Search PubMed⌕ Search

Biomedical subjects

S Batnitzky

Publications and source records attributed to S Batnitzky.

At least 19 recordsLinked to original sources
PubMed1995

Synovial cysts of the lumbar spine: diagnosis, surgical management, and pathogenesis. Report of eight cases.

BACKGROUND: Synovial cysts are uncommon extradural degenerative lesions associated with symptoms of lower back pain and radiculopathy. Most of these lesions occur in the lumbar spine at the L4-5 level and to a lesser extent at the L5-S1 and L3-4 levels. METHODS: A retrospective study involving eight patients seen by the neurosurgery service from January 1, 1989, to May 30, 1994, was analyzed. The type, duration, and distribution of symptoms were evaluated, along with the patient's age and sex. All patients had lumbosacral spine x rays and magnetic resonance imaging. Four had a computed tomography-myelogram of the lumbar spine. All patients underwent a laminectomy or hemilaminectomy and cyst excision, and all were followed for a minimum of 1 year. The presence of a synovial cyst was confirmed by histopathology. RESULTS: Of the eight patients, seven had dramatic pain relief with five having complete resolution of pain. The single care of persistent pain was found to be due to scar tissue at the operative site. All five cases of preoperative lower extremity weakness showed complete resolution. Dysesthesia was either unchanged or decreased. CONCLUSIONS: Surgery is a safe, effective treatment for patients with lumbar synovial cysts and is the treatment of choice for these lesions.

Adult↗
PubMed1995

Doppler US of helical flow in the portal vein.

In helical portal venous blood flow, the usual laminar flow in the portal vein is replaced by a spiral. This changes the color Doppler ultrasound (US) appearance to one of alternating or parallel red and blue bands. Duplex US may appear to show hepatopetal, hepatofugal, or simultaneous bidirectional flow depending on placement of the cursor within the helix. Helical portal venous flow is unusual in normal individuals (2.2% of 135 patients). Its presence should prompt further scrutiny for signs of liver disease, particularly portosystemic shunts, as in 20% of 41 patients who subsequently underwent liver transplantation. It is a normal finding immediately after liver transplantation (43% of 35 patients) and transjugular intrahepatic portosystemic shunt (TIPS) creation (28% of 36 patients). In both liver transplant and TIPS recipients, helical flow is usually transient. Its persistence long after transplantation in association with a prolonged increase in portal venous velocity is a useful sign of portal vein stenosis. Helical flow may also occur in cases of neoplastic invasion or displacement of the portal vein.

Blood Flow Velocity↗
PubMed1994

Aneurysm of the left middle cerebral artery caused by myxoid degeneration of the vessel wall.

BACKGROUND: Myxoid degeneration of arterial walls may result in dissection and dissecting aneurysms in extracranial and intracranial portions of cerebral arteries. Rarely, saccular aneurysms may also develop on that basis, but thus far these have only been reported in the cervical portions of the carotid arteries. We describe a case of a nondissecting aneurysm of the left middle cerebral artery caused by myxoid degeneration of the media. CASE DESCRIPTION: A 39-year-old man had acute onset of frontal headache and neck stiffness. Computed tomographic scan and lumbar puncture established the presence of subarachnoid hemorrhage. Angiography demonstrated a left middle cerebral artery aneurysm. This was clipped and the wall biopsied. Microscopically the entire thickness of the vascular wall showed marked myxoid alterations. No dissection was present. The patient had an uneventful recovery. CONCLUSIONS: This observation confirms that myxoid degeneration of arterial walls may cause aneurysms with eventual rupture even in the absence of dissection. Rare cases of this type of aneurysm have been reported to occur in the cervical portions of the carotid arteries, but this is the first reported observation of such changes involving an intracerebral artery.

Adult↗
PubMed1994

Internal carotid artery sacrifice.

Sacrifice of the ICA can be used to treat a variety of conditions. Whenever possible, temporary occlusion of the carotid artery should be performed before the actual sacrifice to evaluate for tolerance to the occlusion. In many cases, endovascular occlusion of the carotid artery is preferable to surgical occlusion.

Adult↗
PubMed1993

Lack of complications in long-term survivors after treatment with Fluosol and oxygen as an adjuvant to radiation therapy for high-grade brain tumors.

PURPOSE: A Phase I/II trial was initiated in 1987 to determine the toxicity/efficacy of the perfluorochemical emulsion Fluosol-DA 20% and 100% oxygen as an adjuvant to conventional radiation therapy for high-grade brain tumors. METHODS AND MATERIALS: Three grade 3 and 15 grade 4 patients received 1 Fluosol administration (8 mL/kg) per week with daily oxygen breathing prior to and during radiation therapy. Megavoltage radiation was delivered to the whole brain at 25 x 1.8 Gy, followed by 10 x 2 Gy to a boost volume, resulting in a total tumor bed dose of 65 Gy in 7 weeks. RESULTS: Of the 18 patients, 10 (nine grade 4, one grade 3) survived more than 1 year postsurgery, six (all grade 4) lived more than 2 years, four of these patients lived more than 3 years, and three patients are alive at times ranging from 250 to 276 weeks. The median survival of the Fluosol group was 75 weeks, not statistically different from 54 weeks for a historical, matched control group. However, a Gehan-Wilcoxon test applied to those patients that survived > 1 year revealed a significant difference (p = 0.0013) in favor of the Fluosol group. Periodic clinical evaluations showed no evidence of any functional or neurological defects that could be attributed to radiation therapy and/or Fluosol. Radiographic studies (computed tomography and magnetic resonance imaging) revealed no structural alterations outside the original tumor volume, and changes within the tumor region were easily assignable to expected effects of tumor, surgery, or radiation alone. CONCLUSION: These results indicate that, although Fluosol/oxygen added to conventional radiation therapy does not enhance survival of patients who succumb to their disease early, it does confer a significant benefit to patients that survive past 1 year. The minimal acute side effects and no long-term deleterious effects suggest that Fluosol/oxygen sensitizes only hypoxic cells, with no effect on well-oxygenated normal tissues within the brain. We have been impressed by the quality of life of the surviving patients following radiation therapy with adjuvant Fluosol+oxygen.

Adolescent↗
PubMed1992

Osteomyelitis of the skull base.

Three cases of osteomyelitis of the skull base with associated problems in diagnosis and therapy are discussed. Patients with atypical skull base osteomyelitis are difficult to diagnose as they have no ear abnormalities, but they often develop multiple cranial nerve deficits mimicking symptoms of a posterior fossa mass. We conclude that computed tomographic scans, magnetic resonance imaging studies, bone scans indium-labeled white blood cell scans, and gallium scans are useful in making the diagnosis. A biopsy of the bony lesion often is needed to identify the causative organism and to rule out a tumor. Intravenously administered antibiotics are the mainstay of therapy and should be continued until 1 week after the gallium scan shows no abnormalities. Follow-up gallium scans then are done at 1 week and 3 months after the cessation of antibiotic therapy to search for a recurrence.

Adult↗
PubMed1991

Wide area networks for teleradiology.

Teleradiology networks transmit digital radiographic images from one location to another. These networks are wide area networks. Teleradiology networks are used for diagnostic purposes and preview tasks. Wide area networks for teleradiology use public service switching. The use of fiber optics networks provide reduced costs and increased flexibility. An example is presented that compares the cost of teleradiology networks.

Computer Communication Networks↗
PubMed1991

Mn[III] uroporphyrin I: a novel metalloporphyrin contrast agent for magnetic resonance imaging.

We have used an intracranial 9L rat brain tumor model to determine whether a novel metalloporphyrin, Mn[III] uroporphyrin I (MnUROP-I), could function as an intravenous MRI contrast agent for brain tumors. In several experiments, 24 male Fischer 344 rats were inoculated intracranially with 9L brain tumor cells. On day 15 postinoculation, animals were anesthetized and the femoral vein exposed. Prior to the intravenous injection of the contrast agent, a precontrast scan (1 Tesla in a standard head coil) was performed. Thirty min after injection of the contrast agent, a postcontrast scan was performed. Although there was only a suggestion of abnormality on the precontrast scans, the presence of tumor was visibility enhanced in the postcontrast scans. In 3 animals scanned at 24 hr postinjection, persistent tumor enhancement was demonstrated. Measured tumor sizes on the MRI scans were consistent with sizes measured at autopsy and histologically. These results demonstrate that MnUROP-I is an effective MRI contrast agent for the detection of an intracranial brain tumor in the rat model.

Animals↗
PubMed1991

Magnetic resonance image abnormality in migraine with aura.

Cerebral magnetic resonance imaging (MRI) was performed on 18 patients with migraine characterized by aura consisting of both visual symptoms and paresthesias. Fifteen headache-free individuals of the same age range were used as controls. Records were randomized and read in blind fashion by two neuroradiologists. Small subcortical white matter lesions were seen in three migraine cases and two controls. In one migraine case cortical infarctions were seen. In two controls, small areas of increased density similar to those in migraine were seen. No consistent correlation of migraine or its duration with cerebral atrophy was found. It is concluded that identification of both these MRI findings (small subcortical white lesions and cerebral atrophy) as significantly associated with migraine is doubtful.

Adult↗
PubMed1990

Pitfalls and differential diagnosis in biliary sonography.

Ultrasonography has a primary role in the imaging of biliary disease. Most cases are straightforward, but the authors emphasize unusual manifestations, uncommon diseases, and artifacts that may present diagnostic challenges. Issues in differential diagnosis are discussed for the following findings: internal gallbladder echoes (calculi vs tumefactive sludge, air, hematobilia, parasitic infestation, cholecystosis, neoplasia, and artifacts), gallbladder wall thickening (acute cholecystitis vs acalculous cholecystitis, artifacts, ascites, hypoalbuminemia, hepatitis, and sclerosing cholangitis), pericholecystic fluid (cholecystitis vs ascites, perforated ulcer, and trauma), bile duct dilatation (biliary obstruction vs sclerosing cholangitis, biliary air, anomalous portal system, biliary atresia, Caroli disease, and cholangiocarcinoma), perinatal and neonatal biliary disease, and sclerosing cholangitis.

Biliary Tract Diseases↗
PubMed1990

Teleradiology: an assessment.

A teleradiology system acquires radiographic images at one location and transmits them to one or more remote sites, where they are displayed and/or converted to hard copy. These systems often employ wide area networks. Their goal is to provide improved radiologic services at all sites on the network. Experience in the use of teleradiology systems has demonstrated the need for a laser film digitizer, an optical disk, and a high-quality display and/or laser film printer at each site. Single-site hardware purchase costs average $196,000, plus an additional 20% for yearly network services. Hardware purchased for a consultation or central referral facility approximates $344,000.

Computer Communication Networks↗
PubMed1989

Diagnostic imaging of spinal trauma.

The radiologist has a pivotal role in evaluation of spinal trauma patients because proper treatment cannot begin before the abnormality is diagnosed. Plain films remain the screening modality of choice, and by understanding the radiographic signs of injury, patterns produced by various traumatic mechanisms can be recognized. As radiologists we can then provide insight to our clinical colleagues into the optimal methods of further investigation. The objective is to eliminate the possibility of further damage and to identify lesions amenable to correction.

Fractures, Bone↗
PubMed1986

Imaging studies in neonatal herpes simplex encephalitis.

Herpes simplex encephalitis (HSE) is the most common form of sporadic encephalitis in man and usually results in death or permanent neurologic deficit. Neonatal HSE does not show the characteristic anatomic localization in the temporal lobe observed in adults and in older children which suggests that the disease process is different in this age group. The abnormalities observed with radionuclide brain imaging and computed tomography (CT) are more diffuse and bilateral. The clinical outcome of the disease is highly dependent on early institution of therapy. Therefore, early diagnosis is critical. Knowledge of neonatal HSE imaging patterns may alert the clinician to the proper diagnosis.

Brain↗
PubMed1986

Radiologic manifestations of delayed radiation necrosis of the brain.

One of the most effective treatment modalities for tumors of the head and neck has been radiation therapy. In a small number of cases, delayed radiation necrosis of the brain is a dreaded and devastating complication of radiation therapy. The imaging studies (radionuclide brain scan, cerebral angiography, computed tomography and magnetic resonance imaging) in 12 cases of histologically proven, delayed radiation necrosis of the brain are analysed. While both computed tomography and magnetic resonance imaging can depict radiation necrosis with great sensitivity, however, the ability of these imaging techniques to differentiate between radiation necrosis and recurrent or residual brain tumor is low.

Adolescent↗
PubMed1985

Computed tomography in the diagnosis of intracranial neoplasms in children.

The authors discuss their original observations using computed tomography (CT) in the diagnosis of posterior fossa neoplasms in children. The subject of CT diagnosis of childhood supratentorial tumors is also reviewed. However, despite the documented value of CT, the authors believe that magnetic resonance imaging (MRI) will eventually offer certain advantages that will make MRI the primary imaging modality for intracranial neoplasms in children.

Astrocytoma↗
PubMed1985

Radiologic guidelines in assessing children with intracranial tumors.

Computed tomography (CT) is currently the primary and generally the definitive imaging modality for the diagnosis, evaluation, and management of intracranial neoplasms in children. The value of CT in the postoperative period is discussed. The role of CT and myelography is stressed in the evaluation of cerebrospinal fluid seeding. CT is also important in demonstrating the iatrogenic disturbances of the central nervous system as a result of radiation and chemotherapy. The authors recommend that CT scans with and without contrast be obtained 2 weeks after surgery and before starting any form of adjuvant treatment. CT slices should be contiguous and 5-mm thick. Subsequent scans should be obtained every 3 to 4 months for the first year and every 6 months thereafter. Where necessary, CT scans after the introduction of intrathecal metrizamide may be necessary to evaluate the lower portion of the posterior fossa and brain stem.

Adolescent↗