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Biomedical subjects

J Stovring

Publications and source records attributed to J Stovring.

13 recordsLinked to original sources

Wallerian degeneration of the corticospinal tract region of the brain stem: demonstration by computed tomography.

Pathophysiological and CT aspects of wallerian degeneration of the corticospinal tract in the brain stem were studied in patients with old hemispheric infarcts. There was found to be a clear relationship between (a) the location and size of the infarcts and (b) the presence or absence of wallerian degeneration. When most of the motor cortex is involved, degeneration can be seen at least as far as the mesencephalic level and sometimes down to the pontine level. Isolated capsular infarcts which spare the motor cortex are also associated with degeneration. No degeneration could be seen in patients with small infarcts.

Aged

Cerebral infarction in childhood bacterial meningitis.

Forty-nine children with complicated bacterial meningitis were studied. Thirteen had abnormalities on computed tomography compatible with the diagnosis of brain infarction; one had a brain biopsy with the histological appearance of infarction. Factors exist in childhood bacterial meningitis which are associated with the development of brain infraction.

Biopsy

Computed tomography in childhood bacterial meningitis.

Computed tomography has been applied to childhood bacterial meningitis in an attempt to analyze the structural basis for neurologic complications. The CT findings in meningitis patients include acute cerebral swelling; moderate widening of basal cisterns, interhemispheric fissue, and subarachnoid convexity space; ventricular widening; subdural collection; focal cortical necrosis; cerebral infarcts; contrast enhancing basal meninges, ependymitis, and generalized cerebral atrophy. Bacterial meningitis in childhood is more than an inflammation of the subarachnoid space. It is a disease process which often exerts a profound effect on the brain parenchyma.

Brain

Persistent otic artery.

A patient with a persistent otic artery is presented. The radiographic anatomy is presented in the anteroposterior as well as the lateral plane. The significance of the otic artery is twofold. First, it is important in understanding the embryogenesis of the cerebral vessels. Secondly, it is an anatomical variant that is important in performing and evaluating cerebral arteriograms.

Aged

Subcortical arteriosclerotic encephalopathy (Binswanger): computerized tomography.

The subcortical arteriosclerotic encephalopathy of Binswanger is characterized clinically by hypertension, dementia, spasticity, syncope, and seizures. It is usually diagnosed pathologically by the finding in white matter of diffuse demyelination or foci of necrosis plus arteriosclerotic and hypertensive vasculopathy. We present a case in which the diagnosis was made on the basis of the clinical course and a computerized tomogram which demonstrated extensive white matter degeneration. Postmortem examination confirmed both the diagnosis and the extent of the degeneration as shown by CT scan.

Brain Diseases

Occipital encephalocele with holoprosencephaly and aqueduct stenosis.

A case is described in which an occipital encephalocele was removed in a newborn and in which a midline monoventricle did not appear until some months later, suggesting the diagnosis of holoprosencephaly. The relationship of encephaloceles and holoprosencephaly is discussed.

Cerebral Aqueduct

Familial cavernous angiomas.

Cavernous angiomas are rare, surgically remediable vascular malformations of the CNS that may be characterized by hemorrhage, seizures, or focal neurologic deficits. Three families with cavernous angiomas have been described, and we report two more. In the first, the mother died suddenly with headache. A pontine cavernous angioma was found at autopsy in one son. His brother has similar pontine signs and a radiographically proved pontine mass. The brother's son has seizures and a calcified cerebral lesion. In the second family, the father had a cavernous angioma excised from the caudale. One of the daughters had a hemorrhagic mass removed from the spinal cord. Another daughter has seizures and a temporal lobe vascular lesion proved angiographically. Awareness of the possibility of familial involvement may aid in diagnosis of cavernous angioma.

Adult

The follow-up CT scan in childhood meningitis.

CT in childhood bacterial meningitis has indicated that bacterial meningitis is more than an inflammation of the subarachnoid space; it is a disease process which often exerts a profound effect on the brain parenchyma. In some cases ventricular widening may be a reflection of loss of brain substance rather than increased intracranial pressure. A vasculitis may occur in cerebral vessels with consequent ischemic infarct. The abnormalities found on CT during the acute illness are frequently persistent.

Age Factors

Descending tentorial herniation: findings on computed tomography.

Descending tentorial herniation (DTH) can be diagnosed by computed tomography. Encroachment upon the lateral aspect of the suprasellar cistern is an early sign of impending tentorial herniation. Actual herniation is evidenced by rotation and shift of the brain stem with consequent widening of the crural and ambient cisterns on the side of the space-occupying lesion. In a more advanced stage of herniation, obliteration of cisternal spaces at the tentorial level will occur. Aqueductal compression secondary to the herniation will cause increased intraventricular pressure with widening of those parts of the lateral ventricles that are not exposed to the compression by the mass; a characteristic finding is widening of the temporal horn on the side opposite the space-occupying lesion. Infarction in the territory of the posterior cerebral artery may complicate DTH.

Adult

Contralateral temporal horn widening in unilateral supratentorial mass lesions: a diagnostic sign indicating tentorial herniation.

Tentorial herniation secondary to supratentorial mass lesions will cause aqueductal compression and raised intraventricular pressure. Under ordinary circumstances, a raised intraventricular pressure will result in the development of hydrocephalus, but, in the presence of a large supratentorial mass, it is impossible for a generalized hydrocephalus to develop; only those parts of the ventricular system that are somehow shielded from the pressure effect of the mass lesion will be able to dilate. This dilatation will most frequently involve the contralateral temporal horn. Often, the atrium of the ventricle and the occipital horn will also be involved and, occasionally, the entire ventricle on the side opposite the mass will be dilated. The association of a large supratentorial mass with considerable shift of midline structures and computed tomography findings of a dilated contralateral temporal horn should be considered indicative of tentorial herniation, unless there are signs of preexisting atrophy or other preexisting disease processes that could have caused widening of the temporal horn.

Brain Diseases