Biomedical subjects
Publications and source records attributed to G Wilms.
We describe the case of a 14-year-old boy with a Sprengel deformity and a Brown-Séquard syndrome on the basis of a compression of the spinal cord at level C4. Although there are several publications on anomalies associated with Sprengel's deformity, this is, to our knowledge, the first description of a case with spinal cord compression.
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Arteriography in two patients showed a persistent sciatic artery, in one case complete and the other case incomplete, associated with a persistent superficial femoral artery. One case was complicated by the presence of an aneurysm. Embryology, pathology, clinical aspects and surgical repercussions are discussed, and emphasis placed on the need for preoperative angiography to detect this embryologic variant requiring another surgical attitude.
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The history of a patient with bilateral renal cell carcinoma, simulating bilateral renal abscesses is reported. Since hypernephroma can present with misleading systemic effects, all diagnostic tools concerning space-occupying lesions of the kidney must be interpreted with care before treatment. Punctures for cytology can be indicated when both kidneys are affected.
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A 17-year-old female developed a syndrome of benign intracranial hypertension after a minor craniocerebral trauma. On the vertex a congenital scalp anomaly was noticed. An underlying bone defect was revealed by skull radiographs. Cerebral angiography showed absence of the straight sinus as well as other abnormalities of the cerebral venous drainage. In addition, several dysmorphic features, especially of the face and hands were present, which were also found in the mother and the sister. These stigmata could be interpreted as a partial expression of the Aarskog (facial-digital-genital) syndrome after examination of the 9-year-old brother who presented the typical facial, digital and genital features of this X-linked recessively inherited syndrome.
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Digital intravenous subtraction angiography (DIVSA) appears a promising and not highly invasive technique in the study of intracranial tumors and vascular lesions. In combination with computed tomography it should be sufficient in future for determining a preoperative tumourovascular balance. Already now it can be a valuable method in the screening for vascular malformation, in the postoperative evaluation of vascular intracranial lesions or after embolization of those lesions. In the study of the dural venous sinuses, DIVSA appears largely superior to conventional angiography. Advantages of the intravenous approach are the outpatient base, the low risk and low cost.--Low contrast dose and low pressure intraarterial subtraction technique is equivalent to conventional angiography with less risk and discomfort to the patient and resulting in considerable saving in cost.
During the last two years a total of 53 liver angiomas in 35 patients were examined by sonography. The angiomatous nature of these lesions was proven by angiography, CT, laparotomy, laparoscopy or autopsy. In this material the most striking sonographic data are the reflective character of the angiomas (94%), the subcapsular location (70%), the small size under 2 cm. (32%) and the multiplicity (35%). 90% of the lesions larger than 3 cm. tend to display polylobular contours.
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Digital intravenous subtraction angiography (DIVSA) appears to be a technique of minimal invasiveness and high accuracy in the follow-up of patients after percutaneous angioplasty (PTA) allowing correct angiographic evaluation in more than 96% of the cases. Correlation between clinical and angiographic findings seems to be excellent. Of the controlled intravenous examinations performed in 54 successful PTA procedures 75% appeared patent after 10 to 30 months, constituting 52% of the original attempts.
I.V.D.S.A. was performed as a follow-up after a surgical vascular procedure or a percutaneous transluminal angioplasty in 157 patients. The quality of the intravenous angiography was excellent in 91% of the patients. In 6,6% the examination was sub-optimal with possible error and in 2.4% the examination was not diagnostic. The inherent limitations of the technique are less important in these follow-up examinations because a limited region only has to be examined. A more accurate follow-up of vascular procedures is possible with I.V.D.S.A.