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Biomedical subjects

H L Tanghe

Publications and source records attributed to H L Tanghe.

22 records · Page 2Linked to original sources

CT scan prediction of neurological deficit in thoracolumbar burst fractures.

In 139 patients with burst fractures of the thoracic, thoracolumbar or lumbar spine, the least sagittal diameter of the spinal canal at the level of injury was measured by computerised tomography. By multiple logistic regression we investigated the joint correlation of the level of the burst fracture and the percentage of spinal canal stenosis with the probability of an associated neurological deficit. There was a very significant correlation between neurological deficit and the percentage of spinal canal stenosis; the higher the level of injury the greater was the probability. The severity of neurological deficit could not be predicted.

Humans↗

Neurological deficit in injuries of the thoracic and lumbar spine. A consecutive series of 70 patients.

Seventy consecutive patients with injuries of the thoracic and lumbar spine accompanied by neurological deficit were prospectively studied and follow-up. In 40 of these patients with a burst fracture, the degree of involvement of the cross-sectional area of the spinal canal, as revealed on first CT after admission, was not correlated with the type and degree of initial neurological deficit. In patients with injuries of the lumbar spine, neurological deficit may be mild, although the sagittal diameter of the spinal canal may be reduced by as much as 90%. We cannot establish a difference in neurological recovery between those cases who were managed conservatively and those in whom a surgical decompression and stabilization procedure was performed. Surgical stabilizing procedures, however, result in immediate stabilization of the spine, they diminish pain, facilitate nursing care and allow more rapid mobilization and earlier active rehabilitation. If major extraspinal injuries form a relative contra-indication to surgical decompression of the cord and stabilization of the spine injury, the patient can quite well be treated conservatively without endangering neurological recovery.

Follow-Up Studies↗

Progesterone, oestradiol, somatostatin and epidermal growth factor receptors on human meningiomas and their CT characteristics.

The presence of progesterone, oestrogen, somatostatin and epidermal growth factor receptors of 24 meningiomas was related with their radiological CT appearance. Progesterone receptors were present in 16 of 21 (76%), oestrogen receptors in 4 of 21 (19%), somatostatin receptors on 23 of 24 (96%) and epidermal growth factor receptors on 17 of 19 (89%) meningiomas. There was no relationship between the presence of these receptors and the age or sex of the patients, tumour histology, tumour localisation, the presence of perifocal oedema, displacement of the midline cerebri or obstructive hydrocephalus on CT scan. There was a negative correlation (P less than 0.05) between the number of progesterone receptors and "malignant" behaviour of the meningiomas on CT (e.g. the presence of necrosis, cyst formation, intratumoral haemorrhage, irregular surface and/or inhomogeneous attenuation of contrast). The observation that aggressive tumour behaviour on CT is accompanied by low numbers or absence of progesterone receptors makes these meningiomas less attractive candidates for medical therapy with antiprogestins.

ErbB Receptors↗

Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture.

We describe a characteristic distribution of cisternal blood in 52 patients with nonaneurysmal subarachnoid hemorrhage proved by a normal angiogram. On CT, the center of the bleeding was located immediately anterior to the brainstem in all patients, which was confirmed in four patients who were studied with MR imaging. Extension to the ambient cisterns or to the basal parts of the sylvian fissures was common, but the lateral sylvian or anterior interhemispheric fissures were never completely filled with blood. Rupture into the ventricular system did not occur. MR demonstrated downward extension of the blood anterior to the brainstem as far as the medulla, but failed to detect the source of hemorrhage. Our aim was to determine whether this so-called nonaneurysmal perimesencephalic hemorrhage could be distinguished from aneurysmal subarachnoid hemorrhage on early CT scans. Two neuroradiologists were shown a consecutive series of 221 CT scans of patients with subarachnoid hemorrhage who subsequently underwent angiography. Only one patient with a basilar artery aneurysm on angiography was incorrectly labeled by both observers as having a nonaneurysmal perimesencephalic pattern of hemorrhage. The high predictive value of the perimesencephalic pattern of hemorrhage for a normal angiogram (0.95 and 0.94, respectively, for the two observers) and the excellent interobserver agreement (kappa 0.87) demonstrate that nonaneurysmal perimesencephalic hemorrhage can be distinguished on CT in the majority of patients. Recognition of this pattern of hemorrhage is important as patients with this subset of subarachnoid hemorrhage have an excellent prognosis.

Adult↗