Search PubMed⌕ Search

Biomedical subjects

S H Cornell

Publications and source records attributed to S H Cornell.

At least 19 recordsLinked to original sources
PubMed1994

Diagnosing intracranial vasculitis: the roles of MR and angiography.

PURPOSE: To describe our experience with MR and angiography in diagnosing intracranial vasculitis and to test the hypothesis that MR can be used to screen for patients unlikely to have vasculitis. METHODS: Ninety-two patients who had angiography with "exclude vasculitis" as the indication or who had angiography and a clinical diagnosis of vasculitis were identified. Angiograms of all 92 patients and the MRs of the 70 patients who had both studies were reviewed. RESULTS: Eleven patients had intracranial vasculitis. Angiography showed characteristic changes in 8. MR, performed in 9 of 11 vasculitis cases, was significantly abnormal in all 9. Among 70 patients who had both studies, 19 had MR that was completely normal or showed only incidental findings. None of these 19 was diagnosed with vasculitis. The diagnostic yield of angiography performed to exclude vasculitis was only 6%. CONCLUSIONS: Evaluation for intracranial vasculitis should include MR. A negative MR excludes intracranial vasculitis more definitively than does a negative angiogram and makes the likelihood of finding vasculitis with angiography negligible.

Adolescent↗
PubMed1991

Time course of satisfaction of search.

"Satisfaction of search" (SOS) refers to the effect in which a second lesion remains undetected after detection of another lesion on the same radiograph. The objective of this study was to clarify our understanding of SOS by relating it to total time of inspection and time intervals before, between, and after discovery of lesions. Detection accuracy of native lesions in chest radiographs, before and after the addition of a simulated nodular lesion, was measured for ten observers. Analysis of data from this and a previous experiment showed that average perceptual accuracy of individual receiver operating characteristic curves was significantly reduced with the addition of the nodules. Plots and analyses of search time revealed that, on average, during a typical 46-second inspection of a case, simulated nodules were found at 18 seconds, native abnormalities at 25 seconds, and false positives occurred at 33 seconds. Time needed to find nodules did not depend on whether native lesions were present; time to find native lesions did not change with addition of nodules; and total search time was the same for images with one, two, or no lesions. The detection results show that the SOS effect was obtained, but that interrupting search in order to measure it also diminishes accuracy. Analysis of the time course data relates SOS to perceptual capture and strategic halting of search.

Diagnostic Errors↗
PubMed1991

Establishment of a reference interval for beta 2-microglobulin in cerebrospinal fluid with use of two commercial assays.

Increased concentrations of beta 2-microglobulin in cerebrospinal fluid have been used to detect central nervous system involvement with metastatic cancer and with neurological complications of AIDS. However, no adequate reference interval study has been reported for beta 2-microglobulin in cerebrospinal fluid. We established a reference interval with both the Abbott IMx microparticle enzyme-linked immunoassay (EIA) (0.6-2.0 mg/L) and the Pharmacia beta 2-micro EIA 96 method (0.8-2.2 mg/L) for beta 2-microglobulin in cerebrospinal fluid. The two methods correlate well, with the latter method giving slightly higher values. beta 2-Microglobulin increases with age in adults by about 0.1 mg/L every 7.5 years, with no significant difference between genders.

Adult↗
PubMed1988

Magnetic resonance imaging in young adults with cerebral infarction due to moyamoya.

The number, size, and location of cerebral infarctions, and blood flow in the middle cerebral artery as seen on proton magnetic resonance imaging were assessed in six white adults with angiographically documented moyamoya. Findings were correlated with clinical presentation, computed tomography, and angiography. Large hemispheric infarctions were found in five hemispheres, predominantly in watershed regions. Subcortical infarctions (n = 56) were found in all hemispheres. They were predominantly located in the centrum semiovale, in the distal beds of supply of the penetrating branches of the anterior and middle cerebral arteries. Infarction of the putamen was found in three hemispheres, caudate nucleus in four, globus pallidus in two, and anterior limb of the internal capsule in two. There were none in the posterior limb of the internal capsule, thalamus, brain stem, or cerebellum. Middle cerebral artery flow was visualized as a signal-void flow sign in only three hemispheres. Cerebral infarctions due to moyamoya are bilateral, multiple, often small, and asymptomatic, affecting predominantly the carotid circulation in watershed regions. Subcortical infarctions in the centrum semiovale and large hemispheric infarctions in hemodynamically compromised areas are the predominant findings.

Adolescent↗
PubMed1987

Global aphasia without hemiparesis.

Three patients acutely developed global aphasia, but did not manifest the typical accompanying right hemiparesis. Computed tomography and magnetic resonance imaging studies demonstrated that the patients had two discrete left hemisphere lesions, one in the anterior language cortices or language-related subcortical areas, and one in the posterior language cortices. Cerebral angiography showed that two patients had complete occlusion of the left internal carotid artery, and the third had an intraluminal "clot" in the supraclinoid portion of the left internal carotid, findings suggestive of an embolic etiology. Our cases indicate that global aphasia without hemiparesis predicts two discrete lesions and a particularly good recovery of speech and language.

Adult↗
PubMed1987

Management of radiation-induced accelerated carotid atherosclerosis.

Patients with long survival following cervical irradiation are at risk for accelerated carotid atherosclerosis. The neurologic presentation in these patients mimics naturally occurring atheromatous disease, but patients often present at younger ages and with less concurrent coronary or systemic vascular disease. Hypercholesterolemia also contributes to this accelerated arteriosclerosis. Angiographic findings in this disorder include disproportionate involvement of the distal common carotid artery and unusually long carotid lesions. Pathologic findings include destruction of the internal elastic lamina and replacement of the normal intima and media with fibrous tissue. This article describes two surgical patients with radiation-induced accelerated carotid atherosclerosis who typify the presentation and characteristics of this disease.

Adult↗
PubMed1985

Aphasia following pluridirectional tomography with metrizamide. The effect of patient position.

Eight of 67 patients became transiently aphasic after myelography or cisternography with metrizamide. All eight patients had been placed in the left lateral decubitus position for pluridirectional tomography. Immediate EEGs revealed focal left-sided abnormalities in two patients. In one other patient, a computed tomographic scan showed contrast mainly over the left hemisphere. All of the symptoms resolved within 48 hours. In 34 patients who were placed on the right side, no language disturbance was noted. Aphasia after pluridirectional tomography with metrizamide may be due to local irritation of the perisylvian language centers of the dominant hemisphere. The phenomenon is distinct from syndromes of generalized confusion. The complication may be avoided by placing patients in a right lateral decubitus position for pluridirectional tomography.

Adult↗
PubMed1982

Intracranial hemorrhage produced by spontaneous dissecting intracranial aneurysm.

Two patients with intracranial dissecting aneurysms were seen initially because of acute hemorrhage. One patient died, and a false dissecting aneurysm secondary to atherosclerosis was found at autopsy. In the other patient, the appearance of the carotid arteriogram was typical of a dissection. Because of the propensity of these aneurysms to rupture, caution is indicated in the use of anticoagulants or vasopressors in patients with evolving cerebral infarction secondary to intracranial arterial dissection.

Adult↗
PubMed1982

The varied computed tomographic appearance of intracranial cryptococcosis.

CT findings in 12 cases of intracranial cryptococcal infection were reviewed. Five patients had a normal scan. Seven patients had communicating or noncommunicating hydrocephalus. Additional findings included meningeal opacification, cerebritis, abscess, and granuloma. Although not specific for cryptococcosis, the CT scan is helpful for evaluating and following the status of the ventricles, subarachnoid spaces, and meninges.

Adolescent↗
PubMed1981

Management of vein of Galen aneurysms. Report of two cases.

Aneurysms of the great vein of Galen are rare and potentially lethal lesions, especially in early infancy. Sectioning of the feeding arteries and excision of the lesions have been proposed for the best long-term results. An alternative approach was utilized in the two children discussed here. The computerized tomography (CT) scan established the precise diagnosis and demonstrated hydrocephalus and cortical atrophy preoperatively. Parieto-occipital craniotomy with an interhemispheric approach was performed to clip the numerous feeders. The procedure was terminated when the sac collapsed and blood aspirated from the lesion was venous in oxygen saturation. A Doppler probe over the aneurysm then revealed a venous flow. Serial postoperative CT scans demonstrated that the mass had shrunk in size. Follow-up angiography was not thought necessary.

Child, Preschool↗
PubMed1979

The complementary nature of computed tomography and angiography in the diagnosis of cerebellar hemangioblastoma.

Cerebellar hemangioblastomas were seen in seven persons, five being members of the same family. All were studied with constrast enhanced CT scans and vertebral angiograms. The CT scans were superior for demonstrating the cystic component of the tumors and associated hydrocephalus, features not usually evident on the angiograms. The angiograms were superior for revealing the vascular nature, supply and drainage of the tumors. In several patients the angiograms revealed more tumors than could be seen by CT. Both CT and angiography contribute important information in the diagnosis of these neoplasms.

Adolescent↗
PubMed1979

Posterior fossa intra-axial tumors: a comparison of computed tomography with other imaging methods.

Fifty patients with posterior fossa intra-axial tumors were evaluated by computed tomography and the results compared with routine skull films, radionuclide brain scanning vertebral angiography, and cerebral air studies. The routine skull series was found to be of little benefit. Computed tomography was more sensitive than the radionuclide brain scan in detecting all of the lesions except astrocytoma, for which sensitivity was comparable. Angiography was the most sensitive means of detecting hemangioblastoma, and was the only reliable radiographic method of differentiating hemangioblastoma from astrocytoma. Cerebral air studies were the most sensitive and specific means of evaluating brainstem gliomas.

Adult↗
PubMed1978

Diagnosis of extracerebral fluid collections by computed tomography.

The computed tomography scans of 90 patients with extracerebral fluid collections were reviewed. Epidural hematomas, acute, subacute, and chronic subdural hematomas, convexity subarachnoid hemorrhages, subdural hygromas, and one epidural empyema were seen. The CT findings were analyzed and correlated with the time elapsed since injury (when known) and the results of radionuclide scans (when available). The overall accuracy of CT in detecting extracerebral fluid was 90% with no acute hemorrhages missed. In subacute and chronic subdural collections, six CT scans were false negative in whole or in part. Three false positive interpretations were made and are discussed.

Acute Disease↗