Meningitis and spinal subdural empyema as a complication of sinusitis.
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Adult↗
Biomedical subjects
P Anslow
Publications and source records attributed to P Anslow.
The predictive value of high resolution computerized tomography in chronic suppurative ear disease.
High resolution computerized tomographic scanning was used in the preoperative evaluation of 50 patients with chronic suppurative ear disease. The radiological predictions were compared with the operative findings in each case. This form of imaging proved to be highly accurate in depicting the extent of soft tissue within the middle ear cleft and mastoid. With the exception of the long process of the incus and the stapes superstructure, the state of the ossicular chain was correctly predicted in over 90% of cases. Erosion of the labyrinth was clearly depicted in 4 of the 5 cases in which it occurred. A correct pathological diagnosis was made radiologically in 44 cases (88%). The selective use of this modality in the evaluation of patients with chronic suppurative otitis media is valuable.
Adult↗
Neoplastic angioendotheliosis: a case of subacute dementia with unusual cerebral CT appearances and a review of the literature.
A 62 year old woman presented with subacute dementia and hemiparesis which progressed to death with terminal seizures over 5 months. A cerebral biopsy specimen and necropsy showed the features of neoplastic angioendotheliosis which proved to be lymphomatous. Cerebral CT showed multiple low density areas in the white matter with striking enhancement after high-dose intravenous contrast administration. There was temporary clinical improvement with prednisolone therapy. The clinical features, cerebral CT appearances and partial response to treatment are discussed, with a review of the relevant literature.
Brain Neoplasms↗
Subdural empyema--continuing diagnostic problems in the CT scan era.
Fourteen cases of subdural empyema seen in Oxford since the introduction of the CT scanner are reviewed; 11 were male and 12 survived. The clinical presentation was stereotyped and characterised by severe headache, fever and meningism followed after a few days by rapidly progressive drowsiness, focal signs, papilloedema and seizures. All had radiological evidence of paranasal sinus disease (particularly frontal) although this was not apparent clinically in the majority. Plain skull and sinus radiographs remain important early investigations. Over-reliance can be placed on the CT scan which initially may be normal or show only non-specific hemisphere swelling. Parafalcine collections are easily missed. The diagnosis of subdural empyema remains difficult and a high index of clinical suspicion is required. Outcome depends on prompt treatment with parenteral antibiotics and surgical drainage.
Adolescent↗
The radiologic investigation of temporal lobe epilepsy. Value of high resolution CT with temporal orientated sections.
The value of high resolution computed tomography of the temporal lobes using temporal lobe orientated sections and intrathecal contrast is described. The results of this technique are correlated with the pathologic findings in 13 patients subsequently proven to have temporal lobe gliomas. These patients all presented with drug resistant temporal lobe epilepsy and underwent temporal lobectomy. This technique was successful in detecting the tumours in 11 of 13 patients. The average size of the tumours was just over 2 cm. The importance of detecting these small tumours is emphasised because of the profound effect this has on management.
Brain↗
Three-dimensional computed tomography of complex craniofacial fractures.
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Adult↗
Can C.T. detect labyrinthine fistulae pre-operatively?
The aim of the study was to undertake a controlled prospective evaluation of high resolution computerized tomography in the pre-operative diagnosis of labyrinthine fistulae. Fifty consecutive patients with chronic suppurative otitis media were scanned prior to surgery, using a Siemens DRI scanner. The radiological predictions were then compared with the surgical findings. Five patients had labyrinthine erosions and these were predicted in 4 out of the 5 (80%). The one erosion that escaped radiological detection was less than 2 mm in length. The study shows that high resolution computerized tomography is a highly accurate method for demonstrating pre-operatively all but the smallest fistulae.
Adolescent↗
A unique presentation of retroclival chordoma.
Chordomas are rare tumours which arise from remnants of the primitive notochord. They occur primarily in the sacrum, clivus and cervical regions. We report a case of retroclival chordoma which presented as an extradural haemorrhage following minor trauma. The underlying tumour was not apparent on imaging performed immediately following the event, and chordoma presenting in this manner has not previously been described in the literature. The tumour became apparent on subsequent imaging, and progressed despite surgical debulking and radiotherapy.
Adult↗