Case report: cervical intervertebral foramen widening caused by vertebral artery tortuosity--diagnosis with MR and colour-coded Doppler sonography.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to K Heimberger.
Explore the source record for details and available documents.
The aim of the present study was to investigate if there is any causal connection between plain X-ray findings of the cervical spine and tension headache. We evaluated the X-rays of the cervical spine of 243 patients, in 91 of which the diagnosis was "tension headache", in 102 "headache not fulfilling the criteria of tension headache" and in 50 "spondylogenic complaints without headache". We compared these three groups with regard to frequency and severity of radiologically assessable changes of the cervical spine and found that patients with tension headache had normal findings significantly more often and significantly less often functional or organic changes or both than patients of the other two groups. The radiologically assessable changes of the cervical spine are unlikely to have an essential role in the cause or mechanism of tension headache.
Technetium-d, HMPAO SPECT was performed in 70 patients suffering from intracerebral tumors of various histologic types (glioma n = 30, meningioma n = 19, metastases n = 10, angioma n = 3, neuroma n = 2, lymphoma n = 2, neurocytoma n = 1, epidermoid n = 1, gliosis n = 1, cholesteatoma n = 1). Tumor classification was histologically verified in all subjects except in two cases with inoperable angiomas. SPECT was performed under resting state conditions with a dual-head rotating camera (SIEMENS ZLC 37) following intravenous injection of 18-25 mCi 99mTc-d, 1-HMPAO. Regional tracer deposit was expressed in terms of a cerebellar index (CBI). Significantly higher regional HMPAO uptake was found in meningiomas when compared with gliomas of different malignancy (ANOVA p less than 0.05). Within gliomas, regional uptake increased with malignancy (n.s.). In 23 patients, a total of 32 tumor specimens were obtained for histochemical analysis of glutathione (GSH) content using high-pressure liquid chromatography. A significant correlation (least square method, p less than 0.001) between CBIs and GSH values was found, supporting the hypothesis that GSH is the predominant factor for the conversion of the lipophilic complex to hydrophilic derivates.
Explore the source record for details and available documents.
Transarterial EEG-recording is a complementary method to surface and depth-techniques. In 8 patients having superselective angiography because of diagnosis or therapeutic manoeuvres transarterial EEG-recording was performed. There were only few artefacts and no clinical side effects. The value of this additional information is discussed.
In the diagnosis of a so-called scar carcinoma, one of the accepted morphological characteristics is the deposition of dust in tumours of the lung. In 50 bronchial carcinomas in former miners and patients not occupationally exposed to dust, the cause and significance of such lesions were investigated in autopsy and surgical material. Impregnation with dust must be considered to be a secondary phenomenon of the infiltrative tumour growth. Such depositions depend upon previously present dust depositions in the pulmonary parenchyma and on the localisation of the tumour, and reveal a clear correlation with the histological type and degree of differentiation of the tumour.
The concept of a blood brain or blood tumour barrier blocking the passage of lipid insoluble cytoreductive drugs from blood into brain-tumor, leads to a protocol of intraarterial injection of high dose methotrexate (MTX) during reversible, osmotic blood brain barrier disruption (BBBD). Malignant Gliomas of grades III and IV in 9 patients and one primary CNS-lymphoma in one patient have been treated in 2 to 5 sessions per patient with BBBD plus polychemotherapy (MTX, cyclophosphamide, procarbazine). Median progression free intervals (PFI) which are still in continuation are 12.2 months. Median PFI which had been terminated by tumour recurrence are 7.75 months.
Reversible opening of the blood-brain barrier before administration of watersoluble cytoreductive agents constitutes a new tool in the treatment of central nervous malignancies. In this study a volume of 172 ml mannitol 25% has been injected into one of the cerebral arteries within 30 seconds. 5 minutes later the osmolality had augmented from 286 to 303 mosmol/kg and the plasma volume by 15%. The hemodynamic measurements--cardiac index (+47%), heart rate (+7%), LVSWI (+50%), systemic vascular resistance (-20%) and blood volume (+15%)--indicate a biphasic response with early fall in SVR followed by a rise in cardiac performance which is independent of the preload.
Explore the source record for details and available documents.
Postoperative interventional neuroradiology was performed in patients with malignant gliomas to increase target efficacy of chemotherapy. In 8 glioma patients the blood brain or blood tumor barrier was reversibly opened by intraarterial injection of hyperosmolar fluid (Mannitol 25%). One additional patient had primary lymphoma of the central nervous system. During barrier modification chemotherapeutic agents were applied intraarterially and intravenously. A total of 22 blood brain barrier modification procedures have been carried out until now, ranging from one to five per patient. A presently continuing tumor regression or tumor progression free intervals have been noted in 5 patients. Therapeutic effects are being evaluated from repeated computed tomography and single photon emission computed tomography examinations.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Preliminary examinations with digital subtraction myelography revealed the possibility of saving up to 70% of water soluble contrast medium compared with usual myelographic procedures, thereby reducing the risk of neurotoxic adverse reactions.
Within a period of 13 months a 24-year-old male student experienced four attacks of subarachnoid haemorrhage. An intradural-extramedullary haemangioma at the level of the second thoracic segment was found to be the cause of the repeated bleeding.
Explore the source record for details and available documents.
The case of a 29-year-old man with glioblastoma and multiple metastases outside the CNS is presented. Cervical lymph node involvement was ascertained with CT and magnetic resonance (MR), and numerous bone metastases were detected with skeletal scintigraphy. The extent of the cervical tumor and its relationship to the carotid artery could be better assessed with MR than with CT. The patient died despite repeat operations, radiotherapy, and intraarterial systemic chemotherapy. The importance of radiological screening for detecting glioblastoma metastases in patients with long survival is discussed.
OBJECTIVE: A new imaging modality is presented in which a digital subtraction algorithm is applied to spiral CT angiography of extra- and intracranial vessels. MATERIALS AND METHODS: Spiral CT angiography was carried out in 26 patients. When this was done for stereotactic purpose before radiosurgery, a Leksell stereotactic frame was used; in the other cases an atraumatic fixation system was applied. Spiral CT data were acquired twice--before and after contrast agent administration. Then, computerized subtraction of the density values of plain CT from the topographically corresponding enhanced CT was performed. Maximum intensity projection was used to visualize the vessels. RESULTS: This method provided significant effacement of nonvascular structures and a considerably improved visualization of extracranial as well as intracranial vessels could be achieved. In some conditions, e.g., to exclude a suspected thrombotic occlusion of the basilar artery, conventional angiography could even be omitted. CONCLUSION: Adequate visualization of extra- and intracranial vessels is possible with spiral CT angiography and digital subtraction. An important scope of this modality could be its contribution to radiosurgical planning and the follow-up after radiotherapy. In some conditions, CT subtraction angiography may possibly supersede conventional subtraction angiography.