Intracranial space occupying lesions presenting without papilloedema--a retrospective analysis.
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Biomedical subjects
Publications and source records attributed to S Rath.
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A method which characterizes the contraction of the left ventricle (LV) by changes in the LV endocardial contour curvatures is presented. A normalized curvature difference function (NCDF) is defined by the difference between the (normalized) curvature functions of end diastolic (ED) and end systolic (ES) contours. Unlike wall-motion based procedures, NCDF is independent of any reference system and of the method used for ED-ES shape alignment. Normal and pathological diagnosis criteria were first established based on right anterior oblique (RAO) projection ventriculograms of a study group which included 58 normal and 28 abnormal patients. Patients with an infarcted myocardial region differed from the characteristic NCDF pattern of normals and exhibited regionally defined irregularities. The diagnosis criteria were then applied to a total of 159 patients in two groups in two independent laboratories. One group (in Israel) included 49 cases (20 normals, 29 abnormals); the second (in France) included 108 cases (48 normals, 60 abnormals). These two groups yielded similar sensitivity (97% and 97%) and specificity (90% and 100%) in detection of abnormality of the ventricle. When tested against other quantitative wall motion techniques, the NCDF shwos a regional sensitivity of 95%, indicating that curvature difference analysis is a potential tool for the automatic and objective diagnosis of regional LV function abnormalities.
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The effect of intravenous prostaglandin E ( 1 ) (PGE ( 1 ) ) on the incidence of restenosis after elective percutaneous transluminal coronary angioplasty (PTCA) was studied in a prospective, single-blind, randomized trial of 30 patients. Group I (12 patients) received only the conventional medications before and after protocol, and group II (18 patients) received intravenous PGE ( 1 ) infusion for 24 hours starting at least 2 hours before angiography after hemodynamically based titration to a mean dosage of 16 +/- 3 ng/kg/min (range, 10-20 ng/kg/min). All patients received aspirin orally, beginning 24 hours before PTCA and continuing for 6 months, and intravenous heparin at 1000 U/h for 24 hours commencing with the beginning of catheterization before PTCA. Recatheterization was performed routinely at 6 months after PTCA, or earlier when clinically indicated. Angiographic evaluations were made by both visual and quantitative assessment. No significant side effects of PGE ( 1 ) treatment were observed. Only 17% of patients treated by PGE ( 1 ) experienced angina pectoris during 6-month follow-up period, as compared with 42% of patients who received conventional treatment (p = 0.13). Re-PTCA was more frequent in patients receiving conventional therapy than in those receiving PGE ( 1 ) (42% versus 11%; p = 0.06). The use of PGE ( 1 ) during PTCA was associated with 17% restenosis (both by computer and by visual evaluation) 6 months post-PTCA as compared with 33% and 50% restenosis (by computer and by visual evaluations, respectively) in the conventional group (p < 0.05). In conclusion, PGE ( 1 ) appears to decrease coronary restenosis 6 months after PTCA.
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The rarity of orbito-cranial gun shot injury in both war and civilian practice has been reported. In a large series of 351 missile head injuries in the Vietnam war, orbital penetration was noted in 0.6% cases only. Review of literature shows that orbital injury was ipsilateral to the cerebral injury in most reported cases. We have previously reported a rare case of left parieto-occipital lobe injury due to gun shot wound of the contralateral (right) orbit. The case reported here sustained a bullet injury to the left frontal bone but the missile was located below the contralateral (right) optic canal. The rarity of the case prompted this report.
We report the case of a man who presented with in the features of left optic nerve compression. CT scan and carotid angiography demonstrated an unruptured giant aneurysm of the left internal carotid artery possibly kinking the optic nerve. Carotid ligation in the neck saved both life and vision.