Richard L. Mani

Normal cerebral arteriography in patients with spontaneous subarachnoid hemorrhage.

Previous studies have reported that 18 to 27 percent of patients with spontaneous subarachnoid hemorrhage have normal cerebral arteriograms. Our series of 220 patients from three hospitals demonstrated normal arteriograms in only 16 (7 percent). Recent improvements in neuroradiologic techniques, such as femoral catheterization, magnification angiography, oblique and basal projections, and subtraction most probably contribute to the improved yield. Nonvisualization of a cerebral aneurysm probably represents the most common explanation for a normal cerebral arteriogram.

The Superior Cerebellar Artery: An Anatomic-Roentgenographic Correlation

THE INDICATIONS for vertebral arteriography have expanded with the increased use of selective catheter technics. The evaluation of these studies depends on a knowledge of the normal gross and roentgenologic anatomy of the posterior fossa vasculature. A detailed anatomic and roentgen analysis of many of these infratentorial arteries and veins has appeared in the recent literature (1–7, 9). A precise description with correlation of the normal anatomy of the superior cerebellar artery, however, has not been published. In this communication we describe the normal course and distribution of the superior cerebellar artery in anatomic specimens as well as in clinical material. Material and Method The anatomic information was derived from two sources. One was the gross material represented by 30 brains from cadavers. The superior cerebellar arteries were filled with a Micropaque-gel suspension after injection of one of the vertebral arteries. After fixation, the specimens were dissected and photographed to establ...

Spinal Epidural Hematoma after Lumbar Puncture in Liver Disease

Excerpt Spinal epidural hematoma after lumbar puncture has been reported in patients receiving anticoagulant therapy. We describe a lumbar puncture-induced spinal epidural hematoma in a patient who...

The superior cerebellar artery: arteriographic changes in the diagnosis of posterior fossa lesions.

The superior cerebellar artery represents an important arteriographic landmark in the diagnosis of posterior fossa lesions (1, 5, 9). Its position relative to the upper brain stem and superior cerebellum makes it of particular value in the assessment of lesions in and adjacent to these areas. Selective catheter technics have expanded the usefulness of vertebral arteriography by providing a more detailed analysis of the course of the superior cerebellar artery and its branches. The purpose of this report is to summarize the arteriographic changes of the superior cerebellar artery caused by posterior fossa lesions. Angiographic Analysis The superior cerebellar artery may be distorted by avascular masses in the posterior fossa or altered pathologically by aneurysms, arteriovenous malformations, atheromatous disease, or vascular neoplasms. Avascular Masses Causing Displacement of the Superior Cerebellar Artery Trunk of the Superior Cerebellar Artery: Avascular masses produce displacement of adjacent vessels. ...

MSF: a computer-assisted radiologic reporting system. I. Conceptual framework.

The traditional method of preparing radiologic reports is compared with that of a computer-assisted mark-sense reporting system. The design, operation, and accessory functions of this system are described. This system uses a mark-readable form which codifies many of the routine procedures and radiographic findings and, using combinations of these, can generate over twenty million reports from a single form. Differences in time and cost of individual reports are discussed, as are the means by which geographically separate departments may share the same computer-based system. The system provides a rapid, accurate, and simple means of transmitting bulk repetitive data, thereby allowing the radiologist to concentrate on cases requiring prolonged study.

Pain Associated with Peripheral Angiography: Is Lidocaine Effective?

In a double-blind study, 28 patients for peripheral angiography received contrast injection both with and without lidocaine. In 22 patients not receiving premedication, the addition of lidocaine to the contrast medium resulted in increased pain in 54.5% of patients and no difference in pain in 41% when compared to contrast alone. In patients premedicated with 5--10 mg Valium intravenously, the addition of lidocaine to the contrast medium resulted in increased pain in half the patients and no difference in the others. The physiologic mechanisms are discussed, and the importance of hyperosmolality of contrast agents in pain production is stressed.

Pressure dressings and postangiographic care of the femoral puncture site.

Consecutive patient records (900) were reviewed to determine the incidence of local complications following the use of pressure dressings for femoral puncture. The authors found an overall complication rate (0.44%) which was less than that found by others (1%). No statistically significant differences were found in local complication rates between hypertensive (0.56%) and normotensive (0.42%) groups. No advantage was found in the postangiographic application of pressure dressings.

The Catheter Wall Simulating Thrombus Formation Seen on Pullout Angiograms: An Experimental Study

The authors investigated the nature of a radiolucent line that was seen paralleling the radiopaque catheter wall on more than 70% of 176 pullout angiograms. Although this line may indicate a thrombus sleeve, accumulation of thrombus was rarely seen at the puncture site. A series of experiments demonstrated clearly that (a) an identical line could be reproduced in a bloodless model; (b) the width varied directly with the thickness of the catheter wall and appeared irregular in contour with 6.5, 7, and 8 French catheters: and (c) this line represented the outer third of the catheter wall.

Use of a 5 French Catheter with Multiple Side Holes in Abdominal Aortography

The authors describe a simple technique of abdominal aortography using a 5 French catheter with multiple side holes. Bursting points for catheters of varying lengths and numbers of side holes are given.

Use of an alternating pressure pad to reduce patient back pain during neuroangiography.

The authors describe a method of reducing patient back pain during neuroangiography. An alternating pressure pad cushions the body with constantly moving air.