Search PubMed⌕ Search

Biomedical subjects

J M Tew

Publications and source records attributed to J M Tew.

At least 109 records · Page 6Linked to original sources

Intracranial tumors in patients with facial pain.

Over the past 10 years, 2000 patients with facial pain have been evaluated at the Mayfield Neurologic Institute. Sixteen of these patients were found to harbor intracranial tumors. The presenting features of this group of patients are analyzed, and the literature reviewed. Peripherally placed tumors tend to cause atypical facial pain associated with sensory loss. Middle fossa tumors may present as trigeminal neuralgia, but usually cause severe pain of an atypical nature and a progressive neurological deficit. Posterior fossa tumors are most likely to cause trigeminal neuralgia; these neoplasms are usually accompanied by subtle neurological deficits and are readily detected by current diagnostic studies.

Adult↗

Anterior sacral meningocele. Current diagnosis.

One hundred fifty cases of anterior sacral meningocele have been reported in the world literature. This rare pathologic entity was first recognized and described by Bryant in 1837. We report a patient with an incidental anterior sacral meningocele. Our patient is the oldest reported in the literature. The incidental feature of this malformation is uncommon. We review the literature and discuss the clinical aspect, diagnosis, and treatment. Emphasis is placed on the current and optimal method of radiologic evaluation using computed tomography scan combined with metrizamide myelography.

Humans↗

Anterior interhemispheric approach to aneurysms of the anterior communicating artery.

A modified anterior interhemispheric approach for clipping aneurysms of the anterior communicating artery is described. This approach is preferred on anatomical grounds because the anterior circle of Willis can be fully visualized with minimal manipulation of the frontal lobes and anterior cerebral arteries. The advantages of this approach are minimal traction, reduced operative time, and preservation of the olfactory nerve.

Humans↗

Intraventricular hemorrhage due to aneurysms of the distal posterior inferior cerebellar artery. Report of three cases.

Three cases of ruptured aneurysm of the distal posterior inferior cerebellar artery (PICA) presenting with isolated intraventricular hematoma are reported. All of the aneurysms originated from the lateral medullary segment of the PICA and ruptured into the lateral recess of the fourth ventricle. The diagnosis of distal PICA aneurysm should be considered if isolated intraventricular hematoma is found without obvious parenchymal hemorrhage or subarachnoid blood in the basal cisterns. Complete vertebral arteriography is a requisite for the recognition of this condition. The outcome in patients with these aneurysms should be good if surgical repair is performed before rebleeding occurs.

Adult↗

Surgical treatment of trigeminal neuralgia.

Trigeminal neuralgia nearly always can be relieved initially with drug therapy. Long-term relief, however, is achieved in only 25 percent of patients. When medical therapy fails, surgery may be necessary. Percutaneous rhizotomy is an effective technique for pain relief, with few medical contraindications. Posterior fossa exploration and neurovascular decompression or sensory root sectioning is reserved for those patients who do not improve after rhizotomy and for selected younger patients.

Carbamazepine↗

Hemorrhage and epilepsy in cryptic cerebrovascular malformations.

A series of 15 angiographically cryptic, histologically proved, cerebrovascular malformations occurred. Nine patients were admitted to the hospital with evidence of recent neurological deterioration or onset of headache. Six patients had convulsions. Computed tomographic scan and surgical exploration disclosed a substantial cerebral hematoma in eight instances. The pathological diagnosis was arteriovenous malformation in 11 cases, cavernous angioma in three, and venous angioma in one. Histological evidence of previous microhemorrhage was present in the majority of the specimens, including the patients who had seizures. A change in neurological status or onset of seizures probably indicates recent hemorrhage in cryptic cerebrovascular malformations.

Adolescent↗

Tic convulsif, the combination of geniculate neuralgia and hemifacial spasm relieved by vascular decompression.

A patient had combined otalgia and intractable unilateral facial spasm, relieved by microsurgical vascular decompression of the seventh and eighth cranial nerve complex in the cerebellopontine angle without section of the intermediate nerve. A dolicho-ectatic anterior inferior cerebellar artery compressed the seventh and eighth cranial nerves complex, suggesting that vascular compression of the intermediate nerve or of the sensory portion of the facial nerve may cause geniculate neuralgia. "Tic convulsif" seems to be a combination of geniculate neuralgia and hemifacial spasm. This combination could be due to vascular compression of the sensory and motor components of the facial nerve at their junction with the brainstem.

Adult↗

Trigeminal schwannoma in a child.

A 5-year-old girl presented with headache, vomiting, flushing, ptosis, and paroxysmal tachycardia. The neurological findings were partial motor and sensory left trigeminal palsy, left conductive hearing defect, and left cerebellar deficit. The radiological and neuropathological findings were typical for trigeminal schwannoma, which is rare in childhood. The present patient is the youngest yet recorded.

Child, Preschool↗

Giant granular cell tumor of the suprasellar area: immunocytochemical and electron microscopic studies.

We describe a case of a granular cell tumor (GCT) of the suprasellar region with an 11-year history in a 26-year-old woman. The computed tomographic scan showed a midline, contrast-enhancing, noncalcified mass. The biopsy was diagnosed as GCT. The tumor was treated with radiation therapy. At necropsy, a large, homogeneous GCT surrounded by gliosis was found. The tumor cells were filled with granules positive for periodic acid-Schiff, diastase-resistant. The cells did not contain glial fibrillary acidic protein or S-100 protein. Electron microscopy showed tumor cells filled with innumerable lysosomal structures. No intermediate filament was found within the cytoplasm. The tumor cells were not surrounded by a basement membrane. Based on this study and on our review of the literature, the suggestion that GCT has a multicellular origin is upheld.

Adult↗

Human umbilical artery for microvascular grafting. Experimental study in the rat.

As microvascular surgery has developed, the necessity for smaller arterial prostheses of less than 2 mm in internal diameter (ID) has increased markedly. Glutaraldehyde-stabilized human umbilical arteries with 1.5 to 2.0 mm ID are smaller than any other graft material currently available. This study was designed to determine whether this graft material has potential clinical application for microanastomosis. Twenty male albino rats, each weighing 400 to 500 gm, were used in this study. The abdominal aorta was exposed and a 3- to 4-mm segment was resected. A 10-mm interposition graft of glutaraldehyde-stabilized human umbilical artery was implanted by end-to-end anastomosis. The patency of the grafts was determined by repeated operative exploration at intervals of 1 week, and 1, 3, 9, and 12 months. Two grafts were found to be occluded each time at the 1-, 3-, and 9-month explorations. At each exploration time, five rats were sacrificed and histopathological studies conducted. All five remaining grafts were patent at 12 months. There was no evidence of endothelial proliferation on the luminal surface of the patent grafts as determined by scanning electron microscopy. The luminal surface and underlying region consisted of an amorphous proteinaceous-like material. Significant degeneration of the vessel wall was noted in all grafts surviving over 9 months. Central necrosis surrounded by a chronic inflammatory process that extended to and included the adventitia was observed in the occluded grafts. While the patency demonstrated was good, the tissue changes noted in the walls of the grafts indicate that further study is necessary before this material can be used as a graft in humans.

Animals↗

Identification of motoneurons innervating the tensor tympani and tensor veli palatini muscles in the cat.

The somatotopic arrangement of the motoneurons associated with the two non-masticatory muscles innervated by the trigeminal motor nerve, tensor tympani (TT) and tensor veli palatini (TVP), was determined in the cat using retrograde transport of horseradish peroxidase. The motoneurons of the TT are distinct and separate, ventral and ventral-lateral to the rostral two-thirds of the trigeminal motor nucleus. The cells are smaller than those of the motor nucleus and constitute a parvocellular division. Based on functional and morphological criteria, TT motoneurons may be considered as an accessory trigeminal nucleus. The somatotopic arrangement of TVP motoneurons has been described for the first time. These motoneurons are located in the rostral two-thirds of the ventromedial division of the cat trigeminal motor nucleus. The location of motoneurons associated with TT and TVP does not fit the parcellation of the cat trigeminal motor nucleus as described by previous investigators. The motoneurons of these muscles can now be assigned to areas either within (TVP) or adjacent to (TT) the rostral two-thirds of the motor nucleus.

Animals↗