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Biomedical subjects

R E Osborn

Publications and source records attributed to R E Osborn.

35 records · Page 2Linked to original sources

The MR evaluation of pachygyria and associated syndromes.

A retrospective study of 40 children with some form of pachygyria was performed at the Children's Memorial Hospital in Chicago. All 40 children had MR brain scans. We analyzed the MR findings, and correlated these findings with the clinical symptoms and course in all the children. We have autopsy findings in 15% these children. Based on our clinical, MR and autopsy findings, in conjunction with the medical literature, we found the following: (1) Pachygyria can occur as an isolated entity without an association with lissencephaly. The MR findings in these children consisted of a brain that demonstrated normal opercularization with either focal or diffuse areas of pachygyria without areas of agyria. These children live longer and have less severity of symptoms than the children with lissencephaly. (2) The MR findings in children with lissencephaly consisted of a brain that demonstrated abnormal opercularization with areas of total agyria or areas of agyria with pachygyria. (3) The MR findings in 25% of our children with polymicrogyria simulated pachygyria. The MR findings of the brain in these children consisted of a 'nubby' appearance to the outer surface of these abnormal gyri which resembled pachygyria but on histologic exam was polymicrogyria.

Adolescent↗

Internal carotid artery hypoplasia.

Hypoplasia of the carotid arteries is a rare congenital anomaly which when clinically symptomatic presents as cerebral ischemia or hemorrhage. Patients with this anomaly commonly have associated variations of the circle of Willis, an increased incidence of intracranial aneurysms and extensive networks of collateral vessels to accommodate the diminished carotid flow. Carotid artery hypoplasia should not be confused with other conditions which may have a similar appearance such as arterial dissection, vasculitis, and tubular fibromuscular hyperplasia.

Adult↗

Paraganglioma metastatic to the cervical spine.

Paragangliomas are usually benign tumors which may be locally invasive. Only 10% of these tumors are malignant. When metastases occur the most common sites are lung, liver and bone. When bony metastases occur the spine is a common site. In the present case cervical spine metastases with resultant bony encroachment and epidural extension of tumor with cord compression was diagnosed with myelography and CT.

Cervical Vertebrae↗

Cerebral arterial fenestration.

Fenestration or duplication of a cerebral vessel is a rare congenital variation which most commonly involves the vertebral artery and is usually of no clinical significance. Fenestrations may have associated aneurysms remote to the anomaly or involving the proximal bifurcation of the fenestration. They may also be associated with other vascular malformations e.g. arteriovenous malformations and venous angiomas. Four fenestrated cerebral vessels and their angiographic appearances are reported in this study.

Adolescent↗

Epidural lipomatosis with lumbar radiculopathy: CT appearance.

Epidural lipomatosis is a relatively uncommon clinical entity in which large amounts of fat are deposited in the epidural space. In most of the previously reported cases of this entity an associated myelopathy has been reported. We describe a patient who presented with lumbar radiculopathy, which was probably caused by epidural lipomatosis.

Epidural Space↗

MR imaging of the brain in patients with migraine headaches.

Forty-one patients with migraine headaches were referred for MR imaging of the brain. Intermediate and T2-weighted images were obtained to determine the frequency of areas of high intensity within the white matter. The average age of these patients was 29.8 years; only five were over 40 years old. Each patient was evaluated in the axial plane with long TR/short and long TE images. Twenty-three patients also had T1-weighted short TR/short TE MR scans; enhancement with gadopentetate dimeglumine was used in three patients. Intracranial abnormalities were seen in only six patients: foci or white matter high intensity on intermediate and T2-weighted images in five and a venous angioma in one. Prior studies have indicated that parenchymal brain abnormalities may be found in up to 46% of patients with migraines. The current study demonstrated parenchymal brain lesions in only 12%. This study suggests that the frequency of foci of high intensity seen on long TR sequences in the migraine patient is much lower than previously reported, especially in patients under 40 years old (5.5% in our series).

Adult↗

MR imaging of neuronal migrational disorders.

Neuronal migrational disorders of the brain represent abnormalities in the formation of the neocortex caused by faulty migration of the subependymal neuroblasts. These migrational anomalies include lissencephaly (agyria/pachygyria), pachygyria, schizencephaly, heterotopias, hemimegalencephaly, and polymicrogyria. We used MR imaging (performed on a 0.5-T or 1.5-T scanner) to evaluate 21 patients who had neuronal migratory anomalies. Four patients had lissencephaly, seven had pachygyria, including one patient with hemimegalencephaly, seven had schizencephaly, and three had heterotopias. All MR scans included T1-weighted spin-echo sequences, and seven also had inversion-recovery sequences. The cortical surface, cortex, and gray-white matter interface were well evaluated with both sequences; however, the inversion-recovery images were superior. All but two patients were imaged in both the axial and coronal planes: both projections demonstrated well the migrational abnormalities. MR is an excellent method for diagnosing the migrational anomalies of lissencephaly, pachygyria, schizencephaly, heterotopias, and hemimegalencephaly; it appears to be the imaging method of choice for evaluating these disorders.

Adolescent↗

Median cleft face syndrome: MR and CT data from 11 children.

Examination (including CT and magnetic resonance studies) of 11 unrelated children with median cleft face syndrome revealed 6 (55%) with dense calcification of the falx and 5 (45%) with interhemispheric lipoma. Of the 11 children, 3 exhibited Sedano facies type A, 4 exhibited Sedano facies type B, and 4 exhibited Sedano facies type D. Type A patients had no calcification or lipoma. Two of three type A patients were products of separate twin gestations, the only twins in the series. Type B patients had frequent falx calcification (three of four) and interhemispheric lipoma (two of four). Two of the four type B patients had concurrent Goldenhar syndrome, the only such patients in the series. Type D patients also had frequent falx calcification (three of four) and interhemispheric lipoma (three of four). Patients with median cleft face syndrome and Sedano facies type B or D should be examined radiologically for concurrent intracranial pathology.

Brain Neoplasms↗