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J L Salazar

Publications and source records attributed to J L Salazar.

14 recordsLinked to original sources
PubMed1997

MRI artifacts following anterior cervical diskectomy.

BACKGROUND: Magnetic resonance imaging (MRI), despite being an excellent imaging technique in neurosurgical practice, is unfortunately susceptible to numerous artifacts. Some of these artifacts are easily identifiable and do not interfere; however, others are more subtle and can be easily mistaken for false pathology. Postoperative MRI can further complicate the imaging interpretation, by producing another group of artifacts. It is imperative for practicing neurosurgeons, as well as neuroradiologists, to have a clear understanding of these postoperative artifacts. METHODS: We discuss four cases who had been operated for anterior cervical decompression with bony fusion. All the patients had a postoperative MRI of the cervical region that showed a "false compression" of the cervical cord. The normal computed tomography (CT) scan in some cases and the discrepancy with the clinical condition of the patients excluded the diagnosis of compression of the cervical cord. RESULTS: The overall appearance of the postoperative MRI can be very difficult to interpret. The artifact seen following anterior cervical diskectomy is an example of such a situation. We have confirmed that the postoperative MRIs showing artifacts do not indicate cord or root compression; a routine postoperative plain X ray or CT scan of the operated area can also confirm the absence of compression. CONCLUSION: These are examples of cases in which the postoperative MRI had an unexpected metallic artifact that not only caused difficulty in the interpretation of the images but at times suggested a clinical problem when actually there was none. Very thin cut CT scans may not show these artifacts that are picked up by the sensitive MRI study. A proper clinical evaluation and selection of the appropriate MRI techniques and the MRIs can eliminate or at least decrease the incidence of the artifacts. Above all, further education of practicing physicians is needed to avoid false alarms caused by these metallic artifacts.

Adult↗
PubMed1996

Subdural-peritoneal shunt: treatment for bilateral chronic subdural hematoma.

BACKGROUND: Various modalities have been advocated and practiced to maximize the effectiveness of treatment for chronic subdural hematoma. Most patients with chronic subdural hematoma are successfully treated with simple burr-hole evacuation and external drainage. Hematomas with thick membranes have been found to persist or recur, sometimes necessitating reoperation or major surgery; however, they have been satisfactorily treated by repeated drainage or tapping as well. Chronic subdural hematoma can sometimes become an intractable and difficult problem. In recurring chronic collections, subdural-peritoneal shunts have been used as a mode of treatment. Treatment of recurrent subdural collection in infants has been successfully achieved by using subdural-peritoneal shunts. There is also literature to support a similar treatment for recurrent chronic subdural hematoma in older patients. CASE DESCRIPTION: We report a case of recurrent bilateral chronic subdural hematoma in an adult, which was successfully managed by repeated burr-hole evacuation initially, followed by insertion of a subdural-peritoneal shunt. The patient did well clinically, and computerized axial tomography did not reveal any subdural collection on follow-up. CONCLUSION: Treatment of recurrent chronic subdural hematoma is usually straightforward; however, it can sometimes be refractory to regular treatment. In managing such cases, we recommend placement of a subdural-peritoneal shunt in preference to a more complicated craniotomy and membranectomy.

Aged↗
PubMed1980

Direct percutaneous cerebral angiography in neurosurgical practice.

A retrospective analysis of 1171 consecutive percutaneous retrograde brachial and carotid cerebral angiograms was performed on 635 patients, 50.7% of whom were in the sixth decade or older. Symptoms and signs of cerebrovascular disease were the most frequently investigated and diagnosed, accounting for 46.7% of all the angiograms. Despite this relatively high-risk population, we have found direct percutaneous cerebral angiography to have a very low risk. The pros and cons of direct percutaneous versus transfemoral cerebral angiography are discussed. The literature of the previous 10 years is reviewed, and the complication rate of these two techniques is compared.

Adolescent↗
PubMed1980

Surgical treatment of asymptomatic and incidental intracranial aneurysms.

A consecutive series of 78 patients underwent surgery for 106 aneurysms between 1972 and 1978; this group included 14 patients with subarachnoid hemorrhage who had multiple, unruptured, incidental aneurysms (20 additional aneurysms). These aneurysms were operated on with no mortality. In 15 other patients, who underwent angiography for various nonhemorrhagic disorders, a total of 18 asymptomatic aneurysms were found. These were also operated on with no mortality. Three of the 29 patients had postoperative hemiplegia, which persists in only one. The author recommends that all aneurysms should be considered for operation when diagnosed, if the patient's clinical condition is stable.

Adult↗
PubMed1979

Treatment of ruptured and unruptured internal carotid artery aneurysms.

A consecutive series of 95 patients with a total of 131 intracranial cerebral aneurysms came under observation from 1972-1978. Of these, 78 patients had operations for 106 aneurysms. Over half of the patients (41) had operations for an aneurysm of the intracranial internal carotid artery; there were 16 incidental "asymptomatic" aneurysms also found. There was no surgical mortality in this group. Medical treatment, including bed rest, antihypertensive treatment and administration of epsilon amino caproic acid followed by microsurgical obliteration of the aneurysm offers the best results for the treatment of ruptured and unruptured aneurysms.

Carotid Artery, Internal↗
PubMed1978

Embolization and surgical excision of giant arterio-venous malformation.

A case of a giant arteriovenous malformation involving almost the entire dominant hemisphere in a 32-year-old white male with progressive neurologic deterioration, presumbaly due to cerebral steal, is described. Special management included surgical intravascular embolization with latex spheres. and at a later date, resection of the arteriovenous malformation.

Adult↗
PubMed1978

Late thrombosis of middle cerebral artery following clipping and coating of aneurysms.

Twenty days after clipping and coating with Aron Alpha (ethylcyanoacrylate) of two adjacent middle cerebral artery aneurysms, the patient developed a complete thrombosis of the parent vessel at the site of the aneurysms. The routine postoperative angiograms on the seventh day after surgery had revealed a patent middle cerebral artery. The possible roles of Aron Alpha and multiple Heifetz clips are discussed.

Cyanoacrylates↗
PubMed1977

Bilateral optic canal meningioma.

A case of bilateral optic canal meningiomas which presented with progressive visual deterioration and optic atrophy is described. Complete neurologic investigation was negative, only surgical exploration disclosed the tumors.

Adult↗
PubMedDate not supplied

Intracranial neurosurgical treatment of occlusive cerebrovascular disease.

Anastomosis of the extracranial superficial temporal artery to the intracranial middle cerebral artery offers an additional source of blood to the cerebral circulation in patients with transient ischemic episodes. Fourteen cases are reported. Two representative cases with three anastomoses demonstrate the use of this technique in occlusion of the internal carotid artery, occlusion of the middle cerebral artery and stenosis of the middle cerebral artery. Indications and contraindications of the procedure are discussed.

Adult↗