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Biomedical subjects

K L Roos

Publications and source records attributed to K L Roos.

36 records · Page 2Linked to original sources
PubMed1990

Postpartum intracranial venous thrombosis associated with dysfunctional protein C and deficiency of protein S.

Development of intracranial dural sinus thrombosis in the postpartum period has been attributed to the hypercoagulable state of pregnancy. With increasing recognition of the role of the vitamin K-dependent proteins, protein C and protein S, in intracranial venous and arterial thrombotic events, our understanding of the cause of thrombotic events has improved. We report a patient who developed a superior sagittal sinus thrombosis in the second week postpartum, associated with a dysfunctional protein C and a decreased free protein S concentration.

Adolescent↗
PubMed1990

Meningitis as it presents in the elderly: diagnosis and care.

The clinical presentation of bacterial meningitis in the elderly is often more subtle than in younger patients. Delay in diagnosis and treatment contributes significantly to morbidity and mortality. The presence of fever and a change in mental status in an elderly patient should raise suspicion for the presence of meningitis and prompt examination of the cerebrospinal fluid. Knowledge of the bacterial pathogens causing meningitis in this age group and administration of the recommended antimicrobial agents can greatly reduce morbidity and neurologic sequelae. This review updates the primary care physician in the diagnosis and management of this serious infection.

Aged↗
PubMed1989

Mental status abnormalities in temporal arteritis: a treatable cause of dementia in the elderly.

Although temporal arteritis (TA) is a common vasculitis, mental status changes and higher cortical dysfunction have received limited attention in the literature. We report a case which illustrates the potential for TA to produce chronic fluctuating delirium, delusional thinking, and memory impairment in the absence of concomitant symptoms of headache and visual loss. In addition, TA may produce differing symptoms at different times in the same patient.

Aged↗
PubMed1989

Magnetic resonance imaging evaluation of learning difficulties and incoordination in neurofibromatosis.

Areas of increased signal seen on magnetic resonance imaging (MRI) of the brain are frequently present in neurofibromatosis and are considered possible areas of dysplasia or heterotopias. Since Rosman and Pearce [Brain 1967; 90:829-838] have shown that neuronal heterotopias in deep cerebral white matter are associated with mental retardation in neurofibromatosis type 1 (NF-1), we hypothesized that these areas of increased signal seen on MRI should be associated with learning difficulties or incoordination in children with NF-1. Using MRI, we studied 31 children with NF-1 and attempted to correlate the presence of areas of increased signal with learning difficulties or incoordination. We found no association. This suggests that either these areas of increased signal are heterotopias which are not associated with learning difficulties or incoordination, or these areas of increased signal are not heterotopias and are not relevant to the study of learning problems or incoordination in children with NF-1.

Adolescent↗
PubMed1989

Neurofibromatosis, Charcot-Marie-Tooth disease, or both?

The simultaneous occurrence of neurofibromatosis and a peripheral neuropathy that has the clinical and electrophysiological features of Charcot-Marie-Tooth disease (HMSN I) has rarely been reported. A recent report described patients with HMSN I with hypertrophic lumbosacral nerve roots. We report a patient with compelling evidence for neurofibromatosis who also demonstrates clinical and electrophysiological features of Charcot-Marie-Tooth disease. Abdominal and pelvic CT scan revealed diffusely and symmetrically enlarged lumbosacral nerve roots. These nerve roots were biopsied, and the specimens revealed neurofibromas. Histology, electrophysiological studies, radiology, and clinical appearance of the abnormality in peripheral nerves and lumbosacral nerve roots will be emphasized in this paper. The simultaneous occurrence in our patient of neurofibromatosis and Charcot-Marie-Tooth disease suggests a possible genetic relationship between these two disorders.

Adult↗
PubMed1989

The management of fulminant meningitis in the intensive care unit.

Fulminant meningitis requires aggressive management in an intensive care unit setting. The pathophysiology of the various factors that damage the central nervous system in this disease have been reviewed, as well as the management of the many complications of this serious, often devastating, infection. The etiologic agents according to age group have been discussed, and recommendations for empiric therapy have been made.

Adult↗
PubMed1988

Cranial MR imaging in neurofibromatosis.

Cranial MR images of 53 patients with neurofibromatosis were reviewed to determine the nature, extent, and number of intracranial abnormalities present. All patients studied met tentative definitions established for the diagnosis of neurofibromatosis. Twenty-three were scanned for evaluation of known CNS of cranial nerve involvement; the remainder were neurologically asymptomatic patients without suspected lesions referred for screening. Single lesions were noted in 32 patients. Multiple lesions were identified in 14 patients. Seven had normal scans. In 23 patients small focal areas of increased signal on T2-weighted scans within the brain were though to represent heterotopias. Eight patients had chiasmal gliomas and two had optic nerve gliomas. Nine patients had parenchymal gliomas, two had ischemic changes, and one had a colloid cyst. Extraaxial lesions included acoustic neuromas (five patients), meningiomas (four), trigeminal neurofibromas (one), and dysplasia of a sphenoid wing (two). Of the 30 asymptomatic patients referred for screening, lesions were found in 23. MR was found to be an excellent method of imaging known disease and of detecting lesions in asymptomatic patients. Because of the large number of asymptomatic lesions detected in this population, a screening MR study is recommended in patients with neurofibromatosis.

Adolescent↗
PubMed1988

The management of fulminant meningitis in the intensive care unit.

Fulminant meningitis requires aggressive management in an intensive care unit setting. The pathophysiology of the various factors that damage the central nervous system in this disease have been reviewed, as well as the management of the many complications of this serious, often devastating, infection. The etiologic agents according to age group have been discussed, and recommendations for empiric therapy have been made.

Adolescent↗
PubMed1987

Intracranial blastomycoma.

Although meningitis is the most common form of central nervous system (CNS) blastomycosis, solitary mass lesions are not an infrequent presentation. Four of our patients presented with focal neurological deficits as a result of single intracranial mass lesions. Only 1 had clearcut evidence of extraneural blastomycosis. One was a coal miner, another worked with soil samples, and one was an engineer for a wood pulp company. All were previously healthy and 2 had diabetes. Complement fixation and immunodiffusion tests were negative in all 4 patients, and white blood cell counts and erythrocyte sedimentation rates were normal. Wet mount of tissue obtained intraoperatively by aspiration demonstrated the organism in 2 cases, culture from a lung lesion made the diagnosis in 1 case, and stain and culture of ventricular fluid revealed the organisms in the fourth case. Multiple cultures of cerebrospinal fluid from lumbar puncture were negative. All 4 patients survived. Amphotericin B alone was curative in 2 cases; surgical removal alone was curative in 1. All 4 computerized tomographic scans revealed isodense or slightly hyperdense single mass lesions with homogeneous contrast enhancement and surrounding edema, and tumor was the preoperative diagnosis in 2 cases. Such scans should suggest CNS blastomycoma in patients from the endemic area, despite the lack of other systemic manifestations. Diagnosis nevertheless rests on the characteristic histopathologic appearance in tissues and/or culture. Solitary intracranial blastomycomas may be less rare than previously thought; at our institution, we observed 4 cases in 4 years.

Adult↗
PubMedDate not supplied

MR imaging of central pontine myelinolysis.

Central pontine myelinolysis is a demyelinating disorder with characteristic magnetic resonance features. Findings on T1-weighted scans include a symmetric region of low signal involving the basilar pons with sparing of the descending corticospinal tracts as well as the peripheral pontine tissues. The T2-weighted images show an area of high signal corresponding to the abnormal region identified on T1-weighted scans. Associated extrapontine demyelinating lesions are also demonstrated.

Demyelinating Diseases↗
PubMedDate not supplied

Chronic focal seizure disorder as a manifestation of intracranial iophendylate.

A 46-year-old woman developed focal seizures 10-15 years following iophendylate myelography. Focal epileptogenic abnormalities on electroencephalogram corresponded to the localization of residual iophendylate in the right sylvian fissure. Intracranial iophendylate may have produced chronic meningeal reaction leading to cortical irritation and a chronic seizure disorder.

Brain↗
PubMedDate not supplied

Neurofibromatoses.

Explore the source record for details and available documents.

Humans↗
PubMedDate not supplied

Dexamethasone and nonsteroidal anti-inflammatory agents in the treatment of bacterial meningitis.

It has been shown in experimental models of bacterial meningitis that bacterial cell-wall components produce an inflammatory response in the subarachnoid space, probably by stimulating the release of inflammatory cytokines, such as tumor necrosis factor, interleukin-1, and prostaglandins. Interleukin-1 increases the concentration of prostaglandin E2 and leukotriene B4, metabolites of arachidonic acid, which are potent mediators of inflammation. Steroidal and nonsteroidal anti-inflammatory agents decrease formation of these metabolites and minimize the damage to the blood-brain barrier. There is also evidence that anti-inflammatory agents decrease cerebral edema in bacterial meningitis. The results of clinical trials in patients with bacterial meningitis demonstrate that dexamethasone can prevent sensorineural hearing loss and reduce mortality, without interfering with the antimicrobial action of antibiotics.

Animals↗