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Biomedical subjects

P W Cooper

Publications and source records attributed to P W Cooper.

At least 37 records · Page 2Linked to original sources
PubMed1984

Spinal injuries due to hockey.

Although many types of sports and recreational activities have been identified as common causes of acute spinal cord injury, hockey has been a rare cause of acute cord injury in Canada or elsewhere. For example, from 1948 to 1973 there were no patients with cord injuries due to hockey in a series of 55 patients with acute cord injuries due to sports or other recreational activities admitted to two Toronto hospitals. In contrast, between 1974 and 1981, the Acute Spinal Cord Injury Unit, Sunnybrook Medical Centre treated six patients with cervical spinal injury due to hockey, five of whom were seen during a 13 month period from September, 1980 to October, 1981. Five of the six sustained a severe acute cervical spinal cord injury, and one a cervical root injury. The cord injury was complete in two cases, while three had complete motor loss but incomplete sensory loss below the level of the lesion. All were males aged 15 to 26 years. Of the players with cord injury, four struck the boards with the neck flexed, and one struck another player with the neck flexed. The one player without cord injury struck the boards with his neck extended. The commonest bony injury was a burst fracture of C5 or C6. One of the patients with a complete cord injury died three months later of a pulmonary embolus, and the other patients with cord injury showed some recovery of root function, but little or no cord recovery. The reasons for the increase in spinal injuries in hockey are unknown.

Adolescent↗
PubMed1984

Neurologic complications associated with gold therapy for rheumatoid arthritis.

Neurologic complications of gold are rare and include peripheral neuropathy, a Guillain-Barré-type syndrome, cranial nerve palsies and encephalopathy. Three cases of cranial neuropathy complicating chrysotherapy for rheumatoid arthritis are described. One also had a sensorimotor neuropathy associated with segmental demyelination and axonal degeneration, and another developed an encephalopathy which, on contrast enhanced computed tomographic scanning, showed reversible cerebral and cerebellar white matter lesions. Early recognition and prompt withdrawal of chrysotherapy are the mainstay of management of this lesser known complication.

Adult↗
PubMed1983

Squamous cell carcinoma arising in a suprasellar epidermoid cyst. Case report.

A case is presented in which a squamous cell carcinoma developed in an intracranial epidermoid cyst. The patient was a 54-year-old woman with a 3-year history of depression and amblyopia; no focal findings were noted and she was diagnosed as having psychiatric disorders. On her final admission she showed clinical evidence of a rapidly growing intracranial mass. Computerized tomography (CT) identified a right parasellar and temporal lesion which was then incompletely removed. The literature on primary intracranial squamous cell carcinoma is reviewed, and the role of CT scanning in preoperative diagnosis of this lesion is discussed.

Brain Neoplasms↗
PubMed1983

A computed tomographic study of nasal mucosa: effects of vasoactive substances.

Computed tomographic studies of mucosal responses to vasoactive substances (xylometazoline and histamine) in healthy nasal cavities of adult subjects demonstrate the distribution of erectile mucosa. Following artificial congestion of the mucosa by local application of histamine: (1) the middle turbinate and the body of the inferior turbinate limit the main nasal airway as it passes through the middle meatus; (2) an expanded mass of localized erectile tissue in the anterior septal region bars the entrance to middle meatus and intrudes medially into the narrow airway of the piriform aperture and nasal valve; (3) this critical segment of the airway is further limited by forward extension of the anterior tip of the inferior turbinate.

Adrenergic alpha-Agonists↗
PubMed1983

CT of the nasal cavity.

CT demonstrates nasal anatomy extremely well. The intimate relationship of the nasal cavity to the cerebral, orbital, paranasal sinus, nasopharyngeal, and oral tissues is noted. Examples of benign and malignant neoplasms, inflammatory processes, including intrinsic and extrinsic mass lesions are utilized to demonstrate the value of CT in assessing the nasal cavity in conjunction with its surrounding tissues. Congenital and traumatic lesions also are demonstrated to the same advantage.

Diagnosis, Differential↗
PubMed1983

CT in facial trauma.

Recent advances in high resolution CT imaging have provided marked improvement in bone imaging. Complex facial fractures, especially those associated with craniocerebral or spinal injuries, are better and more safely assessed by CT. Degrees of comminution, previously grossly underestimated by conventional radiography, are more accurately assessed by CT. The transaxial axis remains the dominant modality and superbly demonstrates displacements. Complications to soft tissue structures (orbit, brain) are diagnosed at the time of study and provide information often not obtainable by other modalities. High resolution CT has become our definitive study of complex facial fractures involving the mid or upper thirds of the facial skeleton.

Accidents, Traffic↗
PubMed1983

CT of the cranium in head injury.

Computed tomography (CT) allows fast, accurate diagnosis of intracranial bleeding so that the role of cerebral angiography in acute trauma is now quite limited. Management of the patient with multiple injuries including head injury may differ from that of patients with head injury alone. Several different intracranial abnormalities may occur immediately after injury and during the following few days, including intracranial bleeding and edema. CT is of great help in following the clinical course of such patients.

Adult↗
PubMed1983

Radiologic studies of facial trauma associated with a regional trauma centre.

The study of severe facial trauma has been altered by the development of computed tomography (CT). As a regional trauma unit we have gained increasing experience with complex fractures of the face. In those patients most severely injured, high resolution CT has become the imaging modality relied upon to offer the safest and most accurate information. Conventional films still have a role, especially in the less severely traumatized patient. We describe our methods and observations, based upon experience at a trauma unit, in the radiologic investigation of facial injuries.

Accidents, Traffic↗
PubMed1983

Radiology of spinal trauma--practical experience in a trauma unit.

The early diagnostic management of patients with acute spinal canal trauma may be among the most difficult injuries referred to a trauma centre. No standardized protocol exists. Radiographic examinations commence with plain films, including special views. Further radiographic studies, if required, vary and include CT, myelography and conventional tomography. CT and metrizamide myelography are complementary. In more complicated fracture-dislocations, all of the above investigations may be necessary. Recent advances, including water-soluble contrast media, the lateral C1-2 puncture and CT, now offer faster, safer and more thorough follow-up investigations with less radiation exposure. Patients with multiple injuries, previously considered too severely injured to undergo further neurologic investigations, may now be more adequately assessed early in the acute phase of injury such that appropriate surgical decompression or stabilization may be performed. The maximum attainable neurologic improvement for such individuals may be better realized with the improved radio-diagnostic capabilities available.

Diagnosis, Differential↗
PubMed1982

Sophisticated CT in complex maxillofacial trauma.

Conventional radiology and selective complex-motion tomography suffice for the diagnosis of isolated facial fractures. Complex facial fractures, however, require a more directed diagnostic approach, utilizing the imaging potential of computed tomography (CT). In the acutely injured but stable patient, unenhanced axial CT (preview-monitored under clinical orientation) provides the most effective, safe, reasonably rapid diagnostic examination. Direct coronal CT can also be utilized. The brain is studied by contiguous 10 mm slices; the facial skeleton is studied with contiguous 5 mm slices, which permits coronal and sagittal reformations. In suspected cervical spine injury (where direct coronal CT is contraindicated), the axial CT format above will provide essential diagnostic information and allow image reconstruction. The late complications of brain abscess and CSF leak are well imaged by CT; the latter is best assessed (during activity) by preview-controlled CT after intrathecal injection of metrizamide.

Brain Injuries↗
PubMed1982

High resolution computerized tomography in otorhinolaryngology.

Since the initial application of CT to otorhinolaryngology in the 1970's, marked improvements in computed tomographic technology have occurred, especially in the past 2-3 years. Further improvements in density and spatial resolution have resulted in high resolution images of either soft tissue or bony structures. Faster scanning times (5-10 seconds for high resolution images) have allowed studies of areas where motion artifact previously existed. Thinner slices (1.5 mm) and extended bone windows have allowed markedly improved bone detail, especially of the temporal bone. Digital computed radiographs can offer a preliminary overview, allowing improved active radiologic monitoring. Reformatted images in axes not able to be directly scanned have also improved. These improvements have resulted in newer widespread applications of CT to study otorhinolaryngologic disease, with CT often the definitive study.

Craniocerebral Trauma↗
PubMed1982

Computed tomography and cerebrospinal fluid leak.

Cerebrospinal fluid (CSF) rhinorrhea is a serious condition which if untreated may lead to meningitis. Detection of the leak site at surgery may be difficult without prior accurate radiological localization of the leak and at times repeat operation has been required. Clinical and radiological localization of the leak is not always easy and many different tests have been tried. Prior to computed tomography (CT), the most common combination of radiological tests were plain films and tomograms of the skull and CSF isotope studies. Although CT scanning may be helpful in assessing a patient with CSF rhinorrhea, it is most effective when combined with intrathecal Metrizamide. The combination of Metrizamide and CT was first reported in 1977 and several case reports and small series of cases have since been reported. The purpose of this article is to review the value of CT especially when used in combination with Metrizamide in the patient with CSF leak and also to discuss the technique of the combined study and to show its value with illustrative cases.

Adult↗
PubMed1981

Positive contrast cisternography: analysis of 1) false negative studies, 2) false positive diagnoses of acoustic neuroma.

In performing and interpreting positive contrast cisternograms, one must be aware that both false negative and false positive studies are possible. The former may be avoided by an appreciation of normal anatomical variants of the cisterns and by adequate projections. The false positive study in which a lesion other than an acoustic neuroma is found, is mainly a problem where there is non-filling of the internal auditory canal without a significant angle mass. The differential diagnosis of such lesions is discussed.

Adult↗
PubMed1977

Symptomatic intracranial steal.

The phenomenon of shunting of blood in association with various intracranial lesions is well known; however, usually clinical symptoms are attributable to the lesion and not to the redistribution of regional cerebral blood flow (rCBF). We report three patients investigated by angiography and rCBF studies in whom symptoms appeared to be due to a hemodynamic steal within one cerebral hemisphere, between hemispheres, and from the brain into a tumor, respectively.

Adult↗
PubMed1976

Cerebral blood flow changes in cluster headache.

Serial cerebral blood flow studies performed by the intra-carotid 133Xenon method were fortuitously determined during the course of a cluster headache in a 32 year old man. The initial study was performed about 10 min after the headache began and showed values at the upper limit of normal. Twenty min after the headache started a second procedure showed that the autoregulatory response on hyperventilation was normal. Ergotamine tartrate was given intra-muscularly 23 min after the headache began and there was partial relief. A third cerebral blood flow estimation showed abnormally high values. The probable reasons for this are discussed.

Adult↗
PubMed1976

Anatomic variants of the cerebello-pontine cisterns and their significance in positive contrast cisternography.

Far lateral extension of the cerebello-pontine cistern is a common variant which is found in greater than 50% of people. When present it may cause the internal auditory canal to be obscured during positive contrast cisternography. A technique of cisternography is described which facilitates the diagnosis of intracanalicular lesions as well as better delineating small lesions in the cerebello-pontine angle.

Brain Neoplasms↗
PubMed1975

Changes in cerebral blood flow during a migraine attack.

Regional cerebral blood flow studies during a typical prodromal phase of a migraine attack in a young woman showed a global decrease of cerebral blood flow in the carotid artery territory. These studies were repeated during the subsequent headache phase of the same attack and hemispheric blood flow increased considerably. Ergotamine tartrate was then administered intramuscularly which brought definite relief of symptoms but no change in cerebral blood flow. Carotid angiography performed immediately afterwards showed retrograde filling of the proximal portion of the basilar artery, which suggested that the brain stem was the site of hyper-perfusion. These findings illustrate certain features underlying both the pathophysiology of migraine itself and its response to ergotamine preparations.

Adolescent↗