Biomedical subjects
Publications and source records attributed to K Voigt.
Skull radiographs of the pharaoh Seqenenre-Ta'a II with special densitographic techniques have shown that he survived a perforating skull injury. The technique is described and its use in medical history and archaeology is discussed.
Retrospective study of 452 out of 4155 pneumoencephalograms continuously investigated by two independent observers over 20 years. Follow-up and statistics of frequency and sex-differences of asymmetries of lateral ventricles and posterior cornua. Criteria of selection: history and clinical findings in favor of a general cerebral cause and against circumscribed changes due to local damage. Technique standardized and equal bilateral filling in pneumoencaphalography. Results of the numerous findings: 1. Posterior cornua were symmetrical in 370 patients 81.9% (256 male, 114 female, 18.1%). Definite asymmetry of posterior horns in 72 males and 10 males. 2. These asymmetries showed variations from unilateral to bilateral, but clearly different sizes of posterior horns. 3. Unilateral posterior horn "anlagen" seen in 64 (14.1%) of all patients. Males predominated 8:1, left more common than right 3.5:1. 4. Bilateral "anlagen", with one posterior horn predominating, in 18 patients (3.9%). Once more males more common 8:1. Larger "anlagen" on left: 8:1. 5. Accompanying further asymmetries of lateral ventricles with equal bilateral posterior horns were of similar size in 73.7%. In 21.1% the lateral ventricle was larger on the right, in 5.1% on the left. The left side was more common 4.15:1. 6. Large ventricles were of equal size in 45.1 of patients with asymmetry of the posterior horns, 45.1% on left, 9.7% on right the ventricle was larger. Once more the left side predominated 4.6:1. 7. Trying to correlate clinical-neurologic, neurophthalmic, neurophysiologic and tachistocopic findings with pneumoencephalograms with or without asymmetry showed no regular relation with handedness, ocular dominance, limitations of visual fields or--neglect or shapes of ventricles. In all subgroups frequency and sex-distribution corresponded to the norm. 8. Numerical frequency of coupling of right-handedness and right predominant eye with left increased size of ventricle was within the statistically expected and was, therefore, not interpreted as a sign of functional dominance of the left cerebral hemisphere, as done by others. 9. When eliciting from the occiput visually evoked potentials 8 patients showed important findings, in spite of their small number. In 3 patients with symmetrical "anlagen" of the posterior horns, latency and amplitude of potentials were the same; in 5 patients, with asymmetry of posterior horns the side of the larger horn showed significant reduction of amplitude without exception. The investigations show, quantitative statistical findings of frequency and sex-distribution and their negative correlation with examined clinical parameters apart, the anatomic-morphologic variation of asymmetry of posterior horns corresponds to a correlate which can also be shown with a neurophysiologic technique.
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The technique, diagnostic results and significance, differential diagnostic considerations and limitations of selective spinal angiographies in chronic inflammatory processes (Pott's disease 11 cases). hemangiomas (21 cases) and aneurysmal bone cysts (9 cases) as well as benign and malignant tumors (26 cases) of the vertebral bones and adjacent tissues are described and demonstrated with regard to radiological findings.
The radiological appearance and main features of calcifications of the basal ganglia in metabolic, toxic and hypoxemic disorders, degenerative and systemic diseases, tumors as well as infectious and parasitic lesions are described and demonstrated by typical radiographs. The roentgenological differential diagnosis and etiological classification are debated on occurence, incidence, localization, and topography with regard to individual structures of the basal ganglia, distribution pattern and according to the dimension, shape, margin and density pattern of these calcifications.
Anatomy and technique in angiography of extracranial vessels is discussed based upon 1321 own cases. Most frequently catheter technique is used. Main indication is cerebral vascular insufficiency, less often aneurysm, trauma and tumor. Results of angiography are discussed.
Directional Doppler sonography of the carotid arteries in the neck (selective for the common carotid artery, external and internal carotid arteries) and of the supratrochlear artery permits reliable diagnoses and localizations of extracranial stenoses and occlusions of these arteries. In addition, severe intracranial vascular disorders may also be detected by these methods. Characteristic combinations of Doppler results are described in occlusions of the trunk of the middle cerebral artery, cerebral circulatory breakdown, large arteriovenous angiomas of one hemisphere and carotidcavernous fistulas, and are compared with angiographic findings. The knowledge of these Doppler findings is indispensable for the differential critical evaluation of such disorders found at the level of the neck arteries and at the fronto-orbital terminal branches of the ophthalmic artery.
A comparative study has been made of the myelographic, clinical and operative findings in 140 patients with lumbar disk lesions. The myelographic and operative findings corresponded in 95%. The L 4-5 disk was the most frequently affected. With regard to the operation, some of the most important technical points are discussed. A myelography is strongly recommended before every disk operation.
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A method was developed for prenatal, post-mortem angiography, post-mortem angiography of the venous system of the brain, head and neck; its development was studied in the embryos and foetuses of 80 cattle, 20 sheep and 20 pigs with a crown-rump lenght of 19 to 155 mm. Radiological and corrosion preparations were studied. The embryonic and foetal venous systems were filled with thin barium sulphate through the umbilical and omphalic veins. The development and transformation of the cerebral veins and sinuses are compared and are related to the corresponding vascular anatomy of the adult animal and to man. The radio-embryological method for demonstrating cerebral vessels is also applicable to live foetuses.
Following gold therapy in a patient with rheumatoid arthritis a transient rash and permanent nail dystrophy resulted. Following onycholysis of several finger and toe nails the nails showed permanent alterations in form of longitudinal streaks and were extremely thin, soft, and fragile. Intracutaneous tests with the commercial gold solution revealed an allergic reaction of the delayed type.
In a retrospective study of 536 unselected consecutive RIHSA cisternographies a total of 84 cases with normal time-sequential scans were reviewed and, after dividing into three age groups, statistically elaborated with regard to the CSF pathways and flow rate. Our findings on a 5% level of significance are: 1) The total CSF flow and turnover depends on age; the highest rate of CSF flow is found in young patients (less than 25 years) and decreases constantly with increasing age. 2) In old patients (less than 50 years) the dorsal and lateral CSF pathways predominate over the frontomedial ones which are preferred in the younger age group (less than 25 years). 3). The washout of the basal cisterns and the clearance of the isotope over the convexities decreases significantly with increasing age. 4) The normal individual cisternographic variations and significant age-dependent differences agree with simultaneous encephalographic findings.
The diagnostic value of directional ultrasound Doppler-sonography (UDS) of the supratrochlear (medial frontal) artery was evaluated by examination of 191 angiographically controlled cases in whom a carotid obstruction was suspected. A systematic compression of the facial and temporal arteries of both sides was performed. In 108 cases the UDS findings were normal, 6% of these were false negative and actually had a stenosis (n = 6) or occlusion (n = 2) of the internal carotid artery. In 88% of the pathological findings a stenosis (n = 39) or occlusion (n = 34) of the internal carotid artery was revealed by angiography. 79% of the stenoses were of severe degree (more than 50%). These results show that UDS is a useful diagnostic tool for the detection of severe stenoses or occlusions of the internal carotid artery. A distinction between stenosis and occlusion by UDS of the supratrochlear artery is, however, not possible, unless additional examination of the carotid arteries is performed. The method is not suitable for the detection of low grade stenoses.
Reviewing the literature and adding one unusual case the features of 164 cerebral cavernous haemangiomas are described with special reference to incidence, localization, diagnosis and clinical findings. Cavernomas may be found in every age group including the neonatal period. The sex incidence is equal. In 126 cases (76.8%) the cavernomas were of supratentorial, in 34 cases (20.7%) of infratentorial site, and in 4 more cases (2.5%) there was multiple occurence of supratentorial and posterior fossa cavernous haemangiomas. A specific clinical syndrome could not be defined: but the course is usually acute or subacute, and initial symptoms are commonly epileptic fits, acute headache and subarachnoid or intracerebral haemorrhage. Macroscopic calcifications of cerebral cavernomas were found only in 18 cases (11%). Cerebral angiography was done in 31 cases (18.9%). In 9 cases angiography was totally normal, and in 11 cases the cavernoma presented only as an avascular mass. In the remaining cases there was no conformity in the angiographic appearance of cerebral cavernous haemangiomas. Operative extirpation is the treatment of choice if a solitary lesion is favourably located. In addition to our patient there are now 21 cases (12.8%) in which cavernomas were treated successfully by operative extirpation.
The arterial architecture of large meningiomas were studied in the cerebral cortex of medulla by selective arteriography of internal and external carotid arteries, or the common care in 12 patients. The findings were compared with operative observations (or in one case with the autopsy result), and were related to the histological and pathological findings. The origin of the supplying vessel was found to be significant in the differential diagnosis.
A 55-year old woman, suffering from bacteriologically proven tuberculous meningitis showed the angiographic signs typical of tuberculous arteritis: stenosis of the supraclinoid portion of the carotid syphon on the right stenosis of the basilar artery, multiple peripheral occulsions of mediumsize vessels and mild, internal hydrocephalus. As a rarity there was an unusual collateral supply through the basal Moyamoya net which supplied the occluded right middle branch; there was a transtentorial anastomosis of the left meningeal branch of the vertebral artery which supplied the territory of the right posterior cerebral artery in an orthograde manner. The developmental mechanism and radiological findings of this rare collateral system due to tuberculous meningoarteritis is discussed.
The development and technique of a x-ray examination for prenatal and post-mortem angiography is presented. After elaboration of an appropriate method for preservation and treatment of the embryos the angiographic procedure was technically evolved and performed on 55 cow-, 40 pig-, and 5 sheep embryos and fetuses with a vertex- breech- length between 11 and 222mm. Selective filling of the arterial and venous system with good opacification of the peripheral vessels and capillary plexus could be regularly achieved by means of thin catheters or extended glass cannulas which were inserted into the umbilical arteries and veins or the vessels of the foetal membrane. By means of this technique the radiological embryology of the vascular development of different species can be studied in great series and investigated with regard to onto- and phylogenetic aspects. This prenatal angiographic technique can also be applied to man as has been proven by angiograms of 4 human embryos and fetuses aged between 6 weeks and 5 months.
The diagnostic value and technical versatility of the previously described telescopic catheter system was demonstrated in 15 patients by super-selective angiography of the external carotid artery. It was possible in all patients to catheterise the individual branches with the F-catheter; the polyethylene-S-catheter could then be passed 3 to 5 cm, beyond the tip of the F-catheter. In almost half the patients, spasm of the injected artery was observed, particularly of the superficial temporal and external occipital arteries; this was reversed by intravenous papaverine and did not interfere with detailed diagnosis. It was usually possible to obtain filling of peripheral vessels, thereby demonstrating the territory of the middle meningeal artery, the scalp, sub-mandibular gland and the pinna. There were no complications as a result of the catheterisation. The usefulness and advantages of the telescopic catheter system for therapeutic neuro-radiological procedures, with embolisation of external branches in man, are discussed.