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Biomedical subjects

R Oberson

Publications and source records attributed to R Oberson.

At least 37 records · Page 2Linked to original sources
PubMed1976

[Diagnosis of cerebrospinal fluid leakages by gamma-cisternography].

Cerebrospinal fluid (CSF) leakages either secondary (traumatic) or spontaneous (non-traumatic) are first considered in their frequency and origin. The exact topography of the various meningeal and cranial lesions involved are difficult to assess particularly in the most important groups of persistant traumatic CSF rhinorrhea and recurrent meningitis. Among the various diagnostic approaches, direct observation is always necessary, but of limited value. Standard X-rays must be followed by multidirectionnal tomography (Polytome) and, whenever available, computed tomodensitography of the base of the skull. Brain pneumography provides a thorough setting fourth of the congenital or acquired cerebral lesions as well as the new cranio-meningeal conditions. Difficulties encountered with the techniques of subdurography and Pantopaque injection are underlined. Three radioisotope techniques are considered. 1) The earlier technique of cotton-pledgets only shows the external orifice. 2) The recent proposal of nuclide cranial subdurography is criticized for ignoring the leptomeningeal bag. 3) Radioisotope cisternography (RIC) or gamma-cisternography is described more precisely. It remains the most complete and appropriate method for observing the natural behaviour of the leakage. RIC with fistulography is performed through suboccipital injection of 99mTc-DTPA. RIC provides essential clues on the relative importance of associated dynamic disturbances of the third circulation and morphological changes of its anatomical bed (stenoses and widenings of the ependymal and leptomeningeal spaces). If present, the leakage may be directly shown on the RIC pictures. If rhinorrhea is abundant, there is no difficulty in assessing side and site of the fistula. If rhinorrhea is occult, dubious or intermittent, diagnosis is often difficult. There are also indirect signs of rhinorrhea: leptomeningeal dilatation near a frontal or ethmoidal fracture, contamination of the rhinopharynx, examination of the handkerchieves for presence of radioactive material. Statistical results from the literature are summarized in a table.

Cerebrospinal Fluid Otorrhea↗
PubMed1975

[Korsakoff's syndrome and transitory cortical blindness following vetebral angiography].

Neurological complications of vertebral angiography are described with particular emphasis on memory and visual deficits. The material consists of 21 instances of such complications out of a total of 832 vertebral angiographies. A brief account is given of the posterior cerebral artery territory, which makes it possible to establish anatomo-clinical correlations. The pathogeny of the disorder is discussed.

Adult↗
PubMed1975

[Neuroradiologic examinations in ophthalmology].

Radiology can contribute to the solution of numerous diagnostic problems encountered in ophthalmology. Malformations, trauma, tumors and pseudotumors of the orbit and adjacent cranio-facial structures often require well ordered standard and tomographic X-ray techniques. Next in line are important and nonaggressive methods such as bone scintigraphy of the head and brain and orbit scintigraphy. More recently, computer assisted axial transverse tomography has already proved of great assistance. Finally, selective angiography of the branches of the external carotid and of the ophthalmic artery and phlebography of the orbit may be necessary. These techniques are briefly and systematically reviewed.

Angiography↗
PubMed1975

[Abnormal absence of displacement of the cerebral median line].

The angiographic cerebral midline is described. It is pointed out that the midline may be abnormally undisplaced despite the presence of a unilateral or bilateral expansive lesion. The causes of such abnormal non-displacement of the midline are reviewed in the light of examples, and the importance is stressed of bilateral carotid angiograms, sometimes with oblique series, in the case of head injuries and certain tumors.

Adult↗
PubMed1975

[Incidence of extra-arachnoid discharge following lumbar puncture].

Dimer-X is considered a good contrast medium for lumbar myelography. Its physical properties guarantee a homogeneous mixture with cerebrospinal fluid, with the result that postpunctural fluid leakage is easy to detect. One hundred Dimer-X lumbar myelographies were performed with two different spinal needles, a short beveled needle of 1.2 mm outer diameter and a special beveled "Quincke" needle of 0.7 mm outer diameter. Postpunctural fluid leakage is observed in 32% of the cases with the former and in only 12% with the latter. False-route injections occurred in 5% of the cases. Epidural leakage is the most frequent and can be detected by its "Christmas tree" appearance on antero-posterior X-ray. Subdural leakage is represented by a "railroad track" appearance on a lateral view. The leakage is observed more frequently in patients with normal myelogram (28%) than in patients with a herniated lumbar disc (18%).

Cerebrospinal Fluid↗
PubMed1975

[Bone scintigraphy with 99m Tc pyrophosphate in neurology].

99MTc pyrophosphate has restored bone scintigraphy to the position of respectability it had lost with radiostrontium 85 and 87m, and it has rapidly become the method of choice for the detection of osteogenic hyperactivity. In cases of tumor the histologic disorder is frequently detected prior to the morphologic changes seen in X-ray pictures. The biophysical properties of 99mTc pyrophosphate provide high quality imaging of the skeleton. The scans or scintiphotos render possible a more sensitive and earlier diagnosis than radiography, though bone scanning does not of course supersede radiography. The two methods are complementary. In present day oncologic practice, however, bone scintigraphy with 99mTc pyrophosphate replaces to advantage the conventional radiographic "bone survey". In neurology the change is already appreciable and has proved its worth. In the light of results in 78 neurologic patients attention is drawn to the significant changes bone scintigraphy has brought about in diagnosis and therapeutic planning. The indications which have already emerged from this new method of nuclear neurology are tabulated, discussed and illustrated.

Adult↗
PubMed1975

[Variation in the dimensions of the cerebellomedullary cistern after ventriculo-cardiac shunting].

Various morphological changes of the skull and brain were observed after surgical treatment for internal hydrocephalus. An interesting variation is described by the authors, at the site of the cisterna magna, the size of which can vary. Generally it is the last one to dilate when an internal hydrocephalus occurs, but it is the first to regress after inserting a drainage of the cerebrospinal fluid. This behavior of the cisterna magna is discussed, illustrated and reviewed in the literature, after presentation of three clinical histories. From a physiopathological point of view the cisterna magna is considered to be an intermediate formation between the ventricular and the subarachnoid systems.

Adult↗
PubMed1975

[Radiological study of osteoarticular lesions secondary to cervical trauma (author's transl)].

The radiological study of the traumatic cervical spine must often be undertaken in two different ways depending on the time of examination. In patients severely involved, no manipulations can be undertaken during the acute state. Later on in these patients, as well as in those not so deeply involved, a thorough radiological investigation may be performed, e.g. in sitting position. The characteristics of both types are reviewed. Various syndromes are then considered following the different mechanisms of production.

Adult↗
PubMed1975

[Neuroradiological study of traumatic cervical spine (author's transl)].

Only special neuroradiological procedures allow a clear demonstration or exclusion of a traumatic lesion involving or threatening the intraspinal structures. The myelographies are of particular interest. The functional sagittal pneumostratigraphy is the most informative technique, except for the visualization of an avulsion of the plexus. For better selecting the patients for a gas myelography, a scintigraphy of the spinal leptomeningeal bag is very helpful. But the neurological problem may be suspected on the standard X-ray picture. The lateral walls - articular apophyses and the arcus - are well defined. The vascular conditions of the nedk are best appreciated by an arch aortography. A selective study of the carotids and vertebral arteries in functional positions of the head and neck may then proceed.

Angiography↗
PubMed1975

[Cause and treatment of hydrocephalus in newborns and infants].

The history and classification of the various types of hydrocephalus are outlined and the mechanisms as well as causes of infantile hydorcephalus are discussed. Acoording to aetiology the possible operative treatments are described and special mention is made of ventriculocardiac shunting with its indications, advantages and complications. Finally, the results that may be expected from operative treatment of infantile hydrocephalus are studied and the neuropsychological aspect is emphasized.

Cerebral Aqueduct↗
PubMed1974

[Myeloscintigraphy].

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