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Biomedical subjects

G Wilms

Publications and source records attributed to G Wilms.

At least 145 records · Page 8Linked to original sources
PubMed1990

Cerebral venous angiomas. MR imaging at 1.5 tesla.

Sixteen cases of cerebral venous angiomas, seven cerebellar and nine supratentorial were imaged by magnetic resonance, using a T1 sequence and a motion compensated T2 sequence. The transcerebral draining vein of the lesion could be identified in thirteen out of sixteen patients. On T1-weighted images all the lesions were hypointense. On T2-weighted images, five lesions were hypointense, and eleven were hyperintense consistent with slow flow. In three cases the lesion was hemorrhagic. Three lesions with hypointense aspect on T1 and hyperintense aspect on T2-weighted images were only seen in retrospect, due to partial volume averaging in two and concomitant chronic hemorrhage in one. Before contrast, the peripheral dilated medullary veins could only be identified in five cases. On T2-weighted images, in three of these lesions the signal was higher than in the draining veins, pointing to a slower flow. After intravenous administration of Gadolinium, performed in twelve patients, the main transcerebral draining vein as well as the peripheral medullary veins could be well identified in all patients.

Adolescent↗
PubMed1990

Cerebrovascular occlusive complications in osteopetrosis major.

We report the case of a 16-year-old patient with osteopetrosis major, complaining of transient sensory and motor disturbances in the left upper limb and dizziness on changing the position of his head. Selective angiography of the cerebral vessels showed severe narrowing of the internal carotid artery within the petrous carotid canal and in its supraclinoid portion. The cervical vertebral arteries showed multiple stenosis within the vertebral canal. These findings are explained by narrowing of the basal foramina by the osteopetrotic bone.

Adolescent↗
PubMed1990

MR findings in globoid cell leucodystrophy.

The MR findings in an adult patient with globoid cell leucodystrophy (GLD) or Krabbe's disease are presented. MRI showed a bilateral periventricular hyperintensity of the parieto-occipital white matter on the T2-weighted images. A hyperintense signal was seen bilaterally along the corticospinal tract. There was no immediate nor delayed contrast enhancement. The MR findings in this case of GLD are rather atypical.

Adult↗
PubMed1990

Embolization of iatrogenic renal hemorrhage following percutaneous nephrostomy.

Renal bleeding of iatrogenic origin was diagnosed in three patients with massive hematuria. Although percutaneous nephrostomy was the initial injury in all cases, the angiographic presentation was very variable. All cases were successfully managed with arterial embolization, using different techniques. Symptoms regressed totally in all patients avoiding surgical intervention.

Adult↗
PubMed1990

MRI findings in tuberculous meningo-encephalitis.

MRI findings in 3 cases of cerebral tuberculosis are reported. MR features consisted in meningeal enhancement, enhancement of the basilar cisterns and brainstem abscesses. T1 weighted images after intravenous administration of gadolinium appeared most efficient in the demonstration of the lesions.

Adolescent↗
PubMed1990

The role of high resolution ultrasound and MRI in the investigation of infants with macrocephaly.

External hydrocephalus was diagnosed using computed tomography in seven children presenting with macrocephaly. The value of different imaging techniques in distinguishing between subdural effusions and external hydrocephalus was investigated. High resolution ultrasonography combined with magnetic resonance imaging appeared to provide enough information to make a distinction between these two conditions. Radionuclide cisternography was still required to assess the flow pattern of the cerebrospinal fluid (CSF) which was important when placement of a lumboperitoneal shunt was considered.

Gestational Age↗
PubMed1990

Intracranial vascular lesions: optimization and clinical evaluation of three-dimensional time-of-flight MR angiography.

The clinical value of three-dimensional time-of-flight magnetic resonance (MR) angiography was prospectively evaluated in 26 patients with congenital intracranial vascular lesions; 12 had arteriovenous malformations (AVMs), and 14 had venous angiomas. In the initial phase of the study the entire region of interest was imaged with one large acquisition volume (60-120-mm-thick slab). Later, the angiograms were obtained with adjacent but slightly overlapping, 30-mm-thick slabs, which clearly improved vascular detail. Gadolinium enhancement slightly improved depiction of veins but not of arteries. MR angiograms were compared with available conventional angiograms and MR studies. The topography of the AVM nidus was equally well appreciated on the MR as on the conventional angiograms. However, in six of 12 patients the hyperdynamic afferent arteries were incompletely shown on MR angiograms because of incomplete rephrasing. In three patients, venous drainage was also incompletely visualized. Compared with conventional MR studies, MR angiography offered the same detection rate but better anatomic insight. Thirteen of the 14 venous angiomas were also identified on MR angiograms. Detailed imaging, however, necessitated gadolinium enhancement and thin-slab acquisition.

Brain Neoplasms↗
PubMed1990

A prototype medical workstation for computer-assisted stereotactic neurosurgery.

We have developed a prototype display workstation for use in stereotactic neurosurgery. Patient image data from computed tomography, magnetic resonance imaging, and digital subtraction angiography are acquired with the stereotactic frame in place and subsequently transferred to the workstation for further processing. Target points may be identified on any image type and probe trajectories defined. Any point or line indicated on one set of images may be transferred immediately to other images, to determine, for instance, safe avascular probe paths. We present some general outlines for the use of computers for stereotactic neurosurgery and discuss the different components of the current system. Finally, we make some suggestions as to further developments.

Brain↗
PubMed1990

Serial magnetic resonance imaging studies with paramagnetic contrast medium: assessment of disease activity in patients with multiple sclerosis before and after influenza vaccination.

Eleven patients with a relapsing-remitting form of multiple sclerosis (MS) were examined clinically and with magnetic resonance imaging scans 3 weeks before, at the day of vaccination with killed influenza virus and 3 weeks afterwards. No exacerbations were noted in the pre- or postvaccination period. Eight contrast-enhanced or active lesions were present at the onset of the study. Three new active lesions appeared at the end of the prevaccination period while only 1 new active lesion was found at the end of the postvaccination period. We conclude that vaccination with killed influenza virus has no clinical or subclinical short-term effect on the activity of MS.

Brain↗
PubMed1990

Atherosclerosic dissection of the cervical internal carotid artery--a case report.

Atherosclerosis as a cause of spontaneous dissection in the cervical internal carotid arteries has been described in only a few cases. The authors present a surgically and pathologically proven case of dissection on the base of atherosclerosis of the cervical internal carotid artery. A resection of the pathologic segment with arterial reconstruction by direct anastomosis with a venous patch graft was performed. The postoperative course was uneventful.

Aged↗
PubMed1990

[Angioplasty using a Nd:YAG laser with a sapphire probe].

Laser angioplasty with Sapphire Contact Probes coupled to a Nd:YAG laser followed by balloon angioplasty was performed in 30 patients with 26 femoropopliteal and 4 iliac artery occlusions. Mean length of the occlusions was 4.5 +/- 1.6 cm with a mean duration of occlusion of 7.06 +/- 6.18 months. Initial angiographic success was obtained in 25/30 (83%) procedures, including 3/4 successes in the iliac artery (75%) and 22/26 successes in the femoropopliteal artery (84%). Reason for failure was perforation in 2 patients, and subintimal passage of the probe in 2, and heavy calcification of the lesion in 1 patient. Early rethrombosis in 3 patients reduced the primary success rate to 73%. Peripheral emboli necessitating surgical intervention occurred in 2 patients. Of the 22 recanalized arteries 21 remained patent with a mean follow-up of 8.4 +/- 3.3 months. It remains to be determined whether the angiographic and clinical short and long term success rate of "laser assisted balloon angioplasty" will be greater than after thrombolysis or conventional balloon angioplasty.

Aged↗
PubMed1990

MRI of intraparenchymal hematoma: responsible mechanisms.

The MRI appearance and evolution of hemorrhage remains a difficult entity. A typical example of the MR visualization of an intracerebral bleeding in the basal ganglia and the internal capsule at 1.5 T is presented. The sequential biochemical and physical changes in an hemorrhage are described.

Adult↗
PubMed1990

MRI in the diagnosis of Cockayne's syndrome. One case.

Computerized tomography (CT) and magnetic resonance imaging (RMI) showed cortico-subcortical atrophy as well as calcification of the basal ganglia and the cerebellar dentate nuclei in a patient presenting with cerebellar syndrome. RMI was particularly useful in imaging the demyelination of the periventricular white matter and the subcortical U fibres. A diagnosis of Cockayne's syndrome was made. This is an extremely rare hereditary disease of unknown pathogenesis. Defective recovery of DNA synthesis has been suggested.

Adult↗
PubMed1990

Percutaneous transhepatic venous sampling of the pancreas in localizing insulinomas.

Fourteen percutaneous transhepatic venous samplings of the pancreas were performed in 13 patients. Ten patients undergoing 11 samplings were operated, while 3 patients were not operated. Surgical intervention disclosed a single tumor in 8 patients, a double tumor in 1 patient and diffuse hyperplasia in 1 patient. The method allowed correct localization of 5 insulinomas and correct regionalizing of 4 insulinomas in 9 of 10 small tumoral lesions. In 1 double localization of the pancreatic body percutaneous venous sampling only detected 1 lesion. In 1 case of diffuse hyperplasia of the pancreatic tail, the venous sampling was suggestive for a tumor in the pancreatic tail. The method appears to be highly accurate in diagnosing and localizing insulinomas of the pancreas. However, a need persists for 3-dimensional localization of the lesions to facilitate enucleation. Intraoperative ultrasound could become the method of choice for localization of insulinomas.

Adult↗