Solitary osteochondroma of the thoracic spine presenting as spinal cord compression. A case report.
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Biomedical subjects
Publications and source records attributed to R Ethier.
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Five patients with spinal arteriovenous malformations (AVMs) supplied at least in part by the anterior spinal artery were treated by embolization. Complete occlusion of the malformations was obtained without complication in all patients. Improved endovascular treatment of spinal AVMs is now possible with the use of calibrated particles of polyvinyl alcohol, serial digital subtraction angiography, and temporary balloon occlusion of the vertebral artery in cervical AVMs supplied by a pedicle arising from the vertebral artery.
A stereotaxic frame, compatible with digital subtraction angiography, computed tomography, and magnetic resonance imaging, is described along with a set of software programs that run in an independent imaging computer system, as well as in the computers associated with each modality. Plexiglas plates fastened to the sides of the frame contain fiducial markers that can be recognized in the images and from which the section position and in-plane coordinates of any point in the image relative to the frame may be determined. Coordinate measurements of isolated point targets may be made to an accuracy of better than +/- 1 mm within a 15-cm field of view in the plane of the section or projection on all modalities. The stereotaxic system is of sufficiently high accuracy to be used on a routine clinical basis with one or more of the above modalities.
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A case of left carotidocavernous fistula with right exophthalmos is reported. It is the thirteenth reported case in the literature since 1907. Mechanism of the exclusively contralateral exophthalmos is discussed. Temporary venous thrombosis of the ipsilateral ophthalmic vein and inferior petrosal sinus is likely. Successful treatment by detachable balloon with occlusion of the carotid siphon is described.
Early modifications of the flow in the vertebral artery due to subclavian artery stenosis are presented. They have been successfully treated by angioplasty of the subclavian artery. A hemodynamic classification into four types of subclavian artery stenosis is also presented.
We studied 24 patients with autopsy-proven cerebral amyloid angiopathy. Eight patients were demented or had some other medical problem and died of pneumonia or systemic disease. Sixteen patients died of intracranial hemorrhage. Amyloid was found in cortical arteries and arterioles of all patients. CT showed diffuse atrophy in demented patients and intracerebral hematomas in the others. The location and size of the hematoma, with cortical and subarachnoid extension, help to differentiate amyloid angiopathy from other causes of intracranial hemorrhage in the elderly.
The following plain film findings of retrocrural disease were demonstrated by two patients: a) silhouetting, by a soft-tissue density, of a previously seen inner margin of the crus, b) lateral displacement of the crus, c) lateral deviation of the inferior portion of the paraspinal line, and d) abrupt obliteration of the upper portion of a well defined crus.
Twenty-seven patients with epilepsy as the only manifestation of a cerebral AVM were seen at the MNI/MNH from 1973 to 1981. The nine females and eighteen males between the ages of fourteen and fifty-four years (mean 25.2 years) had epilepsy for an average of 3.5 years prior to the diagnosis of AVM. Seven patients had primarily generalized seizures, ten patients had partial seizures with complex symptoms, fourteen patients had partial seizures with elementary symptoms, and thirteen patients had secondarily generalized seizures. Although there was no history of intracranial hemorrhage, seven patients had negative hemispheric signs (hemiatrophy, hemianopia, dysphasia, hemiparesis), two had impaired mentation, and two were ataxic. The EEG, normal in ten cases,showed non-epileptiform activity in six cases, and focal epileptiform activity in eleven cases. Angiographic and/or histological examination revealed eight small (less than 2 cm in diameter) and nineteen large lesions. Fifteen AVMs involved the frontal lobe, ten the temporal lobe five the parietal lobe, and one the occipital lobe. Angiography failed to demonstrate three frontal and three temporal AVMs. Plain CT scanning demonstrated a high or low density lesion without a mass effect in sixteen cases, enlargement of the ipsilateral ventricle or Sylvian fissure in seven cases, and diffuse ventricular enlargement in three cases. CT scanning was performed after the intravenous injection of contrast material in nineteen cases and demonstrated vascular enhancement in fifteen cases and an abnormal blood vessel in six cases. Two angiographically occult AVMs demonstrated vascular enhancement with infusion CT scanning, thereby demonstrating the vascular nature of the lesion where angiography had failed to do so.
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Eight patients with a histologically proven angiographically occult arteriovenous malformation of the brain had plain and infused computed tomographic (CT) examinations. In five cases angiography revealed a hypovascular mass in three cases the angiogram was normal. On CT examination a high density lesion (six cases) and ventricular asymmetry (five cases) were demonstrated. In three patients presenting with intracerebral hemorrhage, the high density appearance and ventricular compression were accounted for by the presence of hematoma. In three of five seizure patients the high density lesion was associated with calcification while ipsilateral (one case) and contralateral (one case) enlargement of the lateral ventricle was seen. In five of the eight cases the vascular nature of the lesion was suggested by vascular enhancement of the infused CT scan. Glioma was a common misdiagnosis.
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During a two year period, March 1977 to April 1979, a total of 92 bovine abortions were studied. The cause of abortion was determined in 34.8% of the cases examined. Opportunistic bacteria, the most commonly diagnosed cause of abortion, accounted for 31.2% of the cases. Leptospirosis was associated with 28.1% of the abortions, infectious bovine rhinotracheitis and fungi in respectively 15.7%, bovine viral diarrhea in 6.2%. A congenital abnormality accounted for one case (3.1%). In 23 cases (25%), there was no definitive diagnosis, in spite of evidence of experience with pathogen or suggestive findings of pathology, but insufficient evidence to warrant diagnosis. No findings were recorded in 35.8% of the (possibly noninfectious) cases and in only four cases (4.4%), specimens were unsatisfactory for examination.
Multiplanar image reconstruction involves the reconstruction of sagittal, coronal or oblique views form a series of transverse computerized tomography images without exposing the patient to more radiation. The technique, especially when used in conjunction with high-resolution scanning, is invaluable in the diagnosis of lesions within the orbit. This paper deals with the clinical application of this new technique.
Thirty-two cases of documented cervical syringomyelia, 13 of which were already surgically proven, were explored by high resolution computed tomography (CT). A central cavitation was demonstrated in all cases. High resolution CT appears to be more reliable than myelography and should be the examination of choice in cervical syringomyelia.
Computed tomography of the spinal cord was a natural development of total body scanning. Much time and effort was spent in order to visualize the spinal cord and the various conditions affecting it. This was achieved by using an EMI CT5005 scanner and a series of step by step modifications and improvements to obtain a very high degree of resolution. The large variety of intraspinal lesions seen at the Montreal Neurological Hospital allowed us, by selecting appropriate cases, to determine the value of CT of the spinal cord.