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Biomedical subjects

G Schroth

Publications and source records attributed to G Schroth.

At least 127 records · Page 7Linked to original sources
PubMed1995

[Neuroradiology--past and future].

After the discovery of X-rays by Roentgen exactly 100 years ago, neurosurgeons and neurologists have been promoting an imaging diagnosis of the central nervous system around the turn of the century with methods like pneumencephalography and angiography. With the induction of computed tomography and magnetic resonance imaging (MRI) in the last two decades, seemingly simple examination methods became available which led to a temporary separation of neuroradiology from its parent fields. Further development of MRI with methods that allow to measure brain perfusion and to visualize brain function has led this diagnostic modality back to its origin, neurology: adequate evaluation of such multimodality imaging is only possible in the context of all neurosciences. On the other hand, interventional neuroradiology with endovascular procedures in the brain has evolved to an operative field that is only feasible in close cooperation with neurosurgery. This also applies to MRI, where the 'open magnets' require close cooperation between neuroradiologist and neurosurgeon to perform image guided procedures online.

Angiography, Digital Subtraction↗
PubMed1995

[Diagnostic tomodensitometry of acute basilar thrombosis].

Basilar artery thrombosis is a potentially treatable neurologic disease whose initial symptoms are sometimes difficult to recognize. The basilar artery is hyperdense on computed tomography in cases with basilar artery thrombosis. We have studied computed tomography attenuation values before and after contrast administration in a total population of 117 patients, 12 of whom were diagnosed angiographically as having basilar artery thrombosis. While it is not always possible to detect basilar artery thrombosis simply by evaluation of the tomodensitometric values before or after contrast, the differential values obtained by subtracting them (after contrast/before), or by an attenuation ratio corresponding to the differential value divided by the value before contrast, are more helpful. Indeed, the differential values and attenuation ratios in the normal population have a mean value of 51.1 and 1.37 compared with 14.47 and 0.33 in patients with basilar artery thrombosis.

Aged↗
PubMed1995

Diffuse vasospasm following stenting of a free gastroepiploic artery graft: resolution with balloon angioplasty and intensive medical therapy.

Vasospasm following balloon angioplasty of gastroepiploic artery bypass grafts can be prevented or reversed with vasodilators. In our patient, stent deployment for ostial stenosis of a free gastroepiploic artery graft was accompanied by severe, diffuse spasm and a change in graft configuration that required both intensive medical therapy and balloon angioplasty for resolution.

Angioplasty, Balloon, Coronary↗
PubMed1995

Successful treatment of chronic total peripheral occlusions that failed conventional techniques using the stiff backend of the Glidewire.

The vast majority of failures of transcatheter interventions in patients with peripheral vascular disease are due to inability to cross the lesion with a guidewire. Although the use of the Glidewire has clearly improved the success rate, failures with especially chronic total occlusions still occur. We describe a new technique using the very stiff backend of the Glidewire, which we have found very successful, when conventional techniques fall in crossing highly resistant lesions.

Aged↗
PubMed1995

Cardiac myxomas: a long term study.

From 1980 to 1992 we followed 12 patients with cardiac myxomas for an average of 4.4 years (8 months-11 years). Presenting symptoms were neurological in four patients (hemiparesis, aphasia, visual field deficits, progressive dementia or vertigo), progressive dyspnoea in six, pulmonary embolism in one, and peripheral arterial or renal emboli in three. The diagnosis was suspected clinically in 11 patients. It was confirmed by echocardiography in ten and by thoracic CT in one. All these patients had cardiac surgery. One diagnosis was made at autopsy; the patient died unexpectedly during surgery for emboli to the leg arteries. At follow-up, two additional patients had died, one from myocardial infarction and one from rhabdomyosarcoma. Only one of the nine surviving patients had recurrent symptoms after cardiac surgery. His dementia continued to progress. The patients without new symptoms after cardiac surgery had normal MRI of the brain or residual ischaemic lesions. MRI of the patient with progressive dementia showed multiple cerebral lesions with a bright centre and a dark rim on T1- and T2-weighted spin-echo images. On CT there were many calcified lesions. CT, MR angiography and contrast angiography revealed multiple fusiform aneurysms. The rare occurrence of progressive neurological symptoms after myxoma resection with multiple cerebral lesions and aneurysms should suggest myxoma metastases to the brain.

Adult↗
PubMed1995

Coronary artery flow monitoring following coronary interventions.

Coronary guidewires with ultrasound transducer tips are commercially available and are appropriately sized for use in coronary interventions. These guidewires permit monitoring of coronary flow before, during and after the interventions. The measured flow signal contains valuable information regarding the quality and the stability of the final result. After completion of the procedure, monitoring the trend in average velocity over several minutes can reveal subtle alterations in flow that may presage abrupt closure. Abnormal or unstable flow patterns also may help predict lesions that might develop recurrences in the weeks and months after successful procedures.

Angioplasty, Balloon, Coronary↗
PubMed1995

Coronary artery flow monitoring: the value of intravascular Doppler for detection of complications after interventions.

Ultrasound transducer-tipped guidewires can be used for coronary interventions, and they permit the monitoring of coronary flow before, during, and after the interventions. The flow signal contains valuable information regarding the quality and stability of the final result. Restoration of typical phasic flow patterns with diastolic predominance is one guide to final result. Monitoring the trend in average velocity over several minutes after completion of the procedure can detect subtle alterations in flow that may presage abrupt closure. These flow alterations might also help predict active plaques with heavy thrombus involvement that may undergo recurrence in the weeks and months after successful procedures.

Angioplasty, Balloon, Coronary↗
PubMed1995

Severe symptomatic vasospasm after rupture of an arteriovenous malformation.

A 31-year-old woman had intracerebral and intraventricular hemorrhage from an arteriovenous malformation. Vasospasm of the internal carotid arteries developed and was treated with angioplasty. On initial CT scans, only traces of blood were seen in the basal cisterns; thus, the development of symptomatic vasospasm was an unexpected complication.

Adult↗
PubMed1994

Myocardial infarction and polycythemia vera: how should we treat it?

Little is known about the management and treatment of coronary thrombosis in polycythemia vera (PV) [1]. We describe a case of acute myocardial infarction in a patient with recently diagnosed PV and thrombocytosis. The patient underwent emergency catheterization with intracoronary thrombolysis and angioplasty of the left anterior descending coronary artery.

Aged↗
PubMed1994

Transcranial color-coded duplex sonography in cerebral aneurysms.

BACKGROUND AND PURPOSE: Diagnosis and successful therapy before rupture of cerebral aneurysms would be most desirable in view of the high mortality and morbidity rates of aneurysmal subarachnoid hemorrhage. Using transcranial color-coded duplex sonography, we studied radiologically proven cerebral aneurysms to define ultrasonographic criteria and sensitivity for their diagnosis and detection. METHODS: Twenty-nine consecutive patients with 30 radiologically proven cerebral aneurysms were prospectively examined using transcranial color-coded duplex sonography. The sonographer was aware of cerebral computed tomographic and magnetic resonance imaging findings but was blinded to the results of cerebral angiography. RESULTS: Ultrasonographic findings for aneurysms studied were as follows: (1) Scanning planes that transsected approximately mid-aneurysm showed a round or oval mass that was divided by a "separation zone" into red and blue areas. (2) The "separation zone" was characterized by dark or no colors. (3) Peripheral scanning planes showed monochromatic images. (4) No turbulence was found. (5) No spontaneous fluctuations were detected. Twenty-three of 27 (85%) nonthrombosed aneurysms with a diameter of 6 to 25 mm were identified. The walls and three thrombosed and four nonthrombosed aneurysms (mean diameter, 5 mm) were missed. CONCLUSIONS: Transcranial color-coded duplex sonography can provide the diagnosis of nonthrombosed aneurysm using the above-cited criteria because of its capacity to reveal flow phenomena. It is not the method of choice in the search for aneurysms because small and thrombosed aneurysms are missed. Careful visual inspection of the intracranial arteries to permit incidental detection of cerebral aneurysms should be part of every transcranial color-coded duplex examination.

Adolescent↗
PubMed1993

[Transcranial color-coded duplex ultrasonography in adults].

UNLABELLED: Transcranial color-coded duplex sonography (TCCD) represents an improvement in ultrasound technology for study of the intracranial circulation. This new method was applied in 33 healthy volunteers and 63 neurological patients in order to study the following questions: (1.) how often can non-occluded intracranial arteries be delineated; (2.) reliability of pathological TCCD findings in comparison with cerebral angiography; (3.) reference blood flow velocity data. RESULTS: 99% of vertebral (VA), 98% of basilar (BA), 96% of middle (MCA) and posterior cerebral (PCA), 95% of internal carotid (ICA; siphon and terminal segment), 93% of anterior cerebral (ACA), and 86% of posterior inferior cerebellar (PICA) arteries were delineated. In conjunction with the findings of extracranial color-coded duplex sonography (ECCD), 4 stenoses (2 MCA, 1 ICA and PCA each), 8 occlusions (4 ICA, 1 ACA, MCA, BA and VA each; differential diagnosis: subtotal stenosis), 9 collateral circulations (anterior and posterior communicating arteries in 4 cases each, occipital artery-intracranial VA in one), 4 cerebral arteriovenous malformations, and 2 giant aneurysms of the terminal ICA were suspected and confirmed by angiography. However, 2 hypoplastic VA's and ipsilateral PICA's were missed. (3.) Maximal +/- SD values were 83 +/- 27, 110 +/- 18, 67 +/- 12, 64 +/- 13, 53 +/- 13, and 51 +/- 12 cm/sec for systolic, and 36 +/- 9, 49 +/- 9, 30 +/- 7, 29 +/- 8, 24 +/- 7, and 25 +/- 7 cm/sec for end-diastolic velocity in the ACA, MCA, PCA, BA, VA, and PICA.

Adult↗
PubMed1993

[The imaging diagnosis of acute cerebral tuberculosis].

5 unusual cases of cerebral tuberculosis are reported. Three of the cases initially showed the typical history and aspect of herpes simplex encephalitis, and two of a cerebral tumour. Both CT and MRI, and also the clinical neurological symptoms, were confusing. Microbiological culture in three and histological preparation in two cases confirmed the diagnosis of cerebral tuberculosis. Three cases showed the development of tuberculomas under therapy. The study of the literature suggests that this is not rare, which is explained by pathogenetic reflexions concerning the allergic genesis of the tuberculomas.

Adult↗