 1 to 30 sec. This control should allow penetration of arteriovenous malformations, which is necessary if cure is to result. The iophendylate adds radiopacity and seems to enhance the suspension of tentalum, another opacifying agent. Preliminary experience in dogs is encouraging, but too few humans have been treated with this method to recommend it as more than an experimental procedure at this time.

Bucrylate↗
PubMed1979

Carotid-cavernous fistula following percutaneous retrogasserian procedures. Report of two cases.

Carotid arterial puncture during percutaneous retrogasserian procedures is a common but usually harmless complication. Strokes, resulting presumably from carotid artery thrombosis, have been reported previously following percutaneous retrogasserian coagulation. The authors report two cases of carotid-cavernous fistula, one following percutaneous radiofrequency rhizotomy and the other after percutaneous retrogasserian block. The latter patient had an anomaully by intracavernous injection of isobutyl-2 cyanoacrylate, using intra-arterial balloon flotation catheters. Carotid-cavernous fistula is a potentially serious complication of such procedures, and may be more common than realized since small fistulas may close spontaneously.

Arteriovenous Fistula↗
PubMed1979

Tortuous vertebrobasilar arteries causing cranial nerve syndromes: screening by computed tomography.

Considerable concern with cranial nerve syndromes has often required detailed information of the relationship between the vertebrobasilar system and the brainstem. The obvious invasiveness of conventional vertebral angiography poses the question of whether computed tomography (CT) might serve as a satisfactory technique or even as a sufficient diagnostic method. During a 12 month period, 12 of 250 patients with cranial nerve syndromes were diagnosed by CT as having vertebrobasilar ectasia. This communication correlates the clinical symptomatology with angiography and CT and presents evidence that CT alone can prove satisfactory.

Adult↗
PubMed1979

Nelson's syndrome and spontaneous pituitary tumor infarction.

Large, adrenocorticotrophic hormone-secreting pituitary tumors (Nelson's syndrome) developed in four of 12 patients treated with a bilateral adrenalectomy for Cushing's disease. Two of the patients with Nelson's syndrome suffered spontaneous pituitary tumor infarctions. One patient improved under close observation and subsequent radiation therapy, although she ultimately died from her locally invasive tumor. The condition of the other patient-which had stabilized-appeared to be worsened by surgical intervention. The high incidence of these tumors after bilateral adrenalectomy, their large and agressive nature, and their apparent propensity to undergo spontaneous infarction supports the position that initial therapy for Cushing's disease should be directed to the pituitary gland.

Adrenalectomy↗
PubMed1978

Reduced morbidity in gas myelography.

Gas myelography is a useful technique in the evaluation of the spinal canal and its contents. Although it has been greatly simplified and the high-resolution imaging greatly improved, morbidity remains a problem. Removal of the gas at the end of the examination through the lumbar route significantly decreases morbidity. This can be achieved through the same needle if the examination is performed via a lumbar puncture. Insertion of a second needle in the lumbar region may be necessary if the cervical or cisternal puncture is employed for gas introduction.

Headache↗
PubMed1978

Rupture of a parasellar aneurysm with a coexisting pituitary tumor.

The unusual occurrence of a pituitary tumor and a parasellar aneurysm is reported. The aneurysm ruptured and mimicked spontaneous infarction of the pituitary tumor. The importance of performing cerebral angiography before emergency surgical decompression of a presumed pituitary tumor infarction is emphasized.

Adenoma, Acidophil↗
PubMed1978

The grain in the stone: a computer search for hidden CT patterns.

Relatively simple but time-consuming computer manipulations of basic CT images have been carried out. We have been unsuccessful in finding significant information when the skewness or kurtosis of the CT image is computed and displayed, but have found recognizable and useful new gray scale images upon reconstruction of sigma mode textures.

Brain↗
PubMed1978

Intraarterial cyanoacrylate: an adjunct in the treatment of spinal/paraspinal arteriovenous malformations.

Arteriovenous malformations are difficult lesions to treat whether surgical or catheter occlusive therapy is used. If the major feeders are ligated or blocked, other arteries open quickly to supply the malformation. Isobutyl 2-cyanoacrylate, deposited with a calibrated leak balloon microcatheter, has given satisfactory short term improvement in both the signs and symptoms of two patients with spinal arteriovenous malformations. Superselective placement of the catheter system, a provocative test perfusion of the arteriovenous malformation and its supplying vessels before the acutal occlusion, and high quality fluoroscopy and angiographic equipment added to the safety of the procedure. No long term results are available, but this system may prove itself another tool in the catheter therapist's armamentarium.

Adult↗
PubMed1978

Cerebral ischemia. I. Current angiographic techniques, complications, and safety.

The angiographic evaluation of the transient ischemic attack has been technically difficult, time consuming, and complication prone because of underlying arteriosclerosis and other medical diseases. The examination described depends upon small soft catheters, dynamic fluoroscopy for positioning, and selective magnified views of the arteries needed for surgical planning. Five basic views are exposed. On the side of clinical interest, a lateral view of the head and neck, a frontal view of the head, and a fluoroscopically positioned view of the carotid bifurcation are obtained; on the other side the frontal view is omitted. A total of 662 consecutive studies were performed on 603 patients without death or permanent strokes. The only permanent complication was a partial radial nerve palsy.

Cerebral Angiography↗
PubMed1977

The primary empty sella syndrome: analysis of the clinical characteristics, radiographic features, pituitary function and cerebrospinal fluid adenohypophysial hormone concentrations.

Twelve cases of the primary empty sella syndrome were analyzed in regard to clinical findings, roentgenographic features, pituitary function and cerebrospinal fluid adenohypophysial hormone concentration. The findings were compared with those in 247 cases of the primary empty sella syndrome reviewed from the literature in order to determine the major characteristics of this disorder. The majority of patients are obese, multiparous women with normal pituitary reserve, normal visual fields and undetectable adenohypophysiol hormone concentrations in cerebrospinal fluid. In addition occasional patients witll have hypertension, pseudotumor cerebri and cerebrospinal fluid rhinorrhea. Patients who present with the typical features of the primary empty sella syndrome should be evaluated periodically with pituitary function testing, visual field examinations and cerebrospinal fluid adenohypophysial hormone determinations. If these parameters remain normal during careful follow-up studies, the patient is likely to have an empty sella, and pneumoencephalographic and angiographic studies can be avoided.

Adult↗
PubMed1977

Catheter therapy: fluoroscopic monitoring of deliberate embolic occlusion.

In the deliberate embolic occlusion of arteriovenous malformations (AVM's and vascular tumors, complications can occur when emboli pass into arteries supplying normal structures. Maximum safety and precision is gained by direct fluoroscopic visualization of the occlusion process done by suspending the particles in a contrast agent and monitoring the ever-decreasing vessel runoff. The technique has been useful in the treatment of intra- and extracranial AVM's and tumors.

Arteriovenous Malformations↗