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Biomedical subjects

U Piepgras

Publications and source records attributed to U Piepgras.

At least 37 records · Page 2Linked to original sources
PubMed1991

[MRT and 99mTc-HM-PAO SPECT of the brain in myasthenia gravis].

Fourteen patients suffering from myasthenia gravis underwent cranial MRI and 99mTc-HM-PAO SPECT examinations. T2-WI revealed solitary white matter and/or basal ganglia lesions in four, multiple lesions in eight patients. The evaluation of the rCBF demonstrated a circumscript decrease of cortical perfusion in one patient whereas eight patients showed multiple cortical areas of hypoperfusion. In the context of an increased incidence of intrathecal immune reaction as well as of a constantly impaired cognitive performance of these patients, imaging findings might be a correlate of a primary cerebral manifestation of myasthenia.

Adult↗
PubMed1991

[Venous anomalies of the brain. The clinical significance of the so-called venous angioma].

In contrast to angiography, MRI not only allows the diagnosis of DVA (developmental venous anomaly, so-called venous angioma), but also shows up cavernomas and other angiographically occult vascular malformations. It also differentiates between DVAs and occult true malformations. This has completely changed the pathological assessment of DVAs. In a retrospective study on 31 patients with angiographically proven DVAs neighbouring cavernoma was a frequent finding (15 patients, 48% group I). Symptoms caused by cavernoma were present in 6 (40%) of these 15 patients. The following associations were also found: cerebral arterial aneurysm (2), spinal arterio-venous dural fistula (1), dermal haemangioma (1), Klippel-Trénauny syndrome (1). Only 16 (52%) of the 31 cases with DVA were free of associated cavernoma (group II). Only 3 (19%) of these patients with a solitary DVA were symptomatic. In our series we have seen no case of bleeding from a DVA. A DVA is a vascular anomaly characterized, like other anomalies, by reduced resistance and limited capacity for regulation and adaptation. In rare cases this can result in haemodynamic disturbances, thrombosis and ischaemia. Wall rupture with bleeding does not occur in DVA. It must be assumed that bleeding reported in patients with DVAs before the availability of MRI resulted from an associated true vascular malformation in most cases.

Adolescent↗
PubMed1991

[Sturge-Weber syndrome. Diagnostic imaging relative to neuropathology].

Clinical presentation of a child with port-wine stain and seizures leads to the suspicion of Sturge-Weber disease (SWD). This diagnosis can be confirmed by the detection of a meningeal angiomatosis. In rare cases, early detection of meningeal pathology by ultrasound has been reported. Key findings are brain atrophy, gyriform cortical calcifications demonstrated by skull radiographs after the first year of life or earlier by cranial CT, and dys- or aplasia of the deep cerebral veins on angiography. Radionuclide imaging shows focal or diffuse tracer accumulation over the affected brain regions. MR demonstrates an abnormal appearance of the affected meninges, especially thickening and pathologically increased signal intensity after Gd-DTPA application. This, in association with the demonstration of abnormal enhancement in deep medullary veins, is the most characteristic finding. Contrast-enhanced MR allows early and non-invasive diagnosis of SWD, mainly by revealing leptomeningeal angiomatosis and abnormal venous vessels.

Adolescent↗
PubMed1991

[Radionuclide cisternography: SPECT- and 3D-technique].

Radionuclide cisternography is indicated in the clinical work-up for hydrocephalus, when searching for CSF leaks, and when testing whether or not intracranial cystic lesions are communicating with the adjacent subarachnoid space. This paper demonstrates the feasibility and diagnostic value of SPECT and subsequent 3D surface rendering in addition to conventional rectilinear CSF imaging in eight patients. Planar images allowed the evaluation of CSF circulation and the detection of CSF fistula. They were advantageous in examinations 48 h after application of 111In-DTPA. SPECT scans, generated 4-24 h after tracer application, were superior in the delineation of basal cisterns, especially in early scans; this was helpful in patients with pooling due to CSF fistula and in cystic lesions near the skull base. A major drawback was the limited image quality of delayed scans, when the SPECT data were degraded by a low count rate. 3D surface rendering was easily feasible from SPECT data and yielded high quality images. The presentation of the spatial distribution of nuclide-contaminated CSF proved especially helpful in the area of the basal cisterns.

Adult↗
PubMed1986

Radiologic studies of cerebrospinal fluid pathways in experimental hydrocephalus-hydrosyringomyelia.

The progress of experimental hydrocephalus-hydromyelia in cats is analyzed in the present study. The animals were rendered hydrocephalic by intracisternal injections of kaolin or by operatively occluding the lateral apertures. Changes in the cerebrospinal fluid (CSF) spaces were monitored by ventriculography or computed tomography. The progress of hydrocephalus in both groups can be divided into two stages: 1) A phase of raised intracranial pressure precedes the dilatation of the central canal, and 2) a progressive phase follows the dilatation of the central canal. The canal acts as a kind of natural bypass between the ventricles and the subarachnoid spaces. Although the spontaneous shunt, the central canal, becomes dilated and pressures drop to near normal values, the disease is apparently not brought to a complete halt. Our observations suggest that the disturbance in CSF flow dynamics is an important factor causing hydrocephalus to remain progressive.

Animals↗
PubMed1986

[Lung involvement in Osler's disease and its cerebral complications].

About 50% of patients with Osler's disease also have arteriovenous lung malformations. The wall-insufficiency mural inadequacy of the malformed vessels is due to the secondary infectious cerebral and meningeal complications which frequently occur in the disease. If a brain abscess is diagnosed, one has first to take into consideration an arteriovenous malformation of the lungs as a possible source of the infection.

Adult↗
PubMed1984

Update and trends in venous (VDSA) and arterial (ADSA) digital subtraction angiography in neuroradiology.

After presentation of the principles and technology of digital subtraction angiography the results of 649 investigations with the peripheral venous method are presented and first experiences are discussed critically. In conclusion the method of venous digital subtraction angiography can be stated to be useful for adequate diagnosis of the extracranial brain vessels. Diagnostic statements about the intracranial vessels by venous injection are limited, and therefore a combined investigation including normal angiography remains necessary. In the near future neuroradiological investigations cannot abandon selective arterial techniques. One may expect however that normal angiographic investigations will subsequently be replaced by digital subtraction angiography with arterial injection of contrast medium.

Angiography↗
PubMed1984

[State of the art and developmental trends of venous and arterial digital subtraction angiography in neuroradiology].

After presentation of principle and technology of digital subtraction angiography the results of 649 investigations with the peripheral venous method are demonstrated and first experience are discussed critically. In conclusion the method of venous digital subtraction angiography can be estimated as useful for an adequate diagnosis of the extracranial brain vessels. Diagnostic statements of the intracranial vessels by venous injection are limited, and therefore a combined investigation including normal angiography remains necessary. In the next future neuroradiological investigations cannot renounce from selective arterial techniques. It can be expected that normal angiographic investigations will be replaced by digital subtraction angiography with arterial injection of contrast medium.

Angiography↗
PubMed1981

Thalamic bleeding: diagnosis, course and prognosis.

Isolated thalamic bleeding without involvement of the internal capsule or other neighboring structures is extremely rare. Thalamic hemorrhage often leads to bleeding into the ventricular system. The extent of the bleeding is not a valid criterion for prognosis. The chance of survival was found to be poorest in initially comatose patients. CT is eminently suitable for determining the size and position of the hemorrhage and also for the followup of thalamic bleeding. No significant correlation was found between the clinical and CT outcome.

Adolescent↗
PubMed1981

[Radiologic diagnosis of orbital lesions--a comparison of methods (author's transl)].

Computed tomography has become the primary radiological procedure to evaluate disease of the orbit, to localize it exactly and to demonstrate its effect on neighbouring structures. In the past few years, considerable progress has resulted from improvement in the equipment, especially in three dimensional visualization of the area by introduction of the coronal and sagittal planes of section either indirectly by computer reconstruction of the coronal and sagittal plane from data obtained from routine transverse scanning or directly by appropriate positioning of the patient in these planes. Three dimensional CT technique is essential for precise localisation, delineation and differentiation of combined lesions of the face, the skull base and the orbits. Although by all this improvement of CT the possibility for exact diagnosis has increased, conventional neuroradiological examinations are still often necessary as a complimentary study to CT, especially in disease which involves the bone.

Fibrous Dysplasia of Bone↗