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Biomedical subjects

G Wortzman

Publications and source records attributed to G Wortzman.

At least 19 recordsLinked to original sources
PubMed1997

Deficits in gray matter volume are present in schizophrenia but not bipolar disorder.

Studies using magnetic resonance (MR) imaging have provided strong evidence that patients with schizophrenia as a group have structural brain abnormalities, including enlarged ventricles and sulci as well as smaller cortical gray matter volumes. This study was undertaken to investigate whether the brain abnormalities found in schizophrenia could be distinguished from those seen in bipolar disorder. The MR scans of 23 patients with schizophrenia were compared to those of 17 healthy community volunteers and 14 patients with bipolar disorder. Images were processed using computer-based image processing techniques to generate quantitative measures of cerebrospinal fluid (CSF), gray matter and white matter volumes. Compared to the community volunteers, the schizophrenia group had larger total CSF volumes while the bipolar group had larger ventricles. Smaller cortical gray matter volumes were found in the schizophrenia group, but not in the bipolar group. The schizophrenia group had regional deficits in gray matter volumes in comparison with both the community volunteers and the bipolar group. These findings suggest that the brain tissue abnormalities found in schizophrenia and bipolar disorder may be distinguishable using MR imaging.

Adult↗
PubMed1996

Progressive multifocal leukoencephalopathy: clinical and MR response to treatment.

Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease that occurs in immunocompromised hosts. We describe two patients with biopsy-proved PML who showed improvement clinically and radiologically after medical therapy. These cases reveal that interval improvement can in rare instances be consistent with a diagnosis of PML.

Adult↗
PubMed1994

Correlation between computed tomography and magnetic resonance imaging in Graves' orbitopathy.

Radiologic examination of patients with severe Graves' disease with possible optic neuropathy has routinely been done with computed tomography (CT). With the more widespread use of magnetic resonance imaging (MRI), its potential use in Graves' disease must be considered. We compared these two imaging techniques for use in severe Graves' orbitopathy. Thirty-nine orbits of 20 consecutive patients with severe Graves' disease (19 with optic neuropathy and 20 without optic neuropathy) were examined clinically. CT and MRI were performed, and the radiologic images were assessed for five measures chosen to illustrate overall muscular changes, tissue plane changes of the orbital apex, optic nerve changes and proptosis. The MR images were significantly more reliable than the CT scans for two measures in particular: degree of fat effacement (a measure of optic nerve compression) and minimal optic nerve index (a measure of optic nerve thickness), both of which involve the orbital apex. We conclude that MRI is a better technique than CT for imaging the apex in Graves' optic neuropathy.

Adipose Tissue↗
PubMed1994

Technetium-99m-HMPAO SPECT, CT and MRI in the evaluation of patients with chronic traumatic brain injury: a correlation with neuropsychological performance.

UNLABELLED: The purposes of this study were: (1) to compare 99mTc-hexamethylpropyleneamineoxime (HMPAO) SPECT with CT and MRI in chronic traumatic brain injury (TBI) patients and (2) to correlate both functional and structural neuroimaging measurements of brain damage with neuropsychological (NP) performance. METHODS: Twenty-nine patients (minor TBI, n = 15 and major TBI, n = 14) and 17 normal controls (NC) underwent HMPAO SPECT, CT, MRI and NP testing. Imaging data were analyzed both visually and quantitatively. RESULTS: Nineteen (66%) patients showed 42 abnormalities on SPECT images, whereas 13 (45%) and 10 (34%) patients showed 29 abnormalities on MRI and 24 abnormalities on CT. SPECT detected relatively more abnormalities than CT or MRI in the minor TBI subgroup. The TBI group showed impairment on 11 tests for memory, attention and executive function. Of these, the anterior-posterior ratio (APR) correlated with six tests, whereas the ventricle-to-brain ratio (VBR), a known structural index of a poor NP outcome, correlated with only two tests. CONCLUSION: In evaluating chronic TBI patients, HMPAO SPECT, as a complement to CT or MRI, may play a useful role by demonstrating brain dysfunction in morphologically intact brain regions and providing objective evidence for some of the impaired NP performance.

Adult↗
PubMed1992

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↗
PubMed1991

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↗
PubMed1990

Parotid gland enlargement in HIV infection: clinical/imaging findings.

Parotid gland enlargement with or without facial paralysis may be the presenting clinical manifestation of AIDS. Submandibular involvement may occur as well. Failure to recognize this association may lead to inappropriate or unnecessary intervention in the investigation and treatment of the salivary gland enlargement. In this paper, we discuss the role of imaging techniques in the investigation of salivary gland enlargement, and identify the specific radiologic signs found in HIV infection. Demonstration of intraparotid or submandibular gland cysts with focal intraparotid mass lesion(s) on imaging may help to differentiate parotid gland enlargement due to HIV infection from the many other causes of parotid enlargement.

Adult↗
PubMed1988

Sexual sadism: brain, blood, and behavior.

The behavior of sadists is bizarre and poorly understood. There are gross endocrine and brain abnormalities in a small number of these men. Approximately two-fifths show subtle temporal lobe brain abnormalities that are logically linked to sexual behavior and require further exploration. It would be interesting to explore the interface of the endocrine system and the brain--that is, to determine if there are interactive processes that may be related to the development of sexual anomalies, perhaps early in life as suggested by Kolarsky et al. Certainly, biological factors cannot determine whether an individual will act on his sexual impulses. Many psychological factors, such as family background and substance abuse, play a significant role in the dangerousness of the individual. However, it appears that biological factors are noteworthy in sexual sadism. Brain pathology, especially, shows some correlation with force used in offences and likelihood of recidivism, and for this reason alone it merits further study.

Aggression↗
PubMed1988

The parathyroid adenoma: an imaging/surgical perspective.

The clinical picture of hyperparathyroidism has changed since the implementation of routine serum calcium testing, resulting in more asymptomatic patients undergoing early surgical exploration. Although operative complications (e.g., recurrent laryngeal nerve paralysis, hypocalcemia, etc.) are not prevalent, the risk can be minimized by minimizing tissue dissection. For this reason, we feel that preoperative tumor localization is of great importance. We report our imaging results of parathyroid adenomas, utilizing ultrasonography, technetium-thallium subtraction scanning, digital subtraction angiography and magnetic resonance imaging. We also present an imaging protocol which, we have found, maximizes preoperative identification of these tumors.

Adenoma↗
PubMed1987

Spinal meningioma en plaque. Report of two cases.

Two cases of spinal meningiomas exhibiting en plaque patterns of growth are presented, one of which is reviewed more fully with emphasis on the radiographic and histological characteristics. The difficulties in diagnosis of this unusual tumor, its surgical management, and its postoperative course are discussed.

Aged↗
PubMed1987

Magnetic resonance imaging of intracranial epidermoids: report of two cases.

Intracranial epidermoids are uncommon benign tumors in the subarachnoid spaces. We have studied two patients with these tumors originating in the basal cisterns using magnetic resonance (MR) imaging, computed tomography (CT), and cerebral angiography. Both CT and MR showed the extraaxial position of these tumors and their extension into the posterior fossa well. Angiography did not show any abnormal vasculature but displacement of vessels by the tumor mass was well demonstrated. MR was found to be relatively specific in characterizing these tumors.

Adult↗
PubMed1986

Computerized tomographic scan assessment of alcoholic brain damage and its potential reversibility.

The assessment of alcoholic brain damage by computerized tomographic (CT) scanning is reviewed and discussed. Alcoholics showed greater cerebral atrophy than aged-matched neurological controls. Supratentorial atrophy measurements correlated significantly with some neurobehavioral assessment measures. The cerebral atrophy reversed in some subjects with maintained abstinence. Computerized assessment of cerebral spinal fluid volume (cerebral atrophy) and mean cerebral density showed decreased cerebral spinal fluid volume and increased cerebral density with maintained abstinence over 4 weeks in a group of 20 alcoholics. CT cerebellar measurements demonstrated atrophy in many subjects, but these measurements did not correlate with measures of ataxia, cognitive impairment, supratentorial atrophy measurements, or age. An example of a magnetic resonance imaging scan of an alcoholic is given. Its advantages in avoiding bony artifact for posterior fossa atrophy estimations and its potential for in vivo description and localization of central nervous system metabolic abnormalities in alcoholism are discussed.

Adult↗
PubMed1984

Partially reversible cerebral atrophy and functional improvement in recently abstinent alcoholics.

52 recently abstinent chronic alcoholics were given repeated psychological tests and 20 of these had repeated CT scans. The first scan was done within 5 weeks of the last drink. The degree of measurably reversible cerebral atrophy on CT scan correlated negatively with the interval between the last drink and the first CT scan. Significantly more reversibility of cerebral atrophy was noted in those subjects claiming interscan abstinence. There were positive correlations between functional improvement scores on neurological exam and reversible cerebral atrophy measurements. Significant improvement on psychological test performance was restricted to patients tested initially within 3 weeks of the last drink. Both the CT results and the psychological test results suggest that reversible changes occur soon after the cessation of drinking.

Alcoholism↗
PubMed1984

Congenitally absent lumbar pedicle: a reappraisal.

Three patients who had a diagnosis of congenitally absent lumbar pedicle underwent CT examination. Findings showed that each patient had an aberrant hypoplastic pedicle plus a retroisthmic defect in the ipsilateral lamina rather than an absent pedicle. Axial CT was the diagnostic modality of choice; reformated images were of little value. The nature of the anomaly explains the difficulty in diagnosis by plain film radiography or tomographic study. The differential diagnosis to be considered from findings of plain film radiography includes pediculate thinning, neoplastic disease, neurofibroma, mesodermal dysplasia associated with neurofibromatosis, and vascular anomalies.

Adult↗
PubMed1984

The clinical significance of radionuclide bone and gallium scanning in osteomyelitis of the head and neck.

Osteomyelitis of the head and neck remains a difficult clinical problem both in diagnosis and treatment evaluation. The purpose of this manuscript is to review our clinical experience with 25 cases of osteomyelitis distributed evenly among the temporal bone and skull base, the paranasal sinuses, and the mandible. Radionuclide bone and gallium scan images accurately depicted the biologic activity of the disease process and permitted accurate treatment evaluation and patient monitoring. This work demonstrates the potentials and limitations of radionuclide imaging with bone and gallium scan agents and attempts to define a role for their contemporary use in the management of osteomyelitis of the head and neck.

Adult↗
PubMed1983

Cerebral dysplastic vascular malformation: a developmental arrest.

A cryptic malformation of the brain was found to represent an arrest in vascular development. Microscopy showed plump endothelium of blood vessels, which did not have a normal lumen and consisted of solid cords of cells. The microscopic, angiographic, and computed tomographic appearance of this anomaly are discussed and compared with cavernous angiomas, arteriovenous malformations, and venous angiomas.

Adult↗