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Biomedical subjects

I F Braun

Publications and source records attributed to I F Braun.

At least 37 records · Page 2Linked to original sources

The use of transarterial microembolization in the management of hemangiomas of the perioral region.

The management of oral and perioral hemangiomas depends on several clinical factors. Surgery of these benign lesions can at times be disfiguring, especially when the lips, muscles, or the maxilla and mandible are involved. In addition, by the very nature of these lesions, surgical treatment may be associated with excessive intra- and perioperative blood loss. A series of five patients who had hemangiomas in the perioral region and who were initially treated with transarterial microembolization, preoperatively in two cases and as the only treatment in three cases, is presented. The technique of microembolization is described and recommendations for its use are given.

Adolescent↗

Jugular venous thrombosis: MR imaging.

Magnetic resonance (MR) imaging of jugular venous thrombosis was investigated in three patients who had symptoms suggestive of this condition; the diagnosis was later confirmed by computed tomography, by venography, and clinically. Bright intraluminal signal intensity was seen throughout the course of the affected jugular vein on MR images in all three patients, in sharp contrast to the lack of signal from the corresponding site in the uninvolved venous system. Temporal changes in signal intensity from the acute to subacute stage of thrombosis were evaluated for one patient. A relative increase in signal intensity for the subacute phase was believed to be related to a decrease in the T1 relaxation time. MR may be the imaging modality of choice in the investigation of venous thrombosis.

Adult↗

Prolactin-secreting pituitary microadenomas: inaccuracy of high-resolution CT imaging.

Computed tomographic (CT) and surgical findings were correlated retrospectively in 51 patients with preoperative diagnoses of prolactin-secreting pituitary microadenomas. Thirty-nine had microadenomas at surgery. Twenty-three had identifiable discrete lesions. Of these, 21 had microadenomas and two did not; these two groups could not be distinguished reliably. Six patients with proven microadenomas had normal CT scans. Focal hypodense lesions, sellar floor erosion, infundibulum displacement, gland height greater than 8 mm, and an abnormal diaphragma sellae configuration are neither sensitive nor specific findings of microadenoma. A significant number of patients with proven microadenomas had few or none of these abnormalities. Thus, recognition of prolactin microadenoma may not be possible by CT alone, even with high-resolution direct coronal imaging.

Adenoma↗

Contrast enhancement in CT differentiation between recurrent disk herniation and postoperative scar: prospective study.

Recurrent disk herniation and postoperative scarring are among the major causes of recurrent symptoms after surgery for lumbar disk disease. The myelographic differentiation between these two etiologies is, at best, difficult. To evaluate the role of intravenous contrast enhancement and its impact on making this differentiation using computed tomography (CT), 98 postoperative symptomatic patients were studied prospectively with this technique. Twenty-two patients had subsequent reexploration (23 disk spaces). The unenhanced and enhanced studies of these patients were interpreted independently without surgical information. With contrast enhancement, only three CT studies were considered indeterminate, whereas 10 studies without contrast enhancement were indeterminate. The overall correct diagnosis with contrast enhancement was 17 (74%) of 23, while only 43% of the unenhanced studies yielded the correct diagnosis. Therefore, intravenous contrast enhancement significantly increased the diagnostic accuracy and level of confidence in making the differentiation between recurrent herniated disk and scar.

Cicatrix↗

Classification and treatment of spontaneous carotid-cavernous sinus fistulas.

An anatomical-angiographic classification for carotid-cavernous sinus fistulas is introduced and a series of 14 patients with spontaneous carotid-cavernous sinus fistulas is reviewed to illustrate the usefulness of such a classification for patient evaluation and treatment. Fistulas are divided into four types: Type A are direct high-flow shunts between the internal carotid artery and the cavernous sinus; Type B are dural shunts between meningeal branches of the internal carotid artery and the cavernous sinus; Type C are dural shunts between meningeal branches of the external carotid artery and the cavernous sinus; and Type D are dural shunts between meningeal branches of both the internal and external carotid arteries and the cavernous sinus. The anatomy, clinical manifestations, angiographic evaluation, indications for therapy, and therapeutic options for spontaneous carotid-cavernous sinus fistulas are discussed.

Aged↗

Pitfalls in the computed tomographic evaluation of the lumbar spine in disc disease.

Computed tomography (CT) is an effective non-invasive method of evaluating the lumbar spine in cases of suspected disc disease. In over a 3-year period in a high volume neuroradiologic practice we have observed a number of pitfalls in the diagnosis of herniated nucleus pulposus which may lead to erroneous conclusions and therefore, decrease the overall accuracy of the examination. These pitfalls, and their implications are presented and discussed.

Humans↗

Gas computed tomographic cisternography: evaluation of small and intracanalicular acoustic neuromas.

With improvements in microsurgical techniques, early evaluation of small and intracanalicular acoustic neuromas has taken on added importance. Since its introduction in 1979 by Sortland, several authors have demonstrated the accuracy and safety of computed tomography combined with gas cerebellopontine angle cisternography in the early diagnosis of acoustic neuromas. We present our experience with 32 patients referred for gas computed tomographic cisternography yielding five surgically proved acoustic neuromas, three of which were less than 1 cm in size. This procedure can be performed on an outpatient basis, has a low morbidity, and is highly accurate in diagnosing even purely intracanalicular tumors. Gas computed tomography cisternography offers several advantages over positive contrast cisternography, and is the procedure of choice in the radiologic diagnosis of acoustic neuromas after contrast-enhanced computed tomography has excluded the presence of a large tumor.

Cerebellopontine Angle↗

Computed tomography of the asymptomatic postsurgical lumbar spine: analysis of the physiologic scar.

Computed tomography (CT) has been shown to be an effective noninvasive means of imaging the lumbar spine in patients with suspected disk disease. The clinical and radiographic evaluation, however, of patients with new or recurrent symptoms after surgery for disk disease is fraught with difficulty. This report describes CT changes seen in seven asymptomatic volunteers scanned at various intervals after disk surgery and discusses the implications of these findings.

Contrast Media↗

Brain stem infarction due to chiropractic manipulation of the cervical spine.

A case of brain stem infarction after chiropractic manipulation of the cervical spine is presented. Proposed mechanisms and sites of possible arterial injury are discussed. A diagnosis of vertebral artery occlusion was made using conventional brachial angiography. Digital intravenous angiography, a relatively new and less invasive vascular imaging technique which was used as an adjunct for evaluating the remainder of the cervicocephalic vessels, documented the vertebral occlusion. Chiropractic manipulation, which is increasing in popularity, may be a cause of potentially devastating neurologic disease.

Adolescent↗

Brain stem infarction due to chiropractic manipulation of the cervical spine.

A case of brain stem infarction after chiropractic manipulation of the cervical spine is presented. Proposed mechanisms and sites of possible arterial injury are discussed. A diagnosis of vertebral artery occlusion was made using conventional brachial angiography. Digital intravenous angiography, a relatively new and less invasive vascular imaging technique which was used as an adjunct for evaluating the remainder of the cervicocephalic vessels, documented the vertebral occlusion. Chiropractic manipulation, which is increasing in popularity, may be a cause of potentially devastating neurologic disease.

Arterial Occlusive Diseases↗

Spinal cord imaging using real-time high-resolution ultrasound.

The myelographic evaluation of patients presenting with persistent or recurrent symptoms following surgery for an intrinsic spinal cord mass is difficult. Possible symptom-causing processes include tumor recurrence, intramedullary cyst formation, postirradiation effects, arachnoiditis, and spinal cord atrophy. Since tumor recurrence and syrinx formation may require further surgery, while the other entities generally do not, the distinction between these processes is clinically important. The authors have successfully employed commercially available high-resolution real-time ultrasound imaging systems to investigate a group of patients with these persistent or recurrent symptoms after surgery. The bony laminectomy defect provides an acoustic window for viewing intraspinal contents. Ultrasound can accurately differentiate between cystic and solid lesions and can clearly demonstrate whether a spinal cord is enlarged or atrophic.

Adolescent↗

Dense intracranial epidermoid tumors. Computed tomographic observations.

Three extra-axial posterior fossa epidermoid tumors manifested nearly identical CT appearance of large size, sharp margination, apparently homogeneously increased attenuation in the range of 80-120 Hounsfield units, and absence of contrast-agent enhancement. This constellation of findings is distinctly different from that reported previously, and appears to be characteristic for some epidermoid tumors.

Adolescent↗

Computed tomography of benign masseteric hypertrophy.

Benign masseteric hypertrophy (BMH), although an uncommon condition, is important in the differential diagnosis of parotid region masses. We believe CT is the ideal imaging modality for investigating patients with parotid region masses and that it has proved to be most useful in the diagnosis of masseteric hypertrophy. We present three cases of BMH and describe and discuss the CT findings and differential diagnosis of parotid region masses.

Adult↗