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Biomedical subjects

G Wortzman

Publications and source records attributed to G Wortzman.

At least 37 records · Page 2Linked to original sources
PubMed1982

Sophisticated CT in complex maxillofacial trauma.

Conventional radiology and selective complex-motion tomography suffice for the diagnosis of isolated facial fractures. Complex facial fractures, however, require a more directed diagnostic approach, utilizing the imaging potential of computed tomography (CT). In the acutely injured but stable patient, unenhanced axial CT (preview-monitored under clinical orientation) provides the most effective, safe, reasonably rapid diagnostic examination. Direct coronal CT can also be utilized. The brain is studied by contiguous 10 mm slices; the facial skeleton is studied with contiguous 5 mm slices, which permits coronal and sagittal reformations. In suspected cervical spine injury (where direct coronal CT is contraindicated), the axial CT format above will provide essential diagnostic information and allow image reconstruction. The late complications of brain abscess and CSF leak are well imaged by CT; the latter is best assessed (during activity) by preview-controlled CT after intrathecal injection of metrizamide.

Brain Injuries↗
PubMed1982

Clinically-directed CT in occult disease of the skull base involving foramen ovale.

Occult disease of the skull base may present as an isolated neurogenic symptom in the absence of physical signs or radiologic findings. It therefore often remains undiagnosed until advanced. Computed tomography (CT) provides the potential for diagnostic imaging far beyond conventional radiology. Not only do current generation scanners provide exquisite bone detail, they also provide the capability of soft tissue imaging. In the past year, we have matched the diagnostic problem of occult disease of the middle fossa skull base and its foramina with the potential diagnostic imaging solution of CT. Five patients were referred with possible occult middle fossa skull base disease--all had persistent unilateral facial paraesthesia in the distribution of one of the lower two trigeminal nerve divisions (V2 V3) as their only complaint; all had previously been extensively investigated (including axial CT); all remained undiagnosed. Utilizing clinically-directed CT (based on acoustic neuroma diagnostic index of suspicion and imaging experience), 2 of the 5 patients were found to have small mass lesions involving foramen ovale. This presentation will demonstrate our experience based on image-manipulated CT, actively monitored by both radiologist and otolaryngologist.

Adult↗
PubMed1982

CT in occult disease of the skull base and basilar foramina.

Current generation CT with its high resolution technology, its capability for soft tissue and bone imaging through an expanded gray scale, its feature of thin section imaging (1.5 mm cuts), and its capacity for multiplanar imaging (axial, direct coronal, coronal, and sagittal reformations, etc.) bring a truly unique element to radiologic evaluation of the skull base and basilar foramina. CT modifications continue to develop, such as dynamic scanning. Thus CT provides the possibility of improved radiologic diagnosis in a clinically problematic area--the recognition of occult disease, invariably tumor, involving the skull base, the neurovascular foramina that penetrate it, and portions of the subjacent visceral cranium and the suprajacent brain. The purpose of this manuscript is to demonstrate and define a role for CT in the possible solution of this problem. Equally, a role for the selective and continued use of conventional radiology and other imaging modalities to both guide and complement CT is considered.

Brain Neoplasms↗
PubMed1981

Cerebral atrophy and functional deficits in alcoholics without clinically apparent liver disease.

Ninety-seven chronic alcoholics, both impaired and unimpaired, without clinically evident liver disease, showed significantly more cerebral atrophy on computed tomography than age-matched neurologic controls. Age was the variable most highly correlated with cerebral atrophy measurements, and it accounted for most of the correlations between atrophy and functional impairment, except in the Wernicke-amnesic group. Analysis of the slopes of atrophy scores versus age showed a more rapid "rate" of development of cerebral atrophy in alcoholics compared with controls. There were no correlations between liver biopsy scores (51 cases), drinking history (47 cases), or dietary intake (39 cases) and cerebral atrophy measurements.

Adult↗
PubMed1978

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↗
PubMed1977

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↗
PubMed1977

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↗
PubMed1977

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↗