Search PubMed⌕ Search

Biomedical subjects

D M Moody

Publications and source records attributed to D M Moody.

At least 55 records · Page 3Linked to original sources
PubMed1988

Relationship between flow cytometric features and clinical behavior of meningiomas.

Meningiomas have a wide range of biological potential and clinical behavior. Histological findings are helpful in recognizing the malignant potential of a given tumor, but often fail to correlate with gross features, liability of recurrence, and extent of associated cerebral edema. To find alternate approaches to improve the correlation between biological and clinical behavior, 20 meningiomas were studied by flow cytometry (FC), an assessment that has been applied to meningiomas previously. Such FC features as DNA index (DI) and proliferative index (PI, %G2 + %S) were correlated with size, location, brain invasion, associated edema, and recurrence. Tumors with severe edema had significantly higher PIs (19.5 +/- 4.1) than those with moderate (12.6 +/- 4.5) or minimal (8 +/- 0) edema (P less than 0.05). The PI was greater than 16 in those tumors that recurred (n = 3) or invaded the brain (n = 3). Six tumors were aneuploid (DI, 1.33 +/- 0.17; PI, 17.1 +/- 5.3). These were uniformly large when compared with the diploid tumors, which were more variable in size. All of the aneuploid tumors were associated with moderate to severe cerebral edema. Two partly psammomatous tumors with high PIs and foci of high cellularity suggesting recent growth were associated with severe edema. One of these exhibited brain invasion. These preliminary data indicate that FC may have a potential use in the clinical management of meningiomas.

Aged↗
PubMed1986

Superior sagittal sinus air after penetrating craniocerebral trauma.

Intracranial air secondary to craniocerebral trauma is not uncommon. Computed tomography scanning may show the air within specific intracranial compartments. We report a case of air within the superior sagittal sinus visualized with computed tomography and documented at operation.

Adult↗
PubMed1986

Chronic vermal herniation in a case of osteosarcoma of the occipital bone.

Upward projection of the cerebellar vermis through the tentorial hiatus is called upward vermal herniation (UVH). UVH is less common in clinical practice than uncal herniation. Even more uncommon is chronic vermal herniation and impaction in the tentorial hiatus. To illustrate this phenomenon, we present the clinical, radiological, and morphological features of vermal impaction in a patient with a postradiation osteosarcoma of the occipital bone. In spite of nearly total excision of the tumor pushing the cerebellum upward, his postoperative course was complicated by respiratory problems and an altered level of consciousness, finally resulting in death. His clinical status paralleled the computed tomographic (CT) demonstration of persistent obliteration of the supramesencephalic cistern. CT makes more reliable the detection and management of UVH, but a high index of suspicion is necessary for prevention of this complication.

Adult↗
PubMed1986

MRI of radiation injury to the brain.

Nine patients with a history of radiation of 2400-6000 rad (24-60 Gy) to the brain were examined by magnetic resonance imaging (MRI) and computed tomography (CT). MRI demonstrated abnormalities in the periventricular white matter in all patients. The abnormal periventricular signal was characterized by a long T2 and was demonstrated best on coronal spin-echo (SE) 1000/80 images. A characteristic scalloped appearance at the junction of the gray-white matter was seen on MR images of seven patients, and represented extensive white-matter damage involving the more peripheral arcuate fiber systems. This differs from transependymal absorption, which is seen best on SE 3000/80 images and has a smooth peripheral margin. Cranial CT demonstrated white-matter lucencies in six cases but generally failed to display the extent of white-matter injury demonstrated by MRI. MRI is uniquely suited to detect radiation injury to the brain because of its extreme sensitivity to white-matter edema.

Adolescent↗
PubMed1986

Encephalic microvascular abnormalities in hypertension. A light and X-ray microscopic study.

Brain and cervical spinal cord removed at autopsy from hypertensive humans have been subjected to 4 levels of microscopic study, 3 being first histochemically prepared so as to stain the arterial and capillary system. Thick (100 microns) sections for light microscopy and thicker (500-1000 microns) for x-ray microscopy facilitate the study of long, complex anatomic units. Arterial and arteriolar microaneurysms have not been found. In addition to the usual age related vascular changes in normal people we have found: moniliform capillary dilatations, focal segments of arteriolar narrowing, état pre-criblé, and lacunar infarcts. Few changes have been encountered in the corpus callosum. While the segmental arteriolar narrowing occurs in the cortex as well as deep white matter, the effects of resultant poor perfusion might be expected to be more profound in the deep white matter.

Animals↗
PubMed1985

MR evaluation of Chiari I malformations at 0.15 T.

Twelve patients with known or presumed Chiari I malformations and two with clinical diagnoses of multiple sclerosis were examined by magnetic resonance (MR) imaging. MR confirmed or established the diagnosis of Chiari I malformation in all 14 cases. The spin-echo technique with a short time to echo (TE = 40 msec) and a short time to recover (TR = 1000 msec) provided optimum imaging of tonsillar position, hydromyelia cavities, and cervicomedullary "kinking." Long TE (greater than 80 msec) and TR (greater than 2000 msec) increase the signal intensity of cerebrospinal fluid and may obscure the pathology. Sagittal, transaxial, and coronal images provided complementary data; sagittal and coronal views best imaged the abnormal spinal cord and tonsils, but slitlike cavities were best seen on transaxial images. Cervicomedullary kinking was found in 10 (71%) of 14 patients and in 90% of the hydromyelic patients. This high incidence suggests that in other radiologic techniques tonsillar herniation masks the kinking. Symptoms of the Chiari I malformation overlap those of demyelinating diseases and brain tumors. Our early experience suggests MR is the preferred noninvasive procedure for identifying Chiari I malformation. Moreover, the ability to portray the variable cavity morphology of hydromyelia directly offers the potential for improved shunt placement.

Arnold-Chiari Malformation↗
PubMed1984

Results of nuclear magnetic resonance with cerebral glioma. Comparison with computed tomography.

Our experience using nuclear magnetic resonance (NMR) in eight patients with abnormalities on computed tomography (CT) scans suggesting glioma is reported. Three patients underwent biopsies. Two patients had grade II astrocytomas. Difficulty was encountered confirming the diagnosis of astrocytoma on frozen sections in one patient, and permanent sections were required for diagnosis in the other. The third patient to undergo biopsy had a grade III anaplastic mixed glioma. Biopsy of subsequent patients with probable gliomas was not done because of the risk of producing neurological deficit. The NMR images suggest that lower-grade astrocytomas are well circumscribed, whereas higher-grade gliomas affect adjacent association bundles by direct extension of tumor cells or vasogenic edema.

Adult↗
PubMed1984

The radiology of nontraumatic coma.

This article describes a logical approach to the neuroimaging evaluation of patients with coma. The decision tree analysis provides an efficient method and attempts to convey the logical sequential concepts of analysis of CCT findings in patients presenting in stupor or coma. The sequential approach tabulated serves as a good mnemonic for clinicians faced daily with decisions to be made in the evaluation and management of comatose patients. The approach also provides a framework for subsequent statistical (Bayesian or other) analysis of efficacy, cost effectiveness, and impact on clinical practice and health care delivery.

Atrophy↗
PubMed1984

Radionuclide techniques for brain imaging.

Over the past decade, many of the prime indications for radionuclide brain scanning have become instead indications for CCT, and nuclear medicine studies of the brain have assumed more of a complementary, supportive role. However, there is great promise for improvement in central nervous system radionuclide applications with advances anticipated in both radiopharmaceuticals and instrumentation. Nuclear medicine is continuing to function as a powerful research tool and, in the relatively near future, may regain its role as a major clinical test of the central nervous system.

Brain Abscess↗
PubMed1981

Cephalic fibromuscular dysplasia in 32 patients: clinical findings and radiologic features.

The clinical and angiographic features of 32 patients with cephalic fibromuscular dysplasia (FMD) are reported. All of our patients were women, 78% of whom were between 41 and 70 years of age. At examination, 18 (56%) patients had the sudden onset of focal ischemic neurologic deficits. Seven (22%) patients had intracranial berry aneurysms, which ruptured in five patients but were asymptomatic in two. The most common angiographic pattern was the "string of beads" deformity, which involved both extracranial internal carotid arteries at or distal to the third cervical vertebral level. The vertebral artery was affected in six cases, while three cases had intracranial involvement. Less common angiographic findings in this series consisted of segmental fusiform dilation of the artery, and lesions in the form of a septum that extended across the lumen. Twelve patients were followed up for an average of four years. Progression of FMD lesions was shown in two of the six patients who had repeated angiograms. The literature contains reports of only nine cases of cephalic FMD with repeated angiograms, three of which demonstrated progression. Our experience suggests a beneficial role for surgery in patients with specific symptoms in the distribution of the affected vessel, when coexistent disease is negligible or absent.

Adult↗
PubMed1981

Biological features of meningiomas that determine the production of cerebral edema.

Although meningiomas are known to cause varying degrees of cerebral edema, the relative importance of their location, size, histological subtype, and other histological features in the production of cerebral edema has not been studied adequately. Therefore, we undertook a retrospective analysis of 43 meningiomas excised between 1975 and 1980. The results indicate that histological subtype has no relationship to the production of cerebral edema, with one exception. Meningiomas containing partly or completely a hemangiopericytic component were the only histological subtype associated consistently with cerebral edema. The location of a meningioma per se may not determine the production of cerebral edema. A relationship between size, aggressive histological features, vascular proliferative changes, and the production of cerebral edema was seen. The need for and the nature of further studies required to explain the cerebral edema that may be associated with small meningiomas are discussed.

Brain Edema↗
PubMed1980

The vascular component in meningiomas associated with severe cerebral edema.

Cerebral edema is usually a complication of the later growth stages of intracranial neoplasms. Three patients with small meningiomas presented with unusually several cerebral edema out of proportion to the size of tumors. All three tumors exhibited benign meningothelial components, the formation of pseudopsammoma bodies, and striking vascular mural proliferation of small dark cells. In two tumors ultrastructural examination of these cells showed features of pericytes. The vascular pericytic component in these tumors may grow more actively than the meningothelial component and thus may cause the production of severe cerebral edema. The clinical, radiological, operative, and light and electron microscopic findings are presented, and the relationship to angioblastic meningiomas is discussed.

Aged↗
PubMed1980

A comparison of brain imaging with gamma camera, single-photon emission computed tomography, and transmission computed tomography: concise communication.

We have evaluated the utility of a single-photon axial tomographic scanner (ECT) in brain imaging, using routine tracers in 238 patients. When compared with routine delayed gamma-camera images (DGCI), there was agreement in 191 negative studies and 39 positive studies. Four patients had positive DGCI and negative ECT studies, and four had positive ECT and negative DGCI. In the 102 patients in this series who also had transmission CT (TCT) studies, there were five who had positive emission studies and negative TCT, and 38 with an abnormal TCT and normal ECT. The ECT was occasionally helpful in distinguishing brain and skull metastases, in better portrayal of deep lesions, and in resolving equivocal DGCI findings. For the ECT to become clinically rewarding, however, we feel that it will need development of new tracers that will provide functional information in addition to that already attainable by routine gamma-camera images.

Adult↗
PubMed1979

Cerebral embolism from septal fibromuscular dysplasia of the common carotid artery.

A rare type of fibromuscular dysplasia of the common carotid artery, in the form of a septum, was observed in a patient suffering from recurrent cerebral infarctions. Angiography demonstrated growth of the lesion and documented the presence of an intraluminal thrombus attached to it. Comparison with reported cases of the more common "string of beads" lesion of fibromuscular dysplasia suggests that the risk for development of ischemic neurological problems is higher for this type of fibromuscular lesion. Surgical correction is recommended, especially for symptomatic patients.

Arterial Occlusive Diseases↗
PubMed1979

Radiographic features of granulocytic sarcoma (chloroma).

The computed tomographic (CT) findings in two patients in whom intracranial granulocytic sarcomas preceded the onset of systemic myelogenous leukemia are presented. On CT, granulocytic sarcomas may be indistinguishable from meningiomas and difficult to differentiate from primary central nervous system malignant lymphoma and eosinophilic granuloma.

Adult↗