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Biomedical subjects

N A Russell

Publications and source records attributed to N A Russell.

At least 19 recordsLinked to original sources
PubMed1994

Adult diastematomyelia.

With modern imaging techniques, various types of spinal dysraphism are being diagnosed in adults with increasing frequency. We report a 42-year-old woman with diastematomyelia whose symptoms characteristically were precipitated by trauma. She exhibited other typical features such as a posterior midline hair patch and vertebral malformations. Metrizamide myelography with computerized tomography showed a bony septum at T11 with a cleft at T9-T11 separating two dural tubes each of which contained a single spinal hemicord. The septum was excised with complete relief of symptoms.

Adult↗
PubMed1988

Multiple noncontiguous fractures of the cervical spine.

Multiple noncontiguous fracture-subluxations of the cervical spine are fractures and subluxations separated by at least one normal intervening cervical vertebra. A review of all 66 consecutive cervical spine fractures treated by the Division of Neurosurgery at the University of Ottawa during 26 consecutive months revealed six such cases (9%). These injuries are more common than previously recognized. Special consideration is required in their treatment because of the presence of a mobile intermediate segment in some of these patients.

Accidents, Traffic↗
PubMed1987

Metrizamide CT scanning in spinal nerve root cysts.

Two cases of lumbosacral root cysts of different etiology are reported. Their specific radiographic features are described using the combined technique of metrizamide myelography followed by computerized tomography of the spine. The terminology of intraspinal cysts is reviewed and their distinguishing features discussed.

Cysts↗
PubMed1987

Interhemispheric subdural hematoma.

Although relatively uncommon, interhemispheric subdural hematoma (ISDH) occurs more frequently than was suspected before the advent of computerized tomographic (CT) scanning. When its mass is sufficiently large to compress the medial cerebral hemisphere, specific focal neurological abnormalities may occur. These include weakness of the contralateral leg, or contralateral hemiparesis with the leg being weaker than the arm. On the unenhanced CT scan ISDH is seen as a crescent shaped, midline hyperdensity. Treatment is dictated by the clinical course. Evacuation of the hematoma by parasagittal craniotomy is recommended if the symptoms are pronounced.

Aged↗
PubMed1987

Intraarterial mitomycin-C for recurrent brain metastases.

Fifteen consenting patients with brain metastases recurrent after cranial irradiation were treated with intraarterial mitomycin-C, 15 mg/m2, administered in a total final volume of 100 ml 0.45% saline over 20 min through a transfemoral catheter with a 0.2-mu in-line filter. There were 2 early deaths (one probably drug-related). Of the 13 evaluable patients, 6 (46%) responded, with both computed tomography (CT) scan and neurological improvement. Median response duration was 25 weeks, and median survival of all 15 patients was 17 weeks. Neurological, ocular, and local skin toxicity were dose-limiting. The degree of toxicity was comparable to that we have noted with other intracarotid regimens, and it appears to be less toxic when infused into the vertebral artery than are most other drugs (although experience is still limited and caution still needs to be exercised). We do not recommend that this replace or be added to cranial irradiation as front-line treatment of brain metastases, but we feel that it is an effective and reasonably well-tolerated regimen for treatment of brain metastases that have recurred after cranial irradiation. We are currently initiating studies of intraarterial mitomycin-C combined with intraarterial cisplatin and teniposide (VM-26) as treatment for recurrent brain metastases.

Adolescent↗
PubMed1987

Spontaneous carotid-cavernous fistula and multiple arterial dissections in type IV Ehlers-Danlos syndrome. Case report.

A 43-year-old woman without phenotypic expression of Ehlers-Danlos syndrome developed a spontaneous unilateral carotid-cavernous fistula (CCF). Attempts at balloon occlusion of the CCF were unsuccessful, and caused multiple arterial dissections and lacerations eventually leading to massive retroperitoneal hemorrhage and death. The CCF was demonstrated during postmortem studies. In addition, the patient had independent dissections of the internal carotid artery at the site of the fistula and an intracavernous aneurysm of the contralateral internal carotid artery. Despite widespread dissections, the major arteries showed only mild histological abnormalities. Morphometric analysis of collagen from the aorta revealed an increase in large-sized fibers, consistent with deficiency of Type III collagen.

Adult↗
PubMed1987

Intraspinal cysts: a classification and literature review.

Advances in radiologic technology have allowed the identification of a variety of cystic lesions of spinal nerve roots. Failure to appreciate the different characteristics of these cysts has led to a confusion in terminology, with different terms often being used to describe the same lesion. In an attempt at clarification, the literature is reviewed and a simplified classification of spinal cysts presented. The distinguishing features of each type of cyst, its investigation, and appropriate treatment are discussed.

Cysts↗
PubMed1986

Hypopituitarism resulting from an intrasellar carotid aneurysm.

We report a 74 year old lady who presented with an exceedingly rare combination of an internal carotid artery aneurysm which was almost entirely intrasellar and associated with hypopituitarism but no neurological deficits. Such a lesion could be misdiagnosed as a pituitary tumour with serious consequences, if surgery is attempted without prior carotid angiography.

Aged↗
PubMed1985

Chronic subdural hematoma mimicking transient ischemic attacks.

A case is reported in which a chronic subdural hematoma caused recurrent episodes of neurologic dysfunction that simulated transient ischemic attacks. Possible pathophysiological mechanisms are: a subdural hematoma could cause local ischemia or focal epileptic discharges; a cerebral mass could cause cortical depression by mechanical stimulation; regional cerebral edema could cause vascular displacement and ischemia; or small repeated hemorrhages could cause transient neurologic deficits. Computer assisted tomography of the head is recommended in the differentiation of the two conditions.

Aged↗
PubMed1984

Familial intracranial gliomas.

The pedigree of two interrelated families with 10 affected members suffering from malignant supratentorial gliomas is reported. In addition, three other unrelated families with two members each who were treated for different types of brain tumors are described. Genetic implications are discussed.

Adolescent↗
PubMed1984

Spinal epidural lipomatosis: a complication of glucocorticoid therapy.

A 21-year-old woman receiving prolonged high dosage glucocorticoids developed spinal cord compression due to excessive accumulation of epidural fat. Computerized tomographic scanning confirmed the diagnosis and revealed a peculiar pattern of spinal cord displacement which we believe to be unique to compression by fat. Laminectomy did not afford relief, possibly because of prolonged neural compression or because of compression at a higher spinal level. Although an unusual complication of Cushing's syndrome, epidural lipomatosis should be considered when such a patient develops symptoms of spinal cord or cauda equina compression.

Adult↗
PubMed1983

Spinal subdural hematoma. A review.

Fifty-eight cases of spinal subdural hematoma were obtained from a review of the literature. Of these, 50 that were reported in detail are analyzed. The data corroborate the opinion that early diagnosis and treatment result in a better prognosis.

Adolescent↗
PubMed1982

Epidural hematoma: report of seven cases with delayed evolution of symptoms.

Epidural hematomas occasionally have a prolonged clinical course with gradual evolution of the neurologic symptoms. Seven such cases are reviewed in this report. Although the clinical course is insidious, there are certain features which should signal the presence of a slowly expanding hematoma. After an apparently minor head injury, the patient who is usually in the younger age group, develops headache. This persists and is accompanied by other non-specific neurologic symptoms which may lead to a mistaken diagnosis of "post-concussion syndrome". Papilledema and focal neurologic deficits eventually appear. Definitive diagnosis is made by the CT scan, although contrast enhancement may be necessary to confirm the nature of the lesion. The treatment is craniotomy and evacuation of the hematoma before serious neurologic deterioration occurs.

Adolescent↗