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Biomedical subjects

J Biller

Publications and source records attributed to J Biller.

At least 127 records · Page 7Linked to original sources
PubMed1986

Painless compressive cervical myelopathy with false localizing sensory findings.

Five patients who presented with clearly defined thoracic sensory levels were found by myelography and follow-up computed tomography (CT) to have cervical spinal cord compression. None of these patients had pain or an immediate preceding history of trauma. There is currently no satisfactory explanation for the large discrepancy between the sensory level and the level of cord compression in such patients. It is crucial that the clinician recognize the possibility of a cervical cord lesion in patients with such a presentation so that appropriate radiographic studies can be performed. Failure to appreciate this syndrome could result in failure to diagnose a treatable lesion.

Adult↗
PubMed1986

Basilar artery occlusion in an adolescent girl: a risk of oral contraceptives?

An 18-year-old adolescent girl died of an extensive pontine infarction. At postmortem examination she was found to have a thrombosis of the basilar and intracranial vertebral arteries with associated focal hyperplasia of the intima. Her ovaries were grossly small and inactive, with absent corpora lutea. Based on these findings, we suspect she was taking oral contraceptives. In cases of unexplained fatal strokes in young females, careful pathologic examination of the ovaries may provide etiological clues.

Adolescent↗
PubMed1986

Paradoxical cerebral embolism: eight cases.

We evaluated eight patients with possible or probable paradoxical cerebral embolism. One patient had a hemispheric transient ischemic attack; the others had infarcts. Ischemic symptoms followed a Valsalva's maneuver in three cases. Others were linked to placement of a Swan-Ganz catheter, deep venous thrombosis and pulmonary embolism, right atrial myxoma, and use of oral contraceptives. Four had no known predisposing conditions. In six patients, contrast echocardiography showed right-to-left shunting. Cardiac catheterization showed a patent foramen ovale in three patients; one had an atrial septal defect. In the clinical setting of otherwise unexplained cerebral embolism in a young patient, paradoxical cerebral embolism should be considered. Contrast echocardiography is a useful screening test for this purpose.

Adolescent↗
PubMed1986

Partial dorsal mesencephalic hemorrhages: report of three cases.

We studied three patients with spontaneous dorsal mesencephalic hemorrhages. One patient had Parinaud's syndrome with a unilateral hemorrhage confined to the rostral tectal plate. The second patient had vertical gaze palsy, skew deviation, and bilateral Horner's syndrome due to a unilateral hemorrhage that involved the superior colliculus and extended anteriorly into the midbrain tegmentum and inferiorly to the rostral dorsal pons. The third patient had a hemorrhage in the caudal tectal plate, with bilateral fourth cranial nerve palsies, unilateral Horner's syndrome, and ataxia. There was hydrocephalus due to obstruction of the aqueduct in two patients. The patients recovered, but with some degree of disability.

Adult↗
PubMed1986

Adult intrasellar teratoid tumor.

Intracranial teratomas rarely occur in adults. The most common sites are the pineal followed by the suprasellar or hypothalamic areas. Infrequently, teratomas can arise within the sella turcica and mimic a pituitary adenoma or craniopharyngioma. Teratoid tumors contain tissue arising from only two of the three primitive germ layers, whereas teratomas have elements of all three. The following case illustrates the unusual occurrence of an intrasellar teratoid tumor in a 33-year-old man.

Adult↗
PubMed1986

Cerebrovascular disorders associated with pregnancy.

Stroke is a leading cause of maternal death. Intracerebral hemorrhage may be associated with eclampsia, metastatic choriocarcinoma or ruptured arteriovenous malformations. Intracranial venous thrombosis may result from a hypercoagulable state or local intracranial vascular damage. Subarachnoid hemorrhage is usually caused by the rupture of an intracranial aneurysm or arteriovenous malformation. Signs and symptoms of stroke in pregnancy can be confusing. The physician must be aware of these signs to avoid mismanagement of the pregnant stroke patient.

Adolescent↗
PubMed1985

Cerebellar venous angiomas. A continuing controversy.

We have studied three patients with angiographically documented cerebellar venous angioma (CVA). One patient had a subacute cerebellar hematoma and underwent posterior fossa craniotomy for evacuation of the hematoma and excision of the malformation. A hemorrhagic venous infarction of the brain stem and cerebellum occurred, and the patient died three weeks postoperatively. A second patient with an unruptured CVA had a history of headaches, tinnitus, and vertigo. Conservative treatment was elected, and the patient's condition remains unchanged after 11 months of follow-up. The third patient, recently diagnosed as having an unruptured CVA had episodic vertigo and disequilibrium. Conservative treatment was chosen, and he is asymptomatic after six months of follow-up. Based on a review of 24 other cases of CVA plus our experience we could not conclude any definite trend regarding natural history or treatment. However, conservative treatment seems the logical choice in patients with unruptured CVA.

Adolescent↗
PubMed1985

Preeclampsia complicated by cerebral hemorrhage and brain abscess.

A 34-year-old, preeclamptic woman developed a right basal ganglia hematoma during a vaginal delivery. Her course was later complicated by an infected episiotomy. As a consequence of bacterial seeding most likely from the infected episiotomy, the intracerebral hematoma became infected, developing into a brain abscess. Because of her existing neurological deficits, the developing brain abscess was not recognized until signs and symptoms of increased intracranial pressure developed. This patient illustrates another potentially life-threatening neurological infection that may occur in the peripartum period.

Adult↗
PubMed1985

Intracranial hematoma with subsequent brain abscess after carotid endarterectomy.

A 62-year-old man developed an infected left carotid endarterectomy with false aneurysm formation and subsequent bacteremia after staged carotid endarterectomies. He was found to have a right frontal lobe hemorrhage that developed into a staphylococcal brain abscess. We postulate there was bacterial seeding of the hematoma resulting in brain abscess formation.

Brain Abscess↗
PubMed1985

Spontaneous cerebellar hemorrhage after coronary artery bypass surgery.

A patient had a spontaneous intracerebellar hemorrhage following coronary artery bypass surgery. His clinical course, characterized by headaches, gait ataxia, and then signs of brain stem compression, is emphasized. Following diagnosis by cranial computerized tomography, successful surgical decompression by suboccipital craniotomy was performed. Reports of neurologic complications, especially intracranial hemorrhage, following coronary artery bypass surgery, are reviewed. Possible pathophysiologic mechanisms for these problems, and the diagnosis and treatment of this previously undescribed complication of coronary artery bypass surgery are discussed.

Cerebellar Diseases↗
PubMed1985

Cerebellar infarction--clinical and cranial computerized tomography correlations.

We analyzed the clinical and cranial computerized tomographic (CT) features of 10 patients with cerebellar infarction. Among patients with recent cerebellar infarction, the initial CT often failed to demonstrate any recognizable abnormality. Because early neurological deterioration may arise despite normal CT studies, a high level of clinical awareness is critical for appropriate intervention.

Adult↗
PubMed1985

Unruptured fusiform aneurysms of the posterior circulation with thalamic infarction.

Three patients with unruptured fusiform aneurysms of the posterior circulation presented with nonhemorrhagic thalamic infarctions. All of the aneurysms were seen on enhanced computed tomographic (CT) scans preangiographically. Although unruptured fusiform aneurysms are probably a rare cause of nonhemorrhagic thalamic infarction, their importance lies in the therapeutic implications of this diagnosis. In patients with nonhemorrhagic thalamic infarction, we suggest careful scrutiny of the blood vessels on enhanced CT scans.

Adult↗
PubMed1985

Syndrome of the paramedian thalamic arteries: clinical and neuroimaging correlation.

Two patients had sudden alteration of consciousness followed by fluctuating hypersomnia and bilateral ophthalmoplegia. Magnetic resonance imaging showed asymmetric, paramedian thalamic and midbrain lesions. The clinical and neuroimaging features are consistent with the syndrome of the paramedian thalamic arteries of the basilar communicating artery. These strokes were caused by an embolus to the rostral basilar artery originating from a fibrillating heart. Magnetic resonance imaging clearly delineates the delicate pattern of arterial involvement in mesodiencephalic junction infarctions.

Aged↗
PubMed1985

Isolated facial myokymia and facial contracture: computed tomography and magnetic resonance imaging correlation.

Isolated facial myokymia with contracture can be the earliest manifestation of intrinsic lesions of the brainstem. We report a case of facial myokymia with contracture occurring as the result of a pontine glioma, as depicted on cranial computed tomography and magnetic resonance imaging studies. The rostral location of the tumor supports the supranuclear disinhibition hypothesis of facial myokymia.

Adult↗