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Biomedical subjects

M K Edwards

Publications and source records attributed to M K Edwards.

67 records · Page 4Linked to original sources
PubMedDate not supplied

Neuroimaging of disseminated germ cell neoplasms.

The purpose of this study was to determine the role of neuroimaging in the management of patients with metastatic germ cell tumors. Retrospective evaluation of 299 patients treated in 1986 and 1987 for initial presentation or recurrence of testicular, retroperitoneal, and mediastinal germ cell tumors was performed to determine indications for neuroimaging, frequency and site of CNS metastases, and occurrence of other CNS abnormalities. Sixty-six patients required CNS imaging with myelography, CT, or MR. Studies were normal in 24 patients. Twenty patients had CNS metastases including 11 with intracranial metastases, eight with spine lesions, and one with both brain and spine involvement. Sixteen had cerebral or cerebellar atrophy of unclear origin and functional significance. Two patients had ventriculomegaly without symptoms of hydrocephalus. Four patients had questionable lesions that were never confirmed. None of the 25 asymptomatic patients with elevated serum tumor markers had brain metastases. Fifteen of 17 patients with focal neurologic deficits and three of six patients with seizures had CNS metastases. CNS imaging to detect germ cell tumor metastases is most useful in the presence of neurologic deficits or seizures but is not useful in patients with unexplained elevation of serum tumor markers in the absence of neurologic deficits.

Adult↗
PubMedDate not supplied

Foci of increased T2 signal intensity on brain MR scans of healthy elderly subjects.

Foci of increased T2 signal intensity were found on brain MR scans in 16 (59%) of 27 healthy elderly volunteer subjects, ages 63 to 86 years old. These foci were not related to cognitive function or cerebrovascular risk factors; instead, they were highly correlated to age, being present in 11 of 11 subjects aged 75 years and over.

Aged↗
PubMedDate not supplied

Cranial MR in spinal cord MS: diagnosing patients with isolated spinal cord symptoms.

MR brain scans, spinal fluid electrophoresis, and evoked responses were obtained in 10 adult patients with isolated spinal cord symptoms diagnosed as possible multiple sclerosis (MS) according to the McAlpine criteria. Typical lesions of MS were found on T2-weighted MR images in six patients. Spinal fluid abnormalities were found in four. Visual-evoked responses or brainstem auditory-evoked responses were abnormal in three. MR in conjunction with spinal fluid analysis supported the diagnosis of MS in eight of 10 patients. Evoked responses appeared less sensitive than MR in identifying subclinical lesions in this population.

Adult↗
PubMedDate not supplied

Cerebral venous distention associated with cardiac failure in infants.

Three infants with congestive cardiac failure demonstrated dilated and hyperdense intracranial veins and sinuses on noncontrast cranial CT. Intracranial venous thrombosis and arteriovenous malformation were excluded in two infants by autopsy and in one infant by MR imaging. We believe the CT findings were secondary to an elevated central venous pressure caused by the cardiac failure. This CT pattern suggests venous congestive failure, and it should alert the clinician and radiologist to the risk of subsequent sinus thrombosis.

Cerebral Veins↗
PubMedDate not supplied

Gd-enhanced MR imaging of acute and chronic experimental demyelinating lesions.

Experimental allergic encephalomyelitis, a demyelinating disease with marked similarity to multiple sclerosis, was produced in two of 12 dogs. All dogs were studied with serial MR imaging. T1- and T2-weighted MR images were obtained both before and after IV Gd-DTPA. Multiple, new periventricular white matter demyelinating lesions were observed after each clinical episode of the disease. Like multiple sclerosis, the acute lesions of experimental allergic encephalomyelitis on T2-weighted MR images were indistinguishable from the older, more chronic lesions. However, after Gd-DTPA, there was bright paramagnetic enhancement of the acute lesions and, in one animal, no enhancement of the chronic lesions on T1-weighted MR images. At necropsy, the differences in the MR paramagnetic enhancement correlated well with the relative histologic age of the demyelinating lesions. Our results suggest that MR with Gd-DTPA may be used to differentiate acute, active demyelinating lesions from the more chronic, inactive lesions in this animal model.

Acute Disease↗
PubMedDate not supplied

Diagnosis of cervical chordoma by fine needle aspiration biopsy.

A case of cervical chordoma diagnosed by fine needle aspiration (FNA) is presented. The cytologic criteria for differentiating chordoma from chondrosarcoma and metastatic adenocarcinoma, the main diagnostic problems, include the finding of physaliferous cells and the presence of bland nuclear features. Significantly, chordomas lack true signet-ring cells. FNA of these rare midline vertebral neoplasms, which produce pain and spinal cord compression, can greatly facilitate diagnosis and optimal treatment.

Biopsy, Needle↗
PubMedDate not supplied

Computed tomography of chiasmal optic neuritis.

Three cases of chiasmal optic neuritis are described with bitemporal visual field loss and enlargement of the optic chiasm as demonstrated by computed tomography (CT). Exploratory craniotomies were performed in two of the patients, but no tumor was found. After corticosteroid treatment, all three patients experienced virtually complete restoration of normal vision. Although the CT presentation in these patients was indistinguishable from that of a chiasmal glioma, the clinical presentation of acute visual loss in an older child or adult should suggest chiasmal optic neuritis. A period of observation, with or without a trial of corticosteroids, might permit the latter diagnosis and obviate exploratory craniotomy.

Adolescent↗
PubMedDate not supplied

Complicated infantile meningitis: evaluation by real-time sonography.

Real-time sonographic findings in 20 infants with bacterial meningitis are reported. The spectrum of features included normal scans, ventricular enlargement, focal areas of increased cortical echogenicity, ventricular bands, and cerebral abscess. Areas of increased cortical echogenicity on sonography representing meningoencephalitis corresponded to areas of contrast enhancement seen on computed tomography (CT). Excellent correlation was found between CT and sonography. Because of the advantage of obtaining sonographic scans at the bedside, it appears that sonography offers an attractive alternative to CT in the evaluation of infantile meningitis and meningoencephalitis.

Brain Abscess↗
PubMedDate not supplied

Melanotic neuroectodermal tumor of infancy.

We present a case of malignant melanotic neuroectodermal tumor of infancy arising in the skull and secondarily invading brain. The central tumor was hyperintense to brain on T1-weighted images and hypointense to brain on T2-weighted images. This appearance corresponded to the surgical and histologic findings of melanin-containing tumor.

Brain Neoplasms↗