PubMed · 896169
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B M O'Brien, L A Chait, P J Hurwitz. 1977. Microlymphatic surgery.. https://pubmed.ncbi.nlm.nih.gov/896169/
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A 10-year-old male with acrania, distal limb anomalies, and abnormal arterial and venous cranial blood vessels is reported. Parental films and examination are normal. This case supports the hypothesis that acrania is a severe form of aplasia cutis congenita and is within the spectrum of Adams-Oliver syndrome. It is proposed that the diagnosis of acrania requires assessment of both parents and proband to assess other manifestations of vascular disruption in order to provide accurate genetic counselling.
OBJECTIVE: To report the safety of pulmonary angiography in a non-teaching hospital and discuss the place of this investigation in the diagnosis of pulmonary embolism. DESIGN AND SETTING: A retrospective review of all patients undergoing pulmonary angiography over a 12-year period, November 1979 to October 1991, at Dandenong Hospital, Melbourne. A protocol was established whereby each procedure was performed with the assistance of staff and equipment from the intensive care unit to provide haemodynamic monitoring and measurement of pulmonary artery pressures. PATIENTS: During the review period 114 patients underwent pulmonary angiography, most (108) for suspected pulmonary embolism. RESULTS: One hundred and fifteen pulmonary angiograms were performed, and no deaths related to the procedure occurred. Complications included perforation of the right atrium in three patients, with no sequelae. Cardiac arrhythmias were common but self-limiting. CONCLUSION: In our series, pulmonary angiography was a safe procedure if undertaken with the appropriate monitoring measures. A protocol which includes the participation of the intensive care unit has proved helpful. In addition, it was found that clinical symptoms and signs were unreliable and in 24 patients who also had ventilation-perfusion (V/Q) scans, only seven scans were accurate. A review of the literature indicates that V/Q scans lack specificity and that pulmonary angiography may be performed safely. The latter investigation should be more frequently performed.
In recent years MR has assumed a central and key role in neuroradiological evaluation of the spinal cord. Because of its noninvasiveness and high sensitivity in the detection of intramedullary lesions, it represents the method of choice today for the work-up of acute, chronic and traumatic myelopathies. The main limiting factor of MR is its rather low specificity. For this reason the clinical history as well as the neurological and laboratory findings continue to be of major importance in arriving at a definite diagnosis. The method is contraindicated in patients with pacemakers or other intracorporeal paramagnetic devices. It is relatively contraindicated in claustrophobic patients. In these cases MR should be replaced by myelography or CT-myelography. For the diagnosis of vascular diseases of the spinal cord, specifically vascular malformations and hypervascular tumors (e.g. hemangioblastoma), selective spinal angiography represents an essential adjunct to MR. Selective angiography can also be used therapeutically to treat preoperatively or definitely vascular malformations (i.e. interventional neuroradiology).