ABSTRACT
Rhino-orbital-cerebral mucormycosis is an acute fungal infection of the oropharynx, paranasal sinuses, orbit and intracranial structures. It is rare, occurring mainly in diabetics in ketoacidosis. The clinical presentation is highly suggestive of the diagnosis. Current treatment has resulted in a greatly improved prognosis for survival and clinical awareness of this disease is important for early initiation of treatment with optimal effect. A clinico-pathological report of two cases is presented.
Subject(s)
Cellulitis/complications , Encephalitis/complications , Mucormycosis/complications , Orbital Diseases/complications , Rhinitis/complications , Sinusitis/complications , Adult , Cellulitis/diagnosis , Cellulitis/therapy , Diabetic Ketoacidosis/complications , Encephalitis/diagnosis , Encephalitis/therapy , Ethmoid Sinus , Humans , Male , Middle Aged , Mucormycosis/diagnosis , Mucormycosis/therapy , Orbital Diseases/diagnosis , Orbital Diseases/therapy , Rhinitis/diagnosis , Rhinitis/therapy , Sinusitis/diagnosis , Sinusitis/therapy , Sphenoid SinusABSTRACT
The accuracy of stereotaxic coordinates determined using the Leksell apparatus with CT and MRI was investigated using an Agar filled head phantom. Both imaging techniques were found to produce an accuracy of better than 2 mm with the exception of the Z coordinate as measured by CT (2.3 mm). This latter error is greater because of the 3 mm slice width used. Direct coronal views were used to determine Z more accurately using MRI. The measurement procedures are described and it is shown that the Leksell system of using orthogonal coordinates enables the scaling of images, which is particularly necessary with MRI, to be done easily.
Subject(s)
Magnetic Resonance Spectroscopy , Stereotaxic Techniques , Tomography, X-Ray Computed , Humans , Models, StructuralABSTRACT
Fifty-six patients with growth hormone-secreting pituitary adenomas, 28 treated by cryoablation and 28 by microsurgery, have been followed up from three to eight years. Mean serum growth hormone concentrations were less than 10 mU/L in 19 patients (68%) after microsurgery as compared with seven (25%) after cryosurgery. Hypopituitarism and operative complications were more frequent after cryosurgery. Transsphenoidal microsurgery was particularly successful in reducing growth hormone secretion without impairing normal pituitary function, when the patient had not been previously treated by another method.
Subject(s)
Acromegaly/therapy , Cryosurgery , Microsurgery , Pituitary Neoplasms/surgery , Acromegaly/physiopathology , Adolescent , Adult , Cryosurgery/methods , Female , Follow-Up Studies , Growth Hormone/blood , Humans , Male , Microsurgery/methods , Middle Aged , Pituitary Function Tests , Pituitary Gland/physiopathology , Postoperative ComplicationsABSTRACT
One month following a right upper lobectomy for bronchial carcinoma, a 50-year-old man developed headaches, confusion and a right hemiparesis. Radiographs revealed intraventricular air. This was thought to have originated from air being forced through a dural tear sustained at the time of operation. Both the intraventricular air and the accompanying symptoms and signs subsequently resolved.
Subject(s)
Pneumocephalus/etiology , Thoracic Surgery/adverse effects , Carcinoma, Bronchogenic/surgery , Humans , Lung Neoplasms/surgery , Male , Middle Aged , Pneumocephalus/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Spinal arachnoiditis is a rare condition. Eighty cases, diagnosed during a period when 7600 spinal contrast investigations were undertaken, have been reviewed. The majority had suffered a previous spinal condition, the most common being lumbar disc disease. There has been a change in the distribution of arahnoiditis with the lumbar region now most frequently involved. This accounts for the persistence of radicular symptoms and the relatively low incidence of paraplegia when compared with earlier series. Surgery does not appear to have any role in the treatment.
Subject(s)
Arachnoiditis/etiology , Spinal Cord Diseases/etiology , Adolescent , Adult , Age Factors , Aged , Arachnoiditis/diagnostic imaging , Arachnoiditis/surgery , Child , Contrast Media/adverse effects , Female , Humans , Intervertebral Disc Displacement/complications , Laminectomy , Male , Middle Aged , Myelography , Sex Ratio , Spinal Cord Diseases/diagnostic imaging , Spinal Cord Diseases/surgery , Spinal Puncture/adverse effectsABSTRACT
Computerized tomograms were studied of 67 adults whose lumbar pneumoencephalograms were normal or showed ventricular dilatation with or without widening of the sulci. The maximum ventricular area, measured from 80 x 80 matrix printouts, correlates well with measures of ventricular size on the pneumoencephalogram. An area of 10 cm2 is suggested as the upper limit of normal. The correlation between measures of sulcal width on computerized tomography and pneumoencephalography is less precise, but normal sulci and gross degrees of cortical atrophy can be identified.
