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Biomedical subjects

G Wortzman

Publications and source records attributed to G Wortzman.

At least 19 recordsLinked to original sources

Schwannoma of the intrasternomastoid portion of the spinal accessory nerve: sophisticated pre-operative MRI diagnosis and appropriate surgical management.

In 1986, the authors reported the CT imaging findings which were specific for the diagnosis of schwannoma of the intrasternomastoid portion of the spinal accessory nerve. This successful imaging diagnosis led to appropriate surgical management with preservation of motor nerve function. In this manuscript, magnetic resonance imaging (MRI) was utilized to correctly diagnose the identical lesion, again with the same satisfactory surgical results. Both the CT and MRI findings are unique and specific, and the purpose of this short manuscript is to identify the MRI findings and link these to the previously recorded CT radiographic signs.

Accessory Nerve

Assessment of cognitive impairment: the role of CT.

The value of CT as a routine screening procedure in the investigation of cognitive impairment is being increasingly challenged. To address this issue, we reviewed the records of 175 patients with intellectual deficits admitted to a Behavioural Neurology Unit over a two-year period. In the vast majority of cases, ie. 82%, the CT served essentially to confirm the clinical impression and added no new diagnostic information that impacted the management of the presenting problem. In 15% of cases the CT scan was helpful for diagnosis, especially in the differentiation between Alzheimer's disease and multi-infarct dementia.

Adult

Computed tomography in craniopharyngiomas.

Computed tomographic examinations of 28 children and 12 adults with surgically proved craniopharyngiomas were retrospectively studied for characteristic findings that might be diagnostic of this tumor. It was found that 8 of 10 children and 2 of 4 adults examined pre-operatively had at least 2 of 3 findings: calcification, cyst, or contrast enhancement on CT. The remaining pre-operative patients did not receive contrast in their initial exams. Unusual presentation of the tumor in adults is also discussed.

Adolescent

Contrast medium extravasation from aneurysmal rupture during cerebral angiography.

The radiographic demonstration of contrast medium extravasation from a rupturing intracranial aneurysm is rare. We have detected this occurrence a mere thrice in 15 years, a period in which angiography was routinely used for the investigation of subarchnoid haemorrhage. We have added these three cases to 14 others that were previously reported in the literature and summarised the total. There does not appear to be a common aetiological factor, though further experimental studies on intracaratid pressures distal to the site of injection seem to be warranted. Ventricular opacification during cerebral angiography occurred in five of the 17 cases: in our most recent case the contrast medium outlined intraventricular haematomata, a finding not hitherto reported in the literature and a feature of prognostic significance. Mortality in this series was extremely high and in excess of that usually found either with an aneurysmal re-bleed or an intracerebral haematoma or both. However, although a combination of these two lesions is notoriously hazardous, perhaps the added insult of the contrast medium extravasation is the cause for the inordinately high fatality rate. Only three of the 17 cases survived, two of whom had a significant residual neurological deficit.

Adult

Pulsatile tinnitus: the role of angiography.

Pulse-synchronous tinnitus is probably due to turbulent blood flow in or around the temporal bone. The anatomy of temporal bone blood supply is reviewed. Eight examples of tinnitus are presented to illustrate the spectrum of lesions that will produce this symptom and the role of angiography in its investigation.

Adolescent

Sophisticated radiology in otolaryngology. I. Diagnostic imaging: roentgenographic (x-ray) modalities.

Conventional radiography is now complemented by a large range of newer radiologic diagnostic techniques, involving both roentgenographic and non-roentgenographic modalities. It is the purpose of this presentation to present these new roentgenographic modalities in graphic form, and demonstrate their application to otolaryngic diagnosis. The major roentgenographic modalities which will be stressed are: xeroradiography, angiography, and computerized tomographic scanning.

Adolescent

Sophisticated radiology in otolaryngology. II. Diagnostic imaging: non-roentgenographic (non x-ray) modalities (ultrasound, nuclear medicine, thermography).

Newer forms of radiologic diagnostic imaging now include non-roentgenographic modalities such as ultrasound, nuclear medicin, and thermography, all of which can be applied to otolaryngology. It is the purpose of this presentation to demonstrate these modalities, and indicate their clinical application, yet in its earliest stages, to otolaryngology.

Adult

The role of CT scanning in the diagnosis of acoustic neuromas.

CT scanning has an important role as a prime investigate technique in the patient with hearing loss and/or vestibular dysfunction. Lesions larger than two cm in size should be further investigated by angiography. Myelography of the posterior fossa remains the only test that can exclude an acoustic neuroma if small or if there is a negative CT scan. Plain films and tomography are used to exclude other lesions.

Angiography

Temporal bone: a tomographic anatomic study.

The complex anatomy of the temporal bone has been illustrated in a tomographic histologic correlative study. All the tomographic cuts were made in AP, basal and lateral projections of temporal bone specimens. These were decalcified, sectioned, stained and then correlated with the original tomographic studies.

Cochlea

The radiologic diagnosis of malignant tumors of the paranasal sinuses and related structures.

Paranasal sinus and related malignancies affect air-containing mucosal-lined bony structures which can only be studied by appropriate radiologic examination. Pre-treatment staging by radiologic study, primarily utilizing tomography with complex motion, is essential for election of proper treatment modalities. It is the purpose of this presentation to define the conventional tomographic and advanced radiologic modalities which can be used in paranasal sinus radiologic examinations. The indications for the studies as well as their limitations are demonstrated. Finally, the role of radiology in post-therapy evaluation is noted.

Adult

Pneumocephalus following mastoid surgery: a report of two cases.

Two cases of spontaneous pneumocephalus following mastoid surgery are presented. In both cases a fistula from the mastoid ended blindly in an area of cerebritis without any definite abscess formation. Etiological factors are discussed with congenital dural defects suspected as the precipitating factor.

Adult