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Biomedical subjects

S J Goldstein

Publications and source records attributed to S J Goldstein.

35 records · Page 2Linked to original sources
PubMed1982

Occipital condyle fracture associated with cervical spine injury.

Fracture of the occipital condyle is a rare sequela of craniocervical trauma; it has been reported in only 8 patients since 1816. In one-third of the cases, the fracture was associated with dislocation of the atlantooccipital junction, a uniformly fatal injury. We report a case of fracture of the occipital condyle associated with fractures of C6 and C7, a combination of injuries not previously reported to the best of our knowledge.

Adult↗
PubMed1982

Limited usefulness of aortic arch angiography in the evaluation of carotid occlusive disease.

The role of aortic arch angiography in the evaluation of cerebral ischemic disease is not well defined. In an attempt to develop guidelines for its optimal use, a prospective study of 100 patients with carotid distribution ischemic events was undertaken. Each patient underwent bilateral selective carotid angiography followed by arch aortography. In only two of the cases did the arch examination affect patient management. In the other individuals, the arch study either added no clinically useful information (69), or demonstrated abnormalities that did not affect patient care (29). The findings of this study support the use of arch aortography only in those patients who have surgical lesions demonstrated by the selective carotid examinations.

Adolescent↗
PubMed1982

Fractures of the articular processes of the cervical spine.

Fractures of the articular processes occurred in 16 (20.8%) of 77 patients with cervical spine fractures as demonstrated by multidirectional tomography. Plain films demonstrated the fractures in only two patients. Acute cervical radiculopathy occurred in five of the patients with articular process fractures (superior process, two cases; inferior process, three cases). Persistent neck pain occurred in one other patient without radiculopathy. Three patients suffered spinal cord damage at the time of injury, which was not the result of the articular process fracture itself. In the other seven cases, no definite sequelae occurred. However, disruption of the facet joint may predispose to early degenerative joint disease and chronic pain; unilateral or bilateral facet dislocation was present in five patients. In patients with cervical trauma who develop cervical radiculopathy, tomography should be performed to evaluate the articular processes.

Cervical Vertebrae↗
PubMed1982

Dissecting hematoma of the cervical vertebral artery. Case report.

A 31-year-old woman developed a sudden onset of vertebrobasilar ischemia while exercising. Cerebral arteriography revealed a dissecting hematoma of the cervical portion of the dominant vertebral artery. Both the neurological deficits and the intramural hematoma of vertebral artery resolved with conservative therapy alone.

Adult↗
PubMed1981

Recurrent subarachnoid hemorrhage complicating cerebral arterial ectasia. Case report.

A case of subarachnoid hemorrhage (SAH) complicating cerebral arterial ectasia is reported. While ischemia and cranial nerve palsies are commonly associated with this condition, review of the literature reveals that SAH is exceedingly rare. The pathogenesis, radiographic findings, and clinical complications of cerebral arterial ectasia are discussed.

Adult↗
PubMed1978

Colitis in Behçet's syndrome. Two new cases.

Two new cases of Behçet's disease with colitis are presented and the radiographic features described. The changes in the colon resemble Crohn's disease more closely than ulcerative colitis but show some features which are distinct from both. One patient had perforation of a cecal ulcer and severe bleeding, stressing the serious nature of this form of colitis.

Adult↗
PubMedDate not supplied

Value of computed tomography in the evaluation of craniosynostosis.

Forty-seven patients with abnormal cranial shape and the clinical diagnosis of craniosynostosis were assessed by computed tomography (CT). In 13 patients the diagnosis of craniosynostosis was established on the basis of skull radiographs and radionuclide bone scans. Eight out of 13 patients had normal cerebral anatomy demonstrated by CT. In four of the 13 patients CT revealed abnormalities not amenable to surgical correction. The only patient in whom CT scanning influenced therapy presented with elevated intracranial pressure secondary to shunt failure.

Adolescent↗
PubMedDate not supplied

Retroperitoneal feeding tube for peritoneal dialysis patients.

Treatment of the cachetic, hypoalbuminemic, peritoneal dialysis patient represents a vexing patient management problem. In the past, when the cause of inanition was intractable vomiting secondary to gastroparesis, the solution was to create a transperitoneal percutaneous enterogastrostomy. This endoscopic procedure bypassed the nonfunctioning stomach and allowed for adequate nutrition. When hypoalbuminemia is present, the patient is predisposed to the possible complications of peritoneal sepsis, dialysis fluid leak, and wound dehiscence. The authors report a unique, enteric feeding tube that is a solution to the problem of continuing adequate, complication-free dialysis in a cachetic, hypoalbuminemic peritoneal dialysis patient with no available site for either temporary or permanent hemodialysis vascular access. The procedure does not violate the peritoneal cavity and has proven to be effective, acceptable to the patient, apparently safe, and easy for both staff and patient use.

Cachexia↗
PubMedDate not supplied

MRI of sarcoid spondylodiskitis.

We report the MR appearance of a rare case of sarcoidosis of the spine presenting as spondylodiskitis. Vertebral and disk signal changes were typical for diskitis. In the appropriate clinical setting the differential diagnosis of diskitis should include sarcoidosis.

Adolescent↗
PubMedDate not supplied

Evaluation of traumatic atlantooccipital dislocations.

The diagnosis of traumatic atlantooccipital dislocation (AOD) from the cross-table lateral radiograph is difficult because of problems in demonstrating the complex anatomy of this area and the intricate radiographic methods used to diagnose AOD. Although CT or polytomography seem to be the most accurate diagnostic methods, it is often the lateral radiograph from which the diagnosis and further decisions are made. To determine both the best radiographic method for diagnosing AOD from the lateral radiograph and the role of CT and tomography in the diagnosis of AOD, the literature was reviewed concerning how the diagnosis of AOD has been obtained. In addition, the Wholey dens-basion line, the Powers ratio, the Dublin method of diagnosing AOD, and measurement of the atlantooccipital joint width were applied to 12 cases of traumatic AOD; and the Wholey dens-basion line and the Powers ratio were determined in 100 normal adults and 50 normal children. An alternative plain radiographic method for diagnosing AOD was developed, called the X-line method. This was the most accurate of the methods tested, correctly diagnosing AOD in 75% of cases. The Wholey dens-basion line and direct measurement of the atlantooccipital joint width were each correct in 50% of cases, the Powers ratio in 33% of cases, and the Dublin method in only 25% of cases. Ultimately, either CT or polytomography should provide the definitive diagnosis. In this regard high-resolution CT with reformatted coronal and sagittal images generated from 2-mm thin axial slices appeared to have the most promise as the first study of choice.

Adult↗
PubMedDate not supplied

Computed tomographic findings in cerebral arterial ectasia.

The computed tomographic findings in 15 patients with angiographically documented cerebral arterial ectasia are reported. In addition to demonstrating the majority of pathologic arterial segments, computed tomography also documents the presence and extent of associated intracranial abnormalities. In this study these included cerebral atrophy (10 patients), infarction (three patients), and subarachnoid hemorrhage (one patient).

Adult↗
PubMedDate not supplied

Fractures of the craniovertebral junction associated with other fractures of the spine: overlooked entity?

In a review of 155 craniovertebral fractures (occiput-C1-C2), 40 of these had associated fractures and/or dislocations or subluxations elsewhere in the spine. This rather common occurrence, one of four, has not been emphasized in the recent literature, indicating that the radiologic examination should not stop after the craniovertebral fracture is identified. Furthermore, in 13 patients, neurologic deficits were encountered that in all instances were from associated lower-level fracture. From this experience it was believed that a minimum of anteroposterior and lateral views of the entire spine should be obtained in patients in whom a craniovertebral fracture is found, especially if neurologic deficits are present. The other sites of injury were in the lower cervical spine in 17 patients, in the thoracic spine in five, in the lumbar spine in two, and in the sacrococcygeal spine in two patients. Eight patients had three or more levels of fracture.

Atlanto-Occipital Joint↗