[Magnetic resonance for better possibilities in studying the connection between alcohol and brain damage].
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Alcoholism↗
Biomedical subjects
T Hindmarsh
Publications and source records attributed to T Hindmarsh.
Influence of improved drinking habits on brain atrophy and cognitive performance in alcoholic patients: a 5-year follow-up study.
In the period 1977-1979, a sample of consecutively admitted alcoholic in-patients was studied with CT scan of the brain and neuropsychological tests. A subsample of 52 patients met the following criteria: age less than 46 years, no history of severe head injury or focal signs of traumatic brain damage, and no history of liver disease, drug abuse, or long-lasting anticonvulsant therapy. However, 72% of the patients showed brain atrophy and 49% intellectual impairment as compared to 16% and 13%, respectively, in an age-matched sample of men from the general population. Five years later, after excluding patients with head trauma, serious alcoholic liver disease and drug abuse, 37 patients were reinvestigated. Sixteen patients were abstinent or had greatly improved drinking habits during the 5-year follow-up period and 21 were still drinking. Alcohol abstinence was found to be associated with a regress of cortical atrophy and central atrophy as assessed by the width of the 3rd ventricle. However, the recovery was not complete as compared with the prevalence of atrophy in the sample from the general population. Among the patients a significant improvement in one cognitive test and a trend to improvement in some other tests associated with improved drinking habits was observed. Regression of central atrophy as assessed by a decreased diameter of the 3rd ventricle was associated with improvement in the very same cognitive tests. The results suggest that both atrophy of the brain and cognitive ability can improve in alcoholics who give up drinking.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Alcohol and brain damage: neuropsychological and computer-tomographic findings].
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Adult↗
Does successful interferon treatment of tumor patients require life-long treatment?
Case histories of 5 tumor patients treated with natural leukocyte interferon-alpha (IFN-alpha) are presented. One patient with juvenile laryngeal papillomatosis responded well to interferon treatment, but the disease recurred when therapy was withdrawn. Upon reinstitution of treatment, the patient once again responded well. Another patient with myelomatosis also responded well to interferon therapy and in this case, too, the tumor recurred when interferon treatment was withdrawn. Reinstitution of interferon therapy was, however, unsuccessful. One patient with generalized giant cell tumor of bone responded with regression after more than 5 years of interferon treatment. Another patient with pulmonary osteosarcoma metastases, having received irradiation and interferon combination therapy followed by sole interferon treatment, responded well with a lasting stationary radiogram after 6 years of interferon treatment. One patient with malignant glioma, showing signs of tumor growth during the first few months of interferon therapy, eventually responded, and became disease-free after 6 years. The latter 3 patients are continuously receiving interferon therapy although more than 5 years have elapsed since their interferon therapy was initiated. It is suggested that interferon therapy for malignant tumors be given for life (or to progression of disease) in responding patients. Such a concept entails biological implications for interferon therapy in general and for antitumor action of interferons in particular. Other possible clinical schedules should only be constructed within the framework of controlled clinical trials.
Adult↗
Magnetic resonance images related to clinical outcome after psychosurgical intervention in severe anxiety disorder.
Postoperative verification of radiosurgical lesions in white matter has been difficult to obtain with CT. With magnetic resonance (MR) imaging, however, lesions could be demonstrated in patients undergoing a psychosurgical procedure, gamma capsulotomy, for anxiety disorder. The appearance and location of the lesions were related to the irradiation dose and to the long-term clinical outcome studied prospectively by two independent evaluators who had not been involved in the selection or the treatment of the patients. Seven consecutive cases were examined. CT was also included for comparison reasons. Lesions were clearly visible with MR in patients who improved after surgery. Conversely, lesions were inadequate in cases who did not benefit. MR proved to be more accurate than CT both in detecting the lesions and in defining their configuration. The observations argue for the use of MR for post-operative verification of radiosurgical lesions. MR may facilitate the determination of a clinically effective radiation threshold estimate for radiosurgical lesions, which should be of value for the planning of studies of this type of limbic system surgery.
Adult↗
A comparison of computed tomography and myelography in the diagnosis of lumbar disc herniation.
Ninety patients suspected to have a herniated lumbar disc were examined by myelography and computed tomography (CT). Of these, 37 were subjected to surgery. The surgical findings were in agreement in 21 patients (57%) with the myelograms and in 28 patients (76%) with the CT examinations. False-positive CT examinations were found in only one patient. CT is as reliable as myelography in the primary diagnosis of disc herniation.
Adult↗
The clinical versus radiological diagnosis of alcoholic cerebellar degeneration.
We report the clinical characteristics of 65 patients with alcoholic cerebellar degeneration as verified by computerized tomography of the brain. Thirty-two patients (49%) had clear clinical signs of the disease such as broad-based staggering gait, impaired heel-to-toe walking, terminal oscillations in heel-knee test and slow (3/s) leg tremor. These signs were virtually absent in 33 patients (51%) who, nevertheless, had radiological signs of cerebellar degeneration. Traumatic brain injuries were more frequent in those patients who had both clinical and radiological signs of alcoholic cerebellar degeneration. Furthermore, this group showed longer periods of heavy drinking, more severe cerebral atrophy and more profound neuropsychological impairment than a control group of 92 alcoholics with neither clinical nor radiological signs of cerebellar disease. We conclude that careful clinical neurological examination is needed to diagnose alcoholic cerebellar degeneration which is apparently a more common disease than first realized. Subclinical cases can be diagnosed with the help of computerized tomography of the brain.
Adult↗
Radiation therapy of ovarian carcinoma: presentation of a six-field technique.
A new technique for radiotherapy in ovarian carcinoma is presented. The aim was to deliver a homogeneous radiation dose to the entire abdominal cavity. The whole abdomen, except for 20% of the upper compartment, received a homogeneous dose of 40 Gy, while 2/3 of the kidneys and the posterior part of the liver received a dose ranging from 40 to 20 Gy. No clinically significant impairment of liver function was seen during follow-up.
Adult↗
Accuracy of computed tomography in the diagnosis of herpes simplex encephalitis.
The accuracy of computed tomography (CT) in the diagnosis of herpes simplex encephalitis (HSE) was assessed in 121 patients who during a 2 1/2 year period entered a prospective Swedish joint study with participation of six University Centres. The patients presented with symptoms and signs of febrile focal encephalopathy. The age ranged from 1 month to 76 years (mean 37.3 years). Only 6 were infants less than one year old. HSE was diagnosed in 50 patients by the demonstration of intrathecal HSV antibody production and/or by HSV isolation or antigen detection in brain tissue specimens. A total of 308 CT examinations--the majority performed during the first 5 days after onset of CNS symptoms--were evaluated under blind conditions. The correct diagnosis of HSE was usually suggested within 5 days after onset of neurologic symptoms yielding a sensitivity of 0.73 and a specificity of 0.89. Predominant location of the HSE lesions was the temporal lobes (88%), which rarely were involved in the non-HSE group (11%). Haemorrhage was a rare finding (12% ) and enhancement after intravenous contrast administration was insignificant. Repeat examinations further increased accuracy. It is concluded that the good reliability of high resolution CT, further improvement of immunologic techniques and the advent of new atoxic antiviral drugs all are factors which may in the future obviate the need for brain biopsy.
Adolescent↗
Magnetic resonance imaging of stereotactic radiosurgical lesions in the internal capsule.
Confirmation of radiosurgical lesions in white matter has earlier been difficult to obtain, which has hampered the evaluation of clinical outcome in relation to the site and the size of the lesions. In this investigation 7 consecutive patients subjected to bilateral stereotactic gamma capsulotomy for intractable anxiety disorders were re-examined several years after treatment. The protocol included both magnetic resonance imaging (MRI) and computed tomography (CT) interpreted under blind conditions and prospective psychiatric evaluations performed by two independent evaluators who had not been involved in the selection and the treatment of the patients. The lesions were clearly visible with MRI in all patients who improved after treatment. MRI proved to be more accurate than CT both in detecting and in defining the size and the configuration of the lesions. The extent of the tissue reaction following the irradiation seemed to be best defined in T2 weighted images. A high correlation (p less than 0.01) was obtained between ratings of clinical outcome and radiosurgical precision as reflected by MRI. It is concluded that MRI may provide the clinician with more information than CT does. In the future MRI may also facilitate the determination of a radiation threshold value for white and grey matter lesions and provide a more detailed knowledge of the time course of the development of such lesions.
Adult↗
A methodologic assessment of studies comparing magnetic resonance imaging and computed tomography of the brain.
To evaluate the methods used in studies comparing magnetic resonance imaging (MRI) and computed tomography (CT) of the brain, we reviewed English language articles published between 1981 and early 1986. Of 83 studies comparing the accuracy of MRI and CT in 10 or more patients, few met methodologic standards for evaluations of the efficacy of new diagnostic tests. Limitations were found in how study populations were assembled, in test performance and interpretation, and in analysis of study findings. Greater attention to design and execution of comparison studies could overcome these limitations and help demonstrate MRI's true diagnostic value.
Brain↗
Computed tomography examination of the influence of autotraction on herniation of the lumbar disc.
The effect of autotraction on the configuration of herniated discs was studied by computed tomography. Twenty-five patients with lumbago and sciatic pain were studied by means of GE CT/T8800 scan of the lumbar spine (two lower levels), before and after autotraction. Four patients had CT scans of the L4-L5 and L5-S1 levels during the actual autotraction. For this part of the study a special table was designed to be fitted into the CT scanner. In this way it was possible to study the configuration of the herniated disc during the time the traction force was applied. The results were uniform. In none of the patients could we register any difference in the disc, which retained its herniation. Despite this, good clinical results were obtained after autotraction. Consequently, the effect of autotraction is not connected with any marked change in the configuration of the herniated disc.
Adult↗
Autotraction in lumbar disc herniation. A myelographic study before and after treatment.
Autotraction is a method of diminishing lower back pain and sciatica in which the patient stretches himself on a specially designed traction table. The pulling force ranges between 400-800 N. Clinical results are encouraging and the method can be recommended as a temporary treatment especially in lumbago with sciatica. The influence on a herniated disc is discussed with respect to the suggestion that autotraction will diminish the herniation. In this study myelographic examination revealed that herniation was the same in location and size before and after autotraction. However, there was a marked clinical improvement in all patients but one.
Adult↗
Experience with a 36 cm image intensifier system in neuroradiological examinations.
A large-sized image intensifier-TV-fluorographic system in combination with 100 mm sheet-film camera was evaluated for use in neuroradiologic practice. The image intensifier tube had new features such as a large input screen diameter, metal input screen cover and fiber optics on the output screen. The system was evaluated both technically and clinically. With some modifications, the tested system can be recommended for use in neuroangiography provided that it is supplemented by facilities for full-size or magnification technique.
Brain Diseases↗
Lumbar myelography with iohexol and metrizamide. A double-blind clinical trial.
Two non-ionic contrast media, iohexol and metrizamide, were compared in a double-blind clinical trial which included 50 patients who underwent lumbar myelography for disc herniation or spinal stenosis. The frequency of adverse reactions was lower for iohexol which is recommended for extended trials and for examination of other compartments of the subarachnoid space.
Adolescent↗
Diagnostic errors discovered by CT in patients with suspected stroke.
We assessed the frequency of stroke diagnostic errors revealed by CT in 197 patients. In five patients, CT was an emergency procedure. In the other 192 patients, CT was used to check diagnosis based on routine investigations. All but eight diagnoses (4%) were thereby confirmed. Either hemorrhage was discovered where an ischemic lesion had been suspected (2 cases) or the reverse (3 cases). Disorders other than stroke were found in three patients--subdural hematoma, hydrocephalus, and suspected tumor. Thus, few but important errors were revealed by the CT investigations.
Adult↗
Neurological and neuroradiological examination of chronic cannabis smokers.
Twelve subjects, eight male and four female, who had smoked on average more than 1 gm of cannabis daily for 10 years, were investigated with a clinical neurological examination and computed tomography (CT) of the brain. No subject had a history of major head trauma or cerebral infection, and just one abused alcohol. Only the subject with a history of alcoholism showed any abnormal cerebral function on clinical tests or any abnormality in the CT scan, compared with normal controls.
Adult↗
Alcohol consumption, neuropsychological status and computer-tomographic findings in a random sample of men and women from the general population.
There was no correlation between reported amount of alcohol consumed on each drinking occasion per se and neuropsychological and neuroradiological signs of cerebral disorder in age-stratified random sample of 200 men and 200 women taken from the general population. Furthermore, moderate to heavy social drinking as assessed by an index based on amount of alcohol consumed on each drinking occasion and the responses to some other alcohol-habit questions was not associated with signs of cerebral disorder. Alcohol dependence, however, was associated with signs often diagnosed in alcoholic patients but milder in degree. There were indications of important differences between men and women with regard to the relationship between advanced alcohol-habits and cerebral disorder.
Adult↗