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Biomedical subjects

V Logue

Publications and source records attributed to V Logue.

At least 19 recordsLinked to original sources

Angiomas of the spinal cord: review of the pathogenesis, clinical features, and results of surgery.

Twenty-four patients with angiomas of the thoraco-lumbo-sacral region of the spinal cord, which characteristically occur in elderly men and are situated on the dorsum of the cord, were subjected to surgery after diagnosis by selective arteriography. It is suggested that in this variety of angioma the operation produced its effect by eliminating the raised pressure in the venous and capillary vessels within the spinal cord. There was no evidence of an arterial "steal." In all cases, followed up for a mean of five years, progression of neurological symptoms was arrested but, apart from motor disability and pain, any improvement among this already seriously disabled group was small. Diagnosis in the early stages is difficult but the history of mechanical factors exacerbating the symptoms and which occur in the majority of patients should suggest the presence of such a lesion and indicate the need for myelography. Any improvement in results can only come from greater awareness of the condition leading to earlier diagnosis and operation.

Adult

Spinal epidural angiomatous malformations draining into intrathecal veins.

Nine angiomatous malformations situated on the outer surface of the dura and one situated in the pelvis, from which draining veins pierced the dura and joined the coronal venous plexus are described. The clinical manifestations and myelographic appearances are similar to those of the majority of intradural angiomatous malformations. This suggests that neurological deficiences with both types of malformation are usually due to raised venous pressure with secondary ischaemic hypoxia.

Aged

Wasting of the hand associated with a cervical rib or band.

Nine patients are described with unilateral wasting of the hand muscles associated with elongated C7 transverse processes or with rudimentary cervical ribs. In three patients there was selective wasting of the lateral part of the thenar pad, accompanied by mild weakness of the other hand muscles. In four patients all the hand muscles were wasted, but this was more marked in the lateral part of the thenar pad than elsewhere. In two patients wasting was uniformly distributed throughout the hand. Weakness and wasting in the forearm was only present in four patients and was relatively mild. Sensory loss, when present, affected mainly the inner side of the forearm. Nerve conduction studies revealed no abnormality in the distal part of the median nerve, but some patients had reduced or absent sensory action potentials when the fifth finger was stimulated. In all nine patients a sharp fibrous band was found at operation, which extended from an elongated C7 transverse process or from a rudimentary cervical rib to the region of the scalene tubercle on the first rib. The fibrous band caused angulation of the C8 and T1 roots in five patients, and of the lower trunk of the brachial plexus in three. Pathological changes were frequently visible in affected nerves at the site of angulation. Division of the fibrous band relieved pain and paraesthesiae in eight patients and arrested muscle wasting and weakness in nine patients. There was, however, only slight recovery of power in affected muscles; wasting in the hand appeared to be unchanged after periods of up to eight years.

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