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Biomedical subjects

M Fine

Publications and source records attributed to M Fine.

At least 37 records · Page 2Linked to original sources

Neonatal posterior fossa subdural hematoma.

Hemorrhage into the posterior fossa is a rare neurosurgical emergency in neonates. CT scanning is diagnostic. Blood layering under the apex of the tentorium cerebelli, however, may resemble a dilated vascular structure, and the rigidity of the pressured tentorium may prevent upward transmission of increased intracranial pressure, resulting in a soft fontanelle.

Cranial Fossa, Posterior

Optic nerve tumors: role of magnetic resonance imaging and computed tomography.

Localization and pathologic diagnosis of optic nerve tumors have been greatly improved by high resolution computed tomography and magnetic resonance imaging. Radiologic differentiation of the most common tumors of the optic nerve (meningioma and glioma) can be made by using these new imaging modalities. Early diagnosis of optic nerve lesions has resulted in better prognosis and surgical outcome.

Cranial Nerve Neoplasms

Adult intrasellar teratoid tumor.

Intracranial teratomas rarely occur in adults. The most common sites are the pineal followed by the suprasellar or hypothalamic areas. Infrequently, teratomas can arise within the sella turcica and mimic a pituitary adenoma or craniopharyngioma. Teratoid tumors contain tissue arising from only two of the three primitive germ layers, whereas teratomas have elements of all three. The following case illustrates the unusual occurrence of an intrasellar teratoid tumor in a 33-year-old man.

Adult

Cerebellar venous angiomas. A continuing controversy.

We have studied three patients with angiographically documented cerebellar venous angioma (CVA). One patient had a subacute cerebellar hematoma and underwent posterior fossa craniotomy for evacuation of the hematoma and excision of the malformation. A hemorrhagic venous infarction of the brain stem and cerebellum occurred, and the patient died three weeks postoperatively. A second patient with an unruptured CVA had a history of headaches, tinnitus, and vertigo. Conservative treatment was elected, and the patient's condition remains unchanged after 11 months of follow-up. The third patient, recently diagnosed as having an unruptured CVA had episodic vertigo and disequilibrium. Conservative treatment was chosen, and he is asymptomatic after six months of follow-up. Based on a review of 24 other cases of CVA plus our experience we could not conclude any definite trend regarding natural history or treatment. However, conservative treatment seems the logical choice in patients with unruptured CVA.

Adolescent

Cerebellar infarction--clinical and cranial computerized tomography correlations.

We analyzed the clinical and cranial computerized tomographic (CT) features of 10 patients with cerebellar infarction. Among patients with recent cerebellar infarction, the initial CT often failed to demonstrate any recognizable abnormality. Because early neurological deterioration may arise despite normal CT studies, a high level of clinical awareness is critical for appropriate intervention.

Adult

Oculomotor nuclear complex infarction. Clinical and radiological correlation.

We describe a patient with an isolated mesencephalic dorsal tegmental infarct affecting the oculomotor nuclear complex and medial longitudinal fasciculus, documented by high-resolution computed tomography, after undergoing percutaneous transluminal coronary artery angioplasty. Clinically, the patient exhibited bilateral ptosis, bilateral internuclear ophthalmoplegia, transient convergence retractory nystagmus, and minimal somnolence. We believe the combined clinical and radiological findings favor the presence of a caudal, dorsal, and paramedian embolic infarct in the territory of the paramedian branches of the mesencephalic artery as the most likely mechanism for these exceptional findings and correlate them with Warwick's scheme of the oculomotor subnuclei.

Cerebral Infarction

Intraoperative and outpatient echoencephalography through a burr hole.

Ultrasound images of the brain were obtained intraoperatively and on an outpatient basis through a burr hole. The patient's tumor was well visualized, prior to biopsy, after biopsy, and during radiation therapy treatment. The ultrasound images correlated closely to the CT scan findings.

Ambulatory Care

Recurrence of the clinical signs of lattice corneal dystrophy (type I) in corneal transplants.

Lattice corneal dystrophy (type I) is characterized by branching stromal lattice figures, white subepithelial opacities, and anterior stromal haze. Corneal transplantation is often required to restore the vision of patients with lattice corneal dystrophy. Our retrospective study of 61 penetrating keratoplasties in 39 patients with lattice corneal dystrophy found clinical signs of lattice corneal dystrophy in 29 transplants (48%) after periods ranging from three to 26 years. Subepithelial opacities or anterior stromal haze or both were the most common signs of recurrence. Lattice figures appeared in only one graft. Regrafting was necessary to restore vision in eight cases (15%) in which primary corneal transplantation had been performed for this condition.

Adult

Mucocutaneous lymph node syndrome.

A 3-year-old child presented with a short clinical history of fever and diffuse cervical lymphadenopathy, and the diagnosis of mucocutaneous lymph node syndrome was reached. We include a discussion of the case history and a brief review of this disorder.

Child, Preschool

CNS lesions in neonatal isoimmune thrombocytopenia.

We treated two siblings with classic neonatal isoimmune thrombocytopenia and porencephalic cysts in whom the CNS lesions occurred in a vascular distribution, for which there is no clear explanation. Whether the CNS vasculature is injured by the immune process at certain susceptible sites in larger vessels or whether there is a thrombotic process occurring at sites of vascular injury is speculative. This observation suggests that vascular factors are involved in the development of CNS lesions in this condition.

Brain Diseases

Foster-Kennedy syndrome due to optochiasmatic arachnoiditis.

A case of optochiasmatic arachnoiditis mimicking Foster-Kennedy syndrome is reported. The difficulties in establishing diagnosis are considered, and the literature of optochiasmatic arachnoiditis presenting in this unusual manner is reviewed.

Arachnoiditis

Long-term changes in corneal endothelium following penetrating keratoplasty. A specular microscopic study.

One hundred clear corneal grafts with a minimum follow-up of 10 years and average follow-up of 17.4 years were studied with specular microscopy. Central and peripheral graft endothelial cell counts as well as central corneal thickness measurements were done and these were correlated with the following parameters: diagnostic subgroups; donor age; graft age (follow-up time); and the postoperative clinical course. The average central endothelial cell counts for the entire series was 684 cells/mm2. Peripheral cell counts were performed in 78 eyes and averaged 749 cells/mm2. Central corneal thickness was measured in 80 eyes and averaged 0.49 mm. There were no statistically significant differences in central or peripheral cell counts when analyzing donor age, graft age, or postoperative course. When cell counts were examined among the diagnostic subgroups, those in the hereditary stromal dystrophy subgroup had a significantly lower cell density when compared to those in the keratoconus subgroup.

Adolescent