Biomedical subjects

G Wilms

Publications and source records attributed to G Wilms.

At least 181 records · Page 10Linked to original sources

PubMed1989

Angiographic diagnosis and treatment of posttraumatic carotid-cavernous fistulas.

Balloon embolization was attempted in 7 patients with posttraumatic carotid-cavernous fistulas. The procedure was successful in 4 patients and failed in 3 other. Two of these fistulas showed spontaneous regression after failed embolization. In one patient, premature detachment of the balloon led to cerebral infarction, but with total clinical recovery. One patient showed temporary palsy of the VIth cranial nerve after embolization.

Angiography↗

PubMed1989

[Computerized tomography and magnetic resonance imaging of the pelvis in a patient with neurofibromatosis].

A case of intrapelvic neurofibroma is presented in a patient with neurofibromatosis. Magnetic resonance imaging proved to be very sensitive in the demonstration and delineation of the tumoral pelvic mass and the detection of smaller subcutaneous lesions. Direct coronal and sagittal images provided important information to the surgeon to evaluate the cranial and caudal extension and the anatomic boundaries of the lesion.

Adult↗

PubMed1989

Percutaneous transluminal renal angioplasty and renal function.

Renal function was studied before and after percutaneous transluminal renal angioplasty (PTRA) in 79 patients. In a prospective study of 28 patients with unilateral renal artery stenosis, renal function was similar during angiotensin-converting enzyme (ACE) inhibition and after PTRA. In 37 patients with bilateral renal artery stenoses, 9 patients with solitary kidneys and renal artery stenoses and 5 patients with transplant renal artery stenoses, there was no statistical difference in the renal function before and after PTRA. Of the 79 patients studied, 50 had normal renal function before PTRA. In 5 of these renal function decreased, requiring temporary hemodialysis in 1. Of 29 patients with impairment of renal function due to renal artery stenosis, improvement was noted in 14, stabilization of renal function in 11, and decrease of renal function in 4. It is concluded that PTRA is a safe technique that can make life-long drug treatment unnecessary in antihypertensive patients. It can restore or stabilize renal function in renal insufficiency caused by renal artery stenosis. It has to be kept in mind that contrast medium toxicity and cholesterol embolization can induce severe renal insufficiency after PTRA.

Angioplasty, Balloon↗

PubMed1989

[Ambulatory myelography using iohexol (Omnipaque): methods and results].

Outpatient myelography with iohexol (Omnipaque) was performed in 150 patients. Side effects were noted in 28 patients (19%), with only 3 (2%) major complaints. It concerned 2 patients with severe and prolonged headache and one patient with seizures. Side effects were not more frequent in outpatient myelography than in reported series of hospitalized patients. The frequency of side effects was significantly lower with the use of iohexol than in comparable studies with metrizamide. Headache was the most frequent side effect, followed by an increase or exacerbation of ischiatiform pain, nausea and vomiting. Side effects were slightly more frequent in cervical myelography than in lumbar myelography and were not related to underlying pathology. It is concluded that outpatient myelography is feasable for as far as iohexol is used and patient surveillance is carefully organized.

Adult↗

PubMed1989

Percutaneous transluminal renal angioplasty versus renovascular surgery: statistical, medical and economical considerations.

Retro- and prospective comparative studies in patients with renal artery stenosis demonstrate that technical results and blood pressure improvement after renovascular surgery or percutaneous transluminal renal angioplasty (PTRA) are strictly comparable. The lesser invasive character of PTRA together with its lower complication rate and the lower cost explain why PTRA is the method of choice in the treatment of renal artery stenosis, with less restrictive selection criteria than used for surgery.

Angioplasty, Balloon↗

PubMed1989

Balloon angioplasty of venous structures.

Percutaneous transluminal angioplasty was attempted in 20 patients with stenoses of venous structures. It concerned one stenosis in a native subclavian vein, 12 stenoses in venous bypass grafts and 7 stenoses in hemodialysis-access fistulas. Primary results were excellent for the procedures in the native vein and the venous bypass grafts with success in all patients (13/13). In the arteriovenous fistulas for hemodialysis, dilatation of the venous stenoses was only possible in 5 out of 7 patients. The subclavian vein stenosis did not recur within a follow-up period of 3 years. Of the stenoses in the venous bypass grafts, two lesions reoccluded within one week and 6 lesions recurred within one year. Two of these lesions were successfully redilated so that 6 lesions remain patent with a follow-up of more than one year. Of the 5 successful dilatations in hemodialysis-access fistulas, two lesions recurred within 2 months. Only 3 veins are still accessible for hemodialysis. It is concluded that attempts at balloon dilatation of stenoses in venous bypass grafts or hemodialysis-access fistulas are meaningful in order to prolong the life of these surgical procedures. Recurrence of stenoses is however likely to occur within one or two years.

Angioplasty, Balloon↗

PubMed1989

Familial occurrence of paragangliomas.

The occurrence of paragangliomas in three members of the same family is reported. It concerned a left carotid body tumor in one patient, a left carotid body tumor in her older sister, and a concomitant jugulotympanic and vagal body tumor in their younger brother. The radiological diagnosis in these patients was based on the typical hypervascular character in specific locations both on angiography and computed tomography. The familial occurrence of these lesions should be kept in mind whenever a chemodectoma is found, even in the absence of clinical symptoms in the direct relatives of the patients.

Adult↗

PubMed1989

Pre-operative embolization of juvenile nasopharyngeal angiofibromas.

Pre-operative embolization of juvenile nasopharyngeal angiofibroma was performed in 15 patients. The lesion was supplied by the internal carotid arteries (8 cases), by the internal maxillary artery (15 cases), the accessory meningeal artery (10 cases) and the ascending pharyngeal artery (10 cases). Superselective embolization of the external carotid artery feeders was performed with Ivalon particles, without neurological complications. Good control of per-operative blood loss was noted in 13 out of 15 cases, 2 patients presenting severe per-operative venous bleeding. Recurrence was noted in only one patient, which could be controlled by reembolization.

Adolescent↗

PubMed1989

A case of intracranial chordoma investigated by MRI and CT studies.

MR imaging of an intracranial chordoma is described. The tumor appeared strongly hyperintense on T2 weighted images and moderately hypointense on T1 weighted images with a strong homogeneous contrast enhancement after IV administration of Gadolinium Dota. MR is superior to CT in delineating the tumor margins and in defining its relationship to the brainstem, optic chiasm and the vasculature, providing essential pre-operative information.

Aged↗

PubMed1989

[Computed tomography and magnetic resonance imaging in anomalies of neuronal migration].

This is a report of the CAT-scan and MRI characteristics in 14 patients with anomalies of neuronal migration. There were 3 cases of heterotopia of the gray matter, 2 cases of agyria, 3 cases of pachygyria, 2 cases of schizencephaly and 4 cases of hemimegalencephaly. The primary advantages of MRI in comparison with CAT-scanning, are better contrast between the white and gray matter; better delineation of the cerebral cortex and the possibility of direct mutiplanar imaging. NMRI will become the investigation of choice in children with epilepsy or psychomotor retardation.

Adolescent↗

PubMed1989

[Spontaneous dissection of the cervical internal carotid artery. Diagnosis by MRI].

A case of spontaneous dissection of the cervical internal carotid artery documented by angiography and MRI is reported. Angiography showed an irregular stenosis of the upper part of the cervical internal carotid artery extending up to the base of the skull, suggestive of spontaneous dissection. The diagnosis was confirmed beyond doubt by MRI which showed a sub-intimal collection of blood with a typical hyperintense appearance.

Aged↗

PubMed1989

MR imaging of the brain: preliminary results with a gradient echo sequence after paramagnetic contrast enhancement.

In a series of 15 patients with contrast enhancing lesions of the brain, a gradient echo sequence (TR = 400 ms; TE = 10 ms; flip angle 90 degrees, one excitation) after IV administration of a paramagnetic contrast agent provided equal diagnostic information and image quality to conventional T1 weighted spin-echo images. Imaging time for one sequence could be reduced by two thirds to 1 min 45 sec. Susceptibility artifacts caused only slight image degradation in the bitemporal region and the region of the sella turcica. This gradient echo sequence can be useful in combination with paramagnetic contrast enhancement, as a complement to conventional T1 and T2 weighted spin-echo sequences.

Brain Diseases↗

PubMed1989

Magnetic resonance imaging in acoustic neurinoma. Comparison with CT.

MRI and CT were performed in 16 patients with 17 acoustic neurinomas. MRI was superior to CT in the detection of small acoustic neurinomas, in the demonstration of intracanalicular extension and in the differentiation with cerebellopontine angle meningiomas. Overall advantages of MRI over CT included better tissue contrast, absence of bone artifacts and easy multiplanar imaging.

Adult↗

PubMed1989

Magnetic resonance imaging in lesions of the eye globe.

Magnetic Resonance Imaging (MRI) findings in 22 patients with lesions of the globe were examined. There were 16 cases of malignant uveal melanoma, 2 cases of retinoblastoma, 3 cases of hemorrhagic choroidal detachment and 1 case of senile macula degeneration. MRI adequately depicted the lesions in 20 cases. In two cases MRI findings were unconclusive due to movement artifacts of the eye globe. Fourteen out of 16 uveal melanomas displayed typical T1 and T2 shortening. In the two other cases the hypointense aspect on T2-weighted images was less pronounced due to a lesser amount of melanin in the lesions as demonstrated by subsequent histology. Unlike with CT, the tumoral lesions could clearly be differentiated from subretinal exudate. The case of senile macula degeneration, two retinoblastomas and two cases of hemorrhagic choroidal detachment had the same MRI characteristics as melanomas.

Adult↗

PubMed1989

High resolution CT findings in diseases of the external auditory canal. A review of 31 cases.

Thirty-one patients with pathology of the external auditory canal (EAC) were examined with high resolution CT. In this retrospective study we found that CT plays an important role in the diagnosis and especially in the determination of the extent of the disease. CT also offered us a good evaluation of the contiguous bone and it was the best method to visualize the middle ear when complete occlusion of the external auditory canal (EAC) occurred.

Adult↗

PubMed1989

Embolization of iatrogenic pelvic and retroperitoneal hemorrhage.

Bleeding of iatrogenic origin was treated by embolization in four patients. It concerned a post-operative bleeding in the thigh after total hip replacement, a post-operative pelvic bleeding after biopsy of the iliac bone, a retroperitoneal hemorrhage after percutaneous sympathicus blockage and an intrarenal bleeding after percutaneous nephrostomy. Embolization proved to be a very efficient method in the control of these iatrogenic bleedings, with minimal risk and stress for the patient. It could prevent reintervention and prolongation of the hospitalisation.

Adult↗

PubMed1988

Intravenous digital subtraction angiography and Duplex scanning in the detection of late human umbilical vein degeneration.

To define the exact incidence of late degeneration, 32 patients underwent intravenous digital subtraction angiography (IVDSA) and/or a Duplex scan more than 3 years after human umbilical vein (HUV) grafting. IVDSA (n = 26) showed a 23 per cent aneurysmal degeneration rate which increased to 40 per cent with Duplex scanning (n = 25). Although the differences obtained in those patients receiving both examinations (n = 19) were statistically not significant, Duplex scanning appeared to be more sensitive, demonstrating two additional cases of aneurysmal degeneration not detected by IVDSA. Since, moreover, Duplex scanning proved able to detect anastomotic stenosis, it appears to be the examination of choice in long-term follow-up of the HUV graft. Despite this relatively high degeneration rate, the authors consider continued use of the HUV graft in selected patients to be justified, especially when the long-term patency rates, the available alternatives, and the less favourable long-term survival after femoropopliteal reconstruction are taken into consideration.

Aneurysm↗

PubMed1988

Intraarterial embolization in combination with surgery in the management of congenital pelvic arteriovenous malformation.

A case of congenital arteriovenous fistula of the pelvis is described. Arteriovenous malformations of the pelvis are rare and can give rise to problems in diagnosis and treatment. A long history of vague complaints precedes determination of the correct diagnosis. Because recurrence is not uncommon after treatment, intraarterial embolization in combination with surgery is mandatory.

Adult↗