Computed tomography of the adult spine: non-traumatic conditions.
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Abscess↗
Biomedical subjects
S Cronqvist
Publications and source records attributed to S Cronqvist.
Iohexol in cerebral angiography. Survey and present state.
The non-ionic contrast medium iohexol has in 15 trials been extensively studied with regard to its use in cerebral angiography. In comparison with mainly the ionic contrast media there was a tendency for iohexol to less frequently cause subjective sensations of warmth and pain. There was a marked difference in the intensity of these sensations, those after iohexol injection being definitely less severe. No severe reactions, whatsoever, could be related to the new contrast medium, and it can be concluded that iohexol with great advantage can be used for cerebral angiography.
Blood Pressure↗
[Early surgery of ruptured intracranial aneurysm, after subarachnoid hemorrhage, improves the result].
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Humans↗
Treatment of severe cervical spine injuries by anterior interbody fusion with early mobilization.
A follow up study of 24 patients treated for severe injury of the cervical spine is presented. The dislocation was initially reduced by skull traction, which was later replaced by anterior fusion using a tibial graft. Solid fusion occurred in all patients. The neurological improvement was unaffected by the operation. Our conclusion is that anterior fusion as opposed to conservative treatment leads to earlier mobilization, shorter hospitalization, and less costly rehabilitation.
Adolescent↗
Diagnostic difficulties in computed tomography of brain abscesses.
In a series of 26 patients with the final diagnosis of brain abscess, 24 initially presented with ring lesions on computed tomography (CT) and two with homogeneous areas of increased attenuation after intravenous contrast medium administration. Twelve had a finding, reported to be characteristic, with a center of low attenuation encircled by a smooth, thin contrast enhancing ring surrounded by marked edema. In 10 patients, the true nature of the lesion was not evident from the first CT examination. An atypical appearance with a thick walled irregular ring or areas with homogeneous increased attenuation indicated malignant tumor. Rapidly progressing changes of the CT appearance and/or supplementary clinical data permitted us to reach the exact diagnosis in most of these. Repeat studies were also valuable in the follow-up during and after conservative (antibiotic) or surgical treatment.
Adolescent↗
Intracranial myeloid metaplasia in myelofibrosis.
In a man aged 62 years with a 14-year-history of polycythaemia vera progressing into a myelofibrotic stage symptoms and signs of an intracranial tumour with increased intracranial pressure developed. CT scan as well as angiography of the right internal carotid artery revealed richly vascularized masses within the meninges. The patient died in endocarditis and progressive heart failure and at autopsy the intracranial masses were shown to be due to meningeal myeloid metaplasia. The literature is reviewed and it appears that myeloid metaplasia within the central nervous system might be more common than has been hitherto anticipated. A CT scan is to be recommended in myelofibrosis whenever symptoms and signs suggesting intracranial disease are present.
Brain Diseases↗
Cerebral angiography with iohexol. A multicentre clinical trial.
An open multicentre clinical trial with the new non-ionic contrast medium iohexol is reported. A total of 38 adult patients were included in the series. No serious side effects or complications occurred. The impression was that subjective reactions were less marked with iohexol than what is usually observed with conventional ionic contrast media.
Adult↗
Early management of aneurysmal subarachnoid hemorrhage.
The Lund Clinic serves a population of 1.46 million inhabitants. During the calendar year 1981, 72 patients presented with a ruptured supratentorial aneurysm, diagnosed either at angiography or at autopsy. Upon admission, 60% of the patients were in good condition and 40% were in poor condition. Eighty-three per cent were admitted within 72 hours after the subarachnoid hemorrhage (SAH). In the total series, 50% made a good recovery; the overall management morbidity was 19% and the management mortality was 31%. Thirty-one patients in Grades I-III underwent early operation (43% of the total series), with a favorable outcome in 74% and 7% mortality. Of the 35 patients who were admitted early and in good condition, 71% made a good recovery, and the management mortality was 9%. These figures may be compared to the 51% favorable outcome and 27% mortality reported from the Cooperative Aneurysm Study with late operation. In the early operation cases, the incidence of significant arterial narrowing at postoperative angiography performed on Day 9 +/- 2 after SAH was 30% and the incidence of permanent neurological deficits of delayed onset was 10%. Two of the early operation patients developed permanent symptomatic hydrocephalus.
Adult↗
Carotid fibromuscular dysplasia and paresis of lower cranial nerves (Collect-Sicard syndrome). Case report.
A patient suffered the acute onset of unilateral pareses of the ninth through 12th cranial nerves (Collet-Sicard syndrome). Ipsilateral retrograde jugular phlebography and carotid angiography revealed irregular aneurysmal changes of the internal carotid artery at the base of the skull, causing compression of the internal jugular vein below the jugular foramen. This finding is discussed in relation to the clinical symptoms and signs, and possible mechanisms are examined. Family history as well as the clinical and roentgenological findings were compatible with a diagnosis of fibromuscular dysplasia.
Adult↗
Cranial computed tomography of patients with malignant melanoma.
Sixty-eight patients with malignant melanoma were examined by CCT and the findings analyzed. Cerebral metastases were detected in 19 patients. Meningiomas were found in three patients, one with neurological symptoms and two without. Typical metastases less than 10 mm in diameter were located superficially in the grey matter, regular, homogenous, hyperdense, with no edema. Extensive peripheral edema was often associated with metastases measuring more than 10 mm. CCT revealed cerebral metastases in 6 (13%) of 46 asymptomatic patients. The metastases measured less than 10 mm in four and less than 20 mm in two of these patients. Scintigraphy was falsely negative in six patients with metastases smaller than 10 mm. Therefore, CCT is the method of choice for screening asymptomatic patients. Angiography may be of value in the differentiation between meningioma and melanoma metastases.
Adult↗
Doppler examination of the carotid arteries. A comparative study with angiography.
The ability of Doppler ultrasound to detect extracranial carotid arterial disease was evaluated in 148 carotid arteries, examined also angiographically. A continuous wave, directional Doppler with zero-crossing meter was used. Doppler diagnosis was based on direct examination of the carotid bifurcation. Of four quantitative variables evaluated, only the end-diastolic ICA/CCA frequency ratio was found to be useful. In stenoses exceeding 75% a deranged Doppler recording was obtained. For stenoses greater than 50% or occlusion sensitivity was 98.3%, specificity 96.6% and over-all accuracy 97.3% with the direct examination technique. Corresponding figures for an indirect Doppler test (frontal artery flow) were 45.8%, 100% and 78.4%. Stenoses less than 50% could not be separated from normal vessels. Direct Doppler examination with a zero-crossing detector is reliable, provided that the limitations of the frequency analysis are considered.
Adult↗
Stereotactic lesions studied by computer tomography.
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Amygdala↗
Significance of tortuous filling defects at lumbar myelography.
At lumbar myelography, tortuous filling defects frequently occur in the presence of a marked local narrowing of the spinal canal. This may lead to a displacement and compression of nerve roots, which may partially or completely fill the subarachnoid space. However, truly elongated nerve roots have also been observed, both at myelography and at operation. Such elongation appears to be a congenital malformation. The recognition of the true nature of tortuous filling defects is important with regard to differentiation against arteriovenous malformations and congested veins.
Cauda Equina↗
Pulsatile tinnitus and therapeutic embolization.
Fifteen patients with disabling pulse-synchronous tinnitus were investigated with super-selective angiography demonstrating an arteriovenous malformation in 8 cases, chemodectoma of the jugular bulb in 3, and a local arterial stenosis in one case. In 12 of these cases the murmur could be registered objectively, while in the 3 cases with a negative angiographic finding no such murmur could be heard, an observation which may be of importance when selecting patients for further angiographic examination. The cases with a tumour and those with an arteriovenous malformation were all treated with gelatin sponge embolizatioected cases embolization is recommended alone or in combination with surgery.
Adult↗
Neurocirculatory analysis of potential EIAB patients.
Twelve patients with gross vascular occlusions and with infarcts demonstrated in CT were examined with regard to their hemodynamic situation. Angiography and rCBF with intra-arterial and inhalation techniques were performed. Response to increased arterial hypertension and to CO2 inhalation was tested. It is concluded that one technique alone does not provide enough information for the selection of patients suitable for EIAB operation.
Brain Ischemia↗
On cerebral infarction in childhood and adolescence.
This report is based on a retrospective analysis of clinical and angiographic findings in 14 children and adolescents suffering from cerebral infarction. They were all examined during the acute stage and selective angiography was performed within a day or two of the stroke. Pathogenesis is discussed and focuses particularly on the occurrence of segmental arteritis from unknown (infectious?) aetiology.
Adolescent↗
Therapeutic embolization in the external carotid artery region.
Therapeutic transcatheter embolization with spongostan in the region of the external carotid artery has been employed in 17 patients, in some of them on several occasions. The technique is presented and different means of avoiding complications are discussed in detail. Embolization has been used preoperatively and as the single mode of treatment of ENT tumours or meningeomas, and also as the only treatment in arteriovenous malformations. The technique has proven particularly useful in preoperative de-arterialization of ENT tumours when surgery follows in 1 to 2 days. In cases with arteriovenous shunts, a subjective improvement has been achieved.
Adolescent↗
Pattern of radioactivity in the CSF after intravenous injection of 99mTc.
It has been shown that intravenously injected pertechnetate enters to CSF space and also that a transport of pertechnetate ions to the blood occurs when injected into the ventricles. Activity curves obtained by repeated samplings of CSF after intravenous injection of pertechnetate appears to differ at different levels of the intraventricular pressure but also in patients with different types of intracranial pathology, i.e. in patients with ventricular dilatation due to hydrocephalus and due to cerebral atrophy.
Brain Diseases↗