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Biomedical subjects

M A Weinstein

Publications and source records attributed to M A Weinstein.

At least 73 records · Page 4Linked to original sources
PubMed1982

Hemorrhage and anticoagulation after nonseptic embolic brain infarction.

Among 54 consecutive patients with acute nonseptic embolic brain infarction, there was CT evidence of hemorrhagic infarction in 1 patient (2%). None had clinical or CT evidence of massive brain hemorrhage even when anticoagulation therapy was used immediately. Seven patients (13%) had recurrent brain emboli, all within 7 days of the initial stroke. None of these patients was adequately anticoagulated at the time of recurrence. Immediate anticoagulation therapy should be employed after nonseptic embolic brain infarction if CT does not show hemorrhage and there is a persistent cardiac source of emboli.

Cerebral Hemorrhage↗
PubMed1982

Digital subtraction angiography of the intracranial vascular system: comparative study in 55 patients.

Intracranial vessels were examined in 55 patients with both conventional selective catheterization and intravenous digital subtraction angiography using a prototype digital subtraction unit. In 65% of the patients, the digital subtraction angiogram was diagnostic, but the overall quality was inferior to conventional selective angiography. In 22%, the digital subtraction angiogram provided diagnostic information, but there was a significant chance of misinterpreting the results of the study. In 13% of cases, the subtraction angiogram was not diagnostic. As now developed, digital subtraction angiography can replace conventional cerebral angiography for preoperative evaluation of the juxtasellar carotid artery prior to transphenoidal surgery because the large intracerebral vessels are consistently well visualized with digital subtraction. The dural sinuses are better visualized with digital subtraction than with conventional angiography because with digital subtraction all the vessels of the brain are opacified, whereas with conventional angiography, there is a mixture of opacified and unopacified blood in the sinuses. Combined with computed tomography, digital subtraction angiography can replace conventional angiography for determining the preoperative extent and vascularity of tumors. It can be used for postoperative evaluation of aneurysms, arteriovenous malformations, extracranial to intracranial bypasses, and after the embolization of vascular lesions.

Adult↗
PubMed1982

Intravenous digital subtraction angiography in neuro-ophthalmology.

The development of computer reconstructed images of the extracranial and intracranial vessels after injecting modest doses of intravenous contrast media has significantly altered standard angiography procedures. Intravenous digital subtraction angiography is a reproducible and rapid outpatient procedure that is less expensive and safer than conventional arteriography. The applications and limitations of this new technique to neuro-ophthalmology are discussed.

Adult↗
PubMed1982

Early patency of the carotid artery after endarterectomy: digital subtraction angiography after two hundred sixty-two operations.

During a 12-month period of study, 265 patients (mean age 65 years) underwent a total of 314 carotid endarterectomies for the management of previous transient cerebral ischemia (39%), prior stroke (10%), or severe asymptomatic carotid stenosis (51%). Five patients (1.6%) died within 30 days of operation, but only three deaths (1%) were related to carotid reconstruction. Six patients (1.9%) experienced postoperative strokes, including 1.6% of those with previous transient ischemia, 9.7% of those with prior strokes (P less than 0.02), and 0.6% of those with asymptomatic carotid stenosis before operation. Digital subtraction angiography (DSA) was performed during the same hospital admission following 262 procedures in a group of 214 patients, including all patients who had postoperative neurologic complications. Seven of these operations were limited to external carotid endarterectomy. The internal carotid artery was entirely normal in 239 (94%) of the remaining 255 DSA studies. The external carotid artery was normal on 238 (93%) of 255 DSA examinations, but was occluded on 12 (4.7%). A focal intimal defect corresponding to the apical arteriotomy suture was found in nine internal carotid arteries (3.6%), but these lesions did not appear to be hemodynamically significant. The internal carotid artery contained over 30% stenosis in two patients (0.8%) and was occluded in five (1.9%). Two of these five patients had neurologic complications, but four others with operative strokes had normal angiograms. Asymptomatic postoperative thrombosis of the internal carotid artery was documented in only three patients (1.2%).

Adult↗
PubMed1981

Visualization of the arteries, veins, and nerves of the orbit by sector computed tomography.

Altering the scintillation crystal configuration of a fixed-detector CT scanner increased the spatial resolution from 6.25 to 10 line pairs per centimeter. Sector scans of th orbit with this modified scanner showed the ophthalmic artery and superior ophthalmic vein and their branches and the intraorbital branches of the third, fifth, and sixth nerves, apparently seen with CT for the first time.

Humans↗
PubMed1981

Digital subtraction angiography of the carotid arteries: a comparative study in 100 patients.

Conventional angiography and intravenous digital subtraction angiography (DSA) were used to examine the common carotid artery bifurcations in 100 patients with clinically suspected arteriosclerotic disease. In 60% of the patients, the quality of the DSA examination was good or excellent bilaterally; in 23%, the quality was good or excellent on one side; in the remaining 17%, both bifurcations were poorly visualized. There was excellent correlation of conventional and digital angiograms when the carotid bifurcations were well visualized with DSA (sensitivity 95%, specificity 99%, accuracy 97%). When the carotid bifurcations were not well visualized with DSA, there was a substantial chance for misinterpretation of the study (sensitivity 54%, specificity 70%, accuracy 64%). Digital subtraction angiography is a safe, rapid procedure that can be performed on an outpatient basis and can accurately evaluate the carotid bifurcation in approximately 70% of the arteries examined.

Adult↗
PubMed1981

Imaging capability of an experimental digital subtraction angiography unit.

We evaluated an experimental digital subtraction unit in terms of field uniformity, linearity of signal response to x-radiation, response of the log amplifier, and imaging capability as measured with the Rose phantom. For comparison, conventional film subtraction phantom measurements were made. Our results indicate that this unit exhibits greater sensitivity to contrast media than conventional film subtraction units.

Angiography↗
PubMed1981

Megalocephaly and hypodense extracerebral fluid collections.

Computed tomographic (CT) scans were identified and reviewed for 25 pediatric patients with enlarged heads and extracerebral fluid collections that showed cerebrospinal fluid-like attenuation. Mild to moderate enlargement of the subarachnoid space over the convexity, interhemispheric fissure, and the lateral ventricles was observed in most of the cases. The CT findings are not specific, and it is not always possible to determine the nature of the extracerebral fluid, whether it lies in the subarachnoid space, the subdural space, or both. The differential diagnosis included subdural effusions, hygromas, preclinical or external hydrocephalus, hypodense subdural hematomas, megalocephaly, and possibly a normal variant. CT remains the method of choice for the initial study of these patients and for subsequent follow-up in selected cases.

Brain Neoplasms↗
PubMed1981

Intravenous digital subtraction angiography: application to cerebrovascular surgery.

Intravenous digital subtraction angiography (DSA) was used to evaluate the extracranial and/or intracranial arteries of 87 patients with suspected cerebrovascular disorders. The examinations were performed on either an inpatient or an outpatient basis. Renografin-76 was injected into an arm vein through an angiocatheter. Extracranial examinations accurately demonstrated major artery disease such as carotid artery occlusion, stenosis, and ulceration. Intracranial examinations demonstrated an aneurysm in 9 of 10 patients and an arteriovenous malformation in 5 patients. The technique was useful in assessing the results of cerebrovascular procedures such as carotid endarterectomy, superficial temporal artery to middle cerebral artery bypass, and the obliteration of vascular anomalies. DSA also excluded the presence of an intrasellar aneurysm and showed the location of the intracranial arteries before trans-sphenoidal surgery. The findings of the DSA examinations correlated closely with the findings of conventional angiography.

Brain Ischemia↗
PubMed1981

Localization of suspected intraocular foreign bodies with a modified Delta 2020 scanner.

Metallic foreign bodies were localized in seven patients using a modified Delta 2020 scanner. In six of these seven, we compared the localization obtained by sector CT scan with ultrasound. The two methods were found to be complementary, with the sector CT scan giving more positive and more easily interpreted localizations, and ultrasonography giving more detailed soft tissue diagnosis. The new sector CT scanner greatly raised the level of confidence in the localization of metallic foreign bodies; however, we recommend the combined use of both techniques for a complete evaluation.

Adolescent↗
PubMed1981

Syndrome of pelvic cellulitis following rectal sexual trauma.

Three cases of a syndrome of pelvic cellulitis following fist fornication are described. These cases are characterized by the history of fist fornication three or more days previously, fever, pararectal induration, acute proctitis and signs of pelvic peritoneal irritation. It is important to recognize this entity as it is usually adequately treated by means of broad spectrum antibiotics. Operative intervention can usually be avoided.

Adult↗
PubMed1980

Anorectal Crohn's disease: definitive surgery for fistulas and recurrent abscesses.

Twenty patients with anorectal Crohn's disease manifested by anal fistulas or recurrent perirectal abscesses underwent attempted definitive surgical eradication of that pathologic process. The role of Parks' partial internal anal sphincterectomy is discussed. The results are presented and correlated with the activity of the underlying Crohn's disease. The excellent results recommend this approach for recurrent perirectal abscess and intersphincteric abscess, even when occurring for the first time.

Abscess↗
PubMed1980

Calcification of the basal ganglia as visualized by computed tomography.

Physiological calcification of the globus pallidus was visualized by computed tomography in 32 patients. The frequency of visualization increased with increasing age. Patients under the age of 40 with calcification of the globus pallidus should be evaluated for disorders associated with pathological calcification of the basal ganglia. Patients of any age with calcification in the lenticular nucleus and elsewhere in the basal ganglia, dentate nucleus, or multiple areas of the cortex should also be evaluated for these disorders.

Adolescent↗