Showing papers in "Neuroradiology in 1978"

Vascular and Nonvascular Intracranial Malformations Associated with External Capillary Hemangiomas

Abstract: Seven patients with facial and scalp capillary hemangiomas with associated vascular and nonvascular intracranial malformations are presented All patients were female The most important anomalies include: Dandy-Walker disease, cerebellar hypoplasia, arterial angiomas, and abnormal origin and intracranial distribution of some of the principal cerebral arteries

The occipital artery. Anatomy--normal arteriographic aspects--embryological significance.

Abstract: An anatomical and radioanatomical study of the intracranial branches of the occipital artery is presented and attempt to systematize the muscular branches of the occipital trunk and its vertebral anastomosis. An embryological hypothesis is presented to explain and memorize all the artrial variations of this area.

CT scan appearances in Leigh's disease (subacute necrotizing encephalomyelopathy)

Abstract: Four cases of Leigh's disease (subacute necrotizing encephalomyelopathy), two confirmed at postmortem examination, have been investigated recently by CT scanning. All four showed the same symmetrical areas of low attenuation in the basal ganglia, especially the putamina. These areas corresponded with the typical areas of necrosis seen in this disease. There was also some evidence of atrophic change in the posterior fossa in some cases. This CT scan appearance may be diagnostic in the appropriate clinical context.

Post-traumatic hydrocephalus in patients with severe head injury.

Abstract: Computerized tomography was performed on 100 consecutive patients suffering from severe head injury, on admission, after 3, 5, 14, and 90 days and 1 year. Ventricular enlargement was evaluated in the surviving patients based upon serial CT examinations. The presence or absence of ventricular enlargement was correlated with the clinical outcome. The study indicates that a significant correlation does exist between the outcome and ventricular size. Hydrocephalus was seen in only four out of the 29 patients who developed ventriculomegaly.

Computed tomography in syringomyelia and the associated Arnold-Chiari type I malformation.

Abstract: A total of 20 patients with an Arnold-Chiari Type I malformation, i.e. without skeletal abnormality and associated with a syringomyelic syndrome, were studied using the EMI Whole Body Scanner CT5000. Two groups were considered: (i) a retrospective series of 12 patients without intrathecal water soluble contrast media and (ii) a prospective series of eight patients after the introduction of intrathecal Metrizamide. In the first group tonsillar herniation could not be conclusively identified on CT and cord visualisation was possible in only two cases. In the second group, tonsillar herniation and cord expansion were consistently demonstrated. Cord cavitation has also been detected. In both groups it was possible to assess the size and position of the ventricular system. The results of this study indicate that evaluation of the upper cervical cord cerebellar tonsillar herniation, may be achieved, but only following opacification of the CSF. The precise extent of cerebellar tonsillar herniation may be difficult to evaluate. The reasons for these findings are discussed.

CT, angiography, and RN scans in intracranial cavernous hemangiomas

Abstract: Nine cases of surgically verified intracranial cavernous hemangiomas are reported. A comparison is made between radionuclide brain scans, angiography, and CT studies: RN scans are sometimes superior to angiography in indicating the presence of the lesion; CT is the most informative investigation, although it does not present a specific pattern. A preoperative specific diagnosis can only be suggested on the basis of the whole complex of the information available, including the clinical history.

Interhemispheric Acute Subdural Hematoma: A Computed Tomographic Manifestation of Child Abuse by Shaking

Abstract: Parieto-occipital interhemispheric acute subdural hematomas (IASH) were found in 17 (61%) of 28 abused children examined by computed tomography, presenting with neurologic symptoms. CT demonstration of IASH correlated with injury due to severe shaking, the presence of retinal hemorrhages, and the absence of the stigmata of battering. Subsequent computed tomographic examination in these patients demonstrated infarction in 50%, and cerebral atrophy in 100%.

Extracranial vertebral aneurysm with neurofibromatosis.

Abstract: With neurofibromatosis neuromas of the cranial and cervical nerves are common findings and meningiomas and ependymonas appear more often than in the average population. Vascular manifestations of the disease are also commonly known in the renal and gastrointestinal vessels but rarely in the large cerebral arteries. The case of a 50 year old man with neurofibromatosis and a vertebral aneurysm is reported. The plain X-ray of the cervical spine and the Pantopaque myelogram were compatible with a cervical neuroma and the patient was operated but a large aneurysm of the vertebral artery was found. The operation was discontinued and vertebral angiography was performed revealing a large saccular aneurysm which was excised. This aneurysm is most probably a manifestation of vascular disease with neurofibromatosis.

The CT scan appearance of the brain in the normal elderly population: a correlative study.

Abstract: Atrophy of the brain as depicted on CT scan was correlated with social and psychological testing in 100 selected volunteers with no known neurologic or psychiatric impairment. The data indicated cognitive impairment based on psychometric test results in those with atrophy, independent of its severity. No organic or biochemical changes could be found that could explain these findings. Repeat examinations at 1-year intervals are planned to evaluate the evolution of these findings.

Treatment of small cerebral gliomas with CT-aided stereotaxic curietherapy.

Abstract: In cases of Stereotaxie irradiation of small tumors, CT makes possible a precise determination of tumor volume and dosage and permits exact positioning of the therapy probe. Iridium 192 wires are interstitially implanted in the tumor (mostly gliomas Grades I – III) after biopsy. The results with 98 CT-controlled patients (from a series of 213 implantations in midline tumors) have provided new information about the method of treating small cerebral gliomas.

Occlusion of the intradural vertebrobasilar artery

Abstract: The diagnosis of occlusion of the intradural vertebrobasilar artery (OIDVBA) was made by means of cerebral angiography in 22 patients. The clinical presentation, course and followup were studied in conjunction with the angiographic findings in each case and the following conclusions made. OIDVBA is not rare. It occurs one-fourth as often as occlusion of the carotid artery. The correct diagnosis is not made clinically before angiography in the majority of patients. Complete visualization of the neck and intracranial vasculature is necessary to document the occlusion. Atherosclerotic thrombosis is the most common type of occlusive lesion. The most common predisposing factors are atherosclerosis, hypertensive cardiovascular disease, diabetes mellitus, and developmental vertebrobasilar hypoplasia. Most patients with occlusion are in the 7th and 8th decades of life and transient attacks of vertebrobasilar ischemia precede the occlusion in one-half of the cases. Emboli usually lodge in the terminal portion of the basilar artery whereas thrombotic occlusions tend not to be located in a characteristic segment. A majority of patients diagnosed angiographically survive their OIDVBA, but most distal occlusions result in death, often following several weeks of coma. In the surviving majority, disturbance of gait, impairment of vision, and symptoms of transient vertebrobasilar ischemia are the most common sequelae.

Cerebral venous angioma: computerized tomography and angiographic diagnosis.

Abstract: Four cases of cerebral venous angioma were studied by both CT and angiography. All cases showed similar angiographic findings: a normal arterial phase and a local network of small veins that converged centrally into a single large draining vein. However, CT showed nodular areas of high density in three cases, and a curvilinear enhanced lesion representing the draining vein in the other. CT findings are nonspecific but very useful for detecting the lesion and demonstrating the associated hematoma. Angiographic findings are not so obvious as in AVM, but are necessary for the final diagnosis of the venous angioma.

Spontaneous closure of cerebral arteriovenous malformation demonstrated by angiography and computed tomography

Abstract: Spontaneous disappearance of a cerebral arteriovenous malformation, presumably secondary to thrombosis, was demonstrated in a young female patient by angiography and computed tomography 11 and 13 years respectively after the initial radiographic demonstration of the lesion.

Normal and non-pathological variations in the angiographic aspects of the arteries of the middle ear

Abstract: After the demonstration of the basic arterial supply of the middle ear, the different types of aberrant arterial flux using tympanic anastomotic channels are presented.

Duplicate origin of left vertebral artery.

Abstract: A verified case of duplicate origin of the left vertebral artery in association with a large aneurysm arising from the aortic arch immediately distal to the left subclavian artery is presented. An anomalous left vertebral artery arises directly from the aortic arch between the left common carotid and subclavian arteries, and joins with the normal left vertebral artery in the transverse foramen of the fifth cervical vertebra.

Iodide and xenon enhancement of computed tomography (CT) in multiple sclerosis (MS).

Abstract: The characteristic findings on computed tomography (CT) in multiple sclerosis (MS) are discussed. In a series of 49 cases plain CT was normal in 21 (43%), cerebral atrophy alone was present in 17 (35%) and plaques were visible in 11 (23%). These were most often adjacent to the lateral ventricles (14 plaques) and in the parietal white matter (10 plaques). CT was performed after the intravenous administration of iodide in 16 of these cases. Three of the low attenuation and three additional isodense lesions enhanced. Two patients with low attenuation plaques were scanned with xenon enhancement; the plaques absorbed less xenon than the corresponding contralateral brain substance and additional, previously isodense plaques were revealed. In one case the white matter absorbed much less xenon than normal and its uptake relative to grey matter was reduced.

The differential diagnosis of pontine angle meningioma and acoustic neuroma with computed tomography.

Abstract: Seven pontine angle meningiomas were examined with computed tomography (CT). The result was compared with that of a study of 61 acoustic neuromas. These two tumor types differ in manner of growth, volume, shape,attenuation, attachment to bone, cisternal deformation, frequency of calcification, peripheral edema, and bone changes.

Results of Computer Tomography on Chronic Alcoholics

Abstract: Sixty adult patients with chronic alcoholism were examined by CT. Psychiatric and neurologic syndromes were given equal consideration. Pronounced brain atrophy was found in 75% of the cases. Cortical, as opposed to subcortical, atrophy was apparent in 64%; it was found especially in the frontotemporal region and cerebellum. Cases of Wernicke's encephalopathy as well as epileptic manifestations revealed global signs of atrophy, not restricted to the brain stem. Further correlations to problems of mental deficiency in alcoholism are discussed together with earlier results.

A fatal brain injury caused by a needlefish.

Abstract: A traumatic internal carotid-cavernous sinus fistula due to a penetrating injury caused by a needlefish is described.

Double fenestration of the extracranial vertebral artery.

Abstract: This is a case report of an angiographically demonstrated double fenestrtion of the extracranial vertebral artery found at the same level.

Postmeningitic hydrocephalus in infancy. Ventriculography with special reference to ventricular septa.

Abstract: Postmeningitic hydrocephalus in infancy accounts for at least 30% (maybe even 40%) of all new paediatric hydrocephalics seen in the Cape Province. The causes of the marked racial preponderance are considered. Meningitis is more prone to cause a CSF pathway block at any site in infancy than later in life. On ventriculography ventricular septa in 23%, foramen of Monro obstruction in 13%, multiple CSF pathway block occasionally and intraventricular detritus causing filling detects and irregularities of the ventricular walls are the salient features. Birth trauma with intraventricular bleeding may on occasion cause similar changes.

Volume of brain ventricles in man determined by computer tomography

Abstract: In order to measure the absolute ventricular volumes in ml we developed a method using the numerical prints of CT (EMI, CT 1000) on which — by comparing with corresponding Polaroid photos — the margin between brain tissue and ventricles was drawn. For further evaluation, a curve digitizer and a digital computer were used. In 51 patients without any abnormal findings in CT, we studied the volume of single ventricles. The mean value of the whole ventricular system was 30.9 ± 5.7 ml. Reproducibility by this method is within a range of 5%.

Comparison of Angiographic and CT Findings between Patients with Multi-Infarct Dementia and Those with Dementia Due to Primary Neuronal Degeneration

Abstract: The CT and angiographic appearances in multi-infarct dementia have been compared with those of primary neuronal degeneration. It was possible to make a CT or angiographic diagnosis of multi-infarct dementia in about 40% of patients diagnosed by the ischaemic scoring method of Hachinski et al. [1].

The hypodense meningioma: report of two cases.

Abstract: Cystic or necrotic hypodense areas are occasionally seen within meningiomas on CT scans. Two diffusely hypodense endotheliomatous meningiomas are reported. The low density was due to a microcystic structure, which caused a spongy appearance and consistency.

Computer Analysis of Periventricular Lucency on the CT Scan

Abstract: Of 53 patients with periventricular lucency, 70% revealed obstructive hydrocephalus, mainly due to infratentorial tumors, and the remainder were cases of communicating hydrocephalus, usually secondary to subarachnoid hemorrhage. Of the patients with PVL, 95% had hypertensive hydrocephalus and 60% showed slightly dilated ventricles. Computer analysis was helpful in displaying PVL objectively and clarifying its nature. In experimentally induced obstructive hydrocephalus, PVL was observed at the acute hypertensive stage. We concluded that the pathogenesis of PVL might be the passive diffusion or acute extravasation of CSF into white matter through the disrupted ventricular wall, rather than transependymal absorption of CSF.

The effect of position of patient on the passage of metrizamide (Amipaque), meglumine iocarmate (Dimer X) and ioserinate (Myelografin) into the blood after lumbar myelography

Abstract: Lumbar myelography was carried out with the contrast media Amipaque, Dimer X and Myelografin in 10 patients each. Five of the patients treated with each contrast medium were kept in a sitting position after the examination, the others lay flat. Blood levels and excretion were measured up to 24 h. The results are interpreted as follow: 1. After lumbar injection of the contrast media there is a short phase of distribution in the subarachnoid space (lag time) and they then are transferred into the blood with a half-life of 3.9±2.4 h. The transport from the CSF is almost completed approximately after 24h. The velocity of transport varies greatly between the individual patients. Watersoluble contrast media presumably flow passively with the CSF through the arachnoid villi into the venous blood. 2. The horizontal position of the patient reduces the lag time until the beginning of the actual transfer of the contrast medium. 3. The transfer of Dimer X begins somewhat later compared with Amipaque and Myelografin.

Computed Tomography in Meningitis

Abstract: Computed tomography in 34 cases of meningitis has revealed a spectrum of findings. In acute cases these include enlargement of the subarachnoid spaces, generalized contrast enhancement of the meninges and ependyma, sterile and pyogenic subdural collections, cortical infarction, and cerebral necrosis.

The empty sella syndrome-intrasellar cisternal herniation-in “normal” patients and in patients with communicating hydrocephalus and intracranial tumors

Abstract: The occurrence of empty sella was studied on 450 pneumoencephalograms. It was not sex dependent, and seemed to be an acquired condition increasing in frequency with age. Empty sella was found in 10% of subjects with otherwise normal encephalograms. The frequency was higher in persons with communicating hydrocephalus (32%), hormoneproducing pituitary tumors (33%) and increased intracranial pressure due to cerebral tumors (18%). In all these subjects empty sella was often accompanied by demineralization and erosion of the sella turcica. Independent of the lumbar pressure, empty sella was most often found in patients with communicating hydrocephalus with only moderately high ventricle index and comparatively increased volume of the third ventricle. Empty sella was also frequent among patients with temporal tumors (32%) causing deformation and displacement of the third ventricle but in whom signs of increased intracranial pressure were lacking. The disturbed anatomy of the third ventricle possibly explains the higher frequency of empty sella in association with these tumors compared to other supratentorial tumors. altogether, these findings indicate that disturbance of the cerebrospinal fluid (CSF) circulation, especially in the third ventricle, with or without established increase of the intracranial pressure, plays an important role in the etiology of empty sella. This is further substantiated by the demonstration that the type of intrasellar herniation could be related to the position of the third ventricle. Neither the type of herniation nor the form of the sella could be related to the presence or absence of a co-existing intracranial tumor or to the location of the tumor.

Carotid artery occlusion and computed tomography. A clinicoradiological study.

Abstract: Computed tomography (CT scanning) was carried out on 35 patients with proven occlusion of the carotid artery. There was a clear correlation of the clinical picture with the CT demonstration of cerebral infarct; 14 patients had no identifiable infarct. The findings were also correlated with angiographic data. The degree of cross or collateral filling of the middle cerebral artery on the affected side correlated better with the clinical features than with the CT data. Radioisotope studies were positive in only 50% of cases in which CT had shown infarction; this was related to the time interval between the onset of symptoms and scanning. The significance of these findings and their relationship to previous clinical necropsy data are discussed.

[Embolization in the treatment of medullary arteriovenous malformations in 38 cases (author's transl)].

Abstract: A Group of 38 medullary arterio-venous malformations have been embolized with solid emboli: 12 retromedullary, 22 intramedullary and four mixed AVM. Indications, contraindications, and long-term results are described.