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Biomedical subjects

E Rossitch

Publications and source records attributed to E Rossitch.

At least 55 records · Page 3Linked to original sources
PubMed1989

Cushing and epilepsy surgery: two successfully treated cases with long-term follow-up.

Two of Dr. Harvey Cushing's patients who were successfully treated surgically for epilepsy are presented to illustrate his understanding of the problem. Both cases include his operative sketches and long-term follow-up, one includes the patient's recent brain computed tomography scan and autopsy specimen. Cushing's operative sketching habits and their importance are discussed.

Epilepsy↗
PubMed1989

Cerebral toxoplasmosis in the acquired immune deficiency syndrome.

We examined the clinical and pathological features of 26 patients who presented with a diagnosis of CNS toxoplasmosis. Patient data was analyzed with respect to demographics, clinical presentation, treatment course and pathology. Patients presented with a wide variety of signs and symptoms. All patients had positive serum antitoxoplasma IgG; ring enhancing lesion(s) were present on all but one brain CT scans. A series of guidelines in the management of CNS toxoplasmosis in AIDS patients are presented. Prior to biopsy, patients with positive serology and characteristic CT scans should receive two weeks of treatment. Biopsy is indicated in those cases with negative serology, atypical presentation, progressive clinical deterioration, or differential response of lesions to empiric therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Merkel cell carcinoma. Long term survival in a patient with proven brain metastasis and presumed choroid metastasis.

Merkel cell carcinoma (Trabecular carcinoma) is a rare malignant tumor of the skin. Because these tumors tend to spread locally via the lymphatic system, very few papers have dealt with the treatment of distant metastasis. Systemic disease is uncommon and usually fatal. In this paper, we report a case of Merkel cell carcinoma with proven brain metastasis and a solid choroidal tumor. The patient responded well to radiation and chemotherapy and is alive and neurologically intact three years after diagnosis. All previous patients with metastatic Merkel cell carcinoma to the brain died within two months of the diagnosis. We use this case to discuss possible routes of metastatic dissemination and to review the treatment options in patients with distant metastatic disease. To our knowledge, this is the first reported case of presumed choroidal metastasis of Merkel cell carcinoma and the longest documented survival in a patient with brain involvement.

Brain Neoplasms↗
PubMed1989

Summer fellowships.

Explore the source record for details and available documents.

Education, Medical, Undergraduate↗
PubMed1989

Nucleus caudalis DREZ for facial pain due to cancer.

Five cancer patients underwent nucleus caudalis DREZ operations for medically refractory facial pain. Etiologies included a posterior fossa microglioma, a lacriminal gland carcinoma, a temporal meningioma, a parasellar tumor (craniopharyngioma), and an orbital fibrosarcoma. Postoperative results were graded as excellent (complete pain relief), good (pain decreased, activity not limited), fair (pain present, but less than before surgery, activity limited), and poor (pain same or worse than before surgery). Immediately following surgery, all patients reported good or excellent pain relief. On later followup (mean = 14.4 mo), three of our five patients reported a significant improvement in pain and level of activity. The remaining two patients reported that the pain was less than before surgery but that their activity was still limited because of the pain. We conclude that the nucleus caudalis DREZ operation is useful in treating medically refractory facial pain due to cancer. At this time, it appears that patients with burning pain, no hyperesthesias, and no previous neuroablative procedures have the better chance at a successful outcome.

Adult↗
PubMed1989

Kluver-Bucy syndrome following recovery from transtentorial herniation.

Kluver-Bucy syndrome is an uncommon constellation of behavioral abnormalities resulting from bilateral temporal lobe damage. The syndrome is rare in humans. In this paper we present a patient who developed the Kluver-Bucy syndrome following recovery from an intracerebral haemorrhage and transtentorial herniation.

Adult↗
PubMed1989

Aspergillus disc space infection: case report and review of the literature.

Aspergillus disc space infection is an unusual complication of the immunocompromised state. Magnetic resonance imaging may aid the clinician in arriving at a prompt diagnosis of discitis in affected patients. We report a case of systemically acquired Aspergillus discitis at multiple levels diagnosed by plain x-ray films, bone scan, magnetic resonance imaging, and biopsy. We review the literature on this subject and suggest that aggressive diagnosis with early biopsy, treatment with systemic antifungal agents, and surgical debridement of the infected disc space yield the best outcome for these patients.

Anti-Bacterial Agents↗
PubMed1988

Intracranial pressure (ICP) monitoring as a guide to prognosis in a lightning-injured, comatose child.

Every year there are many deaths due to lightning injuries in the United States. A case is presented of a young child who suffered cardiopulmonary arrest following being struck by lightning strike and in whom ICP monitoring was utilized. We postulate that ICP and CPP measurements may be useful as prognostic indicators for comatose lightning victims and, therefore, may help in the management of the patient.

Cerebrovascular Circulation↗
PubMed1988

The deafferentation syndrome in the rat: effects of intraventricular apomorphine.

A deafferentation syndrome, produced in rats by dorsal root ganglionectomies, is expressed as scratching of partially deafferented limb areas and/or biting of anesthetic limb areas. This self-mutilation may be objective evidence of dysesthesias, thus serving as an experimental model to study chronic dysesthesias and/or pain from deafferentation in man. This study included behavioral observations of the syndrome and the effects of intraventricular apomorphine, a dopamine agonist, on its expression. Thirty-eight female Sprague-Dawley rats underwent unilateral C5-T2 dorsal root ganglionectomies followed immediately by stereotactically guided cannulation of the right lateral ventricle in 20 of the rats. For 2 weeks continuously via an osmotic minipump, 10 rats received apomorphine (5 micrograms/h) and 10 others received L-ascorbate (the vehicle). Rats with ganglionectomies only, as well as those receiving L-ascorbate, demonstrated early onset, more severe and later onset, less severe biting groups (P less than 0.05 Mann-Whitney U). Animals receiving apomorphine exhibited low autotomy scores irrespective of time of bite onset. Among the control groups, but not the experimental animals, the earlier the onset of biting, the more severe was the autotomy. The rats receiving vehicle via the minipump had earlier bite onsets than the rats in the ganglionectomy only group. This may indicate that the presence of the minipump is a stress which can accelerate the onset of biting. Intraventricular apomorphine can affect the deafferentation syndrome in the rat; it seems to decrease the level of autotomy and disrupt the relationship of bite onset with degree of biting.

Afferent Pathways↗
PubMed1988

Evaluation of memory and language function pre- and postthalamotomy with an attempt to define those patients at risk for postoperative dysfunction.

Memory and language dysfunction has been sporadically reported following stereotaxic thalamotomies. In order to determine which patients are at greatest risk and to better define the nature of this dysfunction, we have prospectively evaluated 18 patients undergoing stereotaxic thalamotomies for movement disorders (MDs). Patients were evaluated clinically, with computed tomography (CT) and with memory and language protocols (MLPs) pre- and postoperatively. Patients exhibiting postoperative deficits were again evaluated with the MLP on follow-up visits to the clinic. Significant changes in memory and language function occurred in 7 out of 18 patients. These 7 patients had diverse etiologies for their MDs. Five of the 18 patients had undergone previous thalamotomies on the contralateral side. Three of these 5 patients with bilateral thalamotomies experienced postoperative functional impairments in memory and language while only 4 of 13 patients with a unilateral thalamotomy experienced these problems. The postoperative functional impairments noted were primarily those requiring orientation and speech. All patients with postoperative memory and language impairments were again evaluated with MLPs months after the operation. In 3 of 7 patients, no improvement was noted, while the remaining 4 did recover to baseline. More severe deficits tended to occur in those patients with ventriculomegaly or evidence of other major cerebral tissue loss by preoperative CT scan and in those patients with lower MLP scores preoperatively. Postoperative memory and language dysfunction was not correlated with the number or size of the lesions made, the postoperative general neurologic examination or CT scans, or the clinical response of the MDs. From our data, it appears that patients with more profound neurologic compromise and/or bilateral involvement as evidenced by poor performance on the MLP, tissue loss on CT scanning, or previous thalamic lesion, are most at risk for memory and language dysfunction postoperatively. However, this dysfunction is not necessarily permanent. Preoperative evaluation with MLPs and CT scanning appear to be of value in predicting those patients at greatest risk for postoperative and language dysfunction.

Adolescent↗