Enlarging skull fractures of childhoodLende, R.
doi: 10.1007/BF00344315pmid: 4843041
234 7 7 3 3 R. A. Lende Division of Neurosurgery Albany Medical College 12208 Albany New York USA Summary Essential to the development of the syndrome of enlarging skull facture of childhood are: 1) a diastatic skull fracture of infancy or early childhood, which is the period of most active cranial growth (50% occur under the age of 1 year); 2) a diastatic dural defect which may be surprisingly extensive and usually exceeds the initial fracture in width; 3) contusion and local swelling of the brain beneath the fracture, commonly resulting in local bulging of the skull in that region. The local cerebral injury is usually severe and may result in a variety of late pathological sequelae including: local cerebral atrophy, porencephalic or other cysts, focal ventricular dilatation, and complex scarring involving dura, pia-arachnoid and cerebrum. A leptomeningeal cyst is not essential for the development of this syndrome. Experimental studies in infant animals confirm the significance of a dural defect in the persistence of an overlying skull defect. Early operations for repair of the skull and dural defects may be indicated in certain patients. The term leptomeningeal cyst as a name for this disorder should be discarded.
Angiography of pontine hemorrhageMoscow, N.; Margolis, M.
doi: 10.1007/BF00344316pmid: 4842034
234 7 7 3 3 N. P. Moscow M. T. Margolis Department of Radiology University of California School of Medicine San Francisco California USA Summary The differentiation between cerebellar and pontine hemorrhage is important for prognostic and therapeutic reasons. Yet this distinction is often difficult to make on clinical grounds alone. Pontine hemorrhage can be located accurately by means of angiography.
Meningeal branch of the posterior cerebral arteryWeinstein, M.; Stein, R.; Pollock, J.; Stucker, T.; Newton, T.
doi: 10.1007/BF00344317pmid: 4842035
234 7 7 3 3 M. Weinstein R. Stein J. Pollock T. B. Stucker T. H. Newton Department of Radiology University of California SanFrancisco Department of Radiology Peralta Hospital Oakland Department of Radiology Sutter Community Hospital Redwood City California USA Department of Radiology Sacramento and Permanente Medial Group, Kaiser Medical Center Redwood City California USA Summary A meningeal branch of the posterior cerebral artery was visualized in three patients. This artery, not previously identified by angiography, supplies the medial aspect of the tentorium and the posterior segment of the flax cerebri.
Calcifying cerebral cavernous hemangioma with brain scan and angiographic findingsSegall, H.; Segal, H.; Teal, J.; Rumbaugh, C.; Bergeron, R.
doi: 10.1007/BF00344318pmid: 4842815
234 7 7 3 3 H. D. Segall H. L. Segal J. S. Teal C. L. Rumbaugh R. T. Bergeron Department of Radiology Los Angeles County-University of Southern California Medical Center Los Angeles Calif. USA Department of Neurosurgery Los Angeles County-University of Southern California Medical Center Los Angeles Calif. USA Department of Neurology Los Angeles County-University of Southern California Medical Center Los Angeles Calif. USA Summary A case of a cavernous hemangioma of the right frontal lobe of the brain is reported. The lesion showed a myriad of tiny discrete calcifications and was associated with a well-circumscribed uptake on technetium brain scan and positive findings on cerebral angiography. The patient has done well since excision of the hemangioma.
Remarks on radioisotope studies of the leptomeningeal and ependymal spacesOberson, R.; Kushelevsky, A.
doi: 10.1007/BF00344319pmid: 4842036
234 7 7 3 3 R. Oberson A. Kushelevsky Section of Neuroradiology and Neuroradioisotopes, Radiological Institute University and State Hospital Lausanne Switzerland Institut de Radiologie Hôpital Cantonal Universitaire CH-1011 Lausanne Switzerland Summary The number of pneumoencephalographic and myelographic X-ray examinations is decreasing every year. The steady increase, not only of cerebral angiographies and radionuclide brain scanning, but also of the corresponding neuroradioisotope procedures of cisternography and myeloscintiphotography, are responsible for this trend. Neuroradioisotope (NRI) procedures allow for more efficient functional examinations than the corresponding neuroradiological X-ray methods (NRX). The signficance of NRI as screening tests is manifest. — Some technical specifications are given regarding the signal-to-noise problem. Tables indicate some characteristics of the new radioactive agents: 169 Yb DTPA and 111 In DTPA and their radiation dosimetry for the brain, the spinal cord and the whole body. — The diagnostic possibilities of NRI have caused the techniques to be altered. The most innocuous methods must be used at first, and if, as usually happens, these are morphologically adequate and functionally better suited, the most cumbersome become unnecessary.
Functional evaluation of ventriculo-atrial and ventriculo-peritoneal shunts with 99m Tc-pertechnetateFrick, M.; Rösler, H.; Kinser, J.
doi: 10.1007/BF00344320pmid: 4842037
234 7 7 3 3 M. Frick H. Rösler J. Kinser Dept. of Nuclear Medicine, Central Radiology Institute University of Berne Switzerland Summary More and more ventriculo-atrial shunt operations are being carried out on every type of hydrocephalus and in every age group. Thus, the need for a simple, repeatable and atraumatic examination of the shunt function is increasing. The examination method of Bueno, in which 99m Tc-pertechnetate is injected into the shunt system, has been adapted for our use. Here, the isotope is introduced into the reservoir of a Rickham valve. In this way visualization of the proximal and distal catheters, as well as of the ventricles, is possible. By using sequence scintigraphy it is possible to demonstrate obstructure of the CSF flow in the proximal, i.e. the intracranial, and/or in the distal, i.e. the extracranial, catheter. Localization of the block is necessary before an operative procedure can be performed. The method presented here is simple, quick, without risk to the patient, and can be repeated at will. In addition to examples of normally functioning shunts, characteristic disturbances are also described.
Meningeal and glial tumors in combinationSackett, J.; Stenwig, J.; Songsirikul, P.
doi: 10.1007/BF00344321pmid: 4367176
234 7 7 3 3 J. F. Sackett J. T. Stenwig P. Songsirikul Department of Neuroradiology, Neuropathology and Neurosurgery Ullevål Sykehus Oslo Norway Department of Radiology New York Hospital—Cornell Medical Center 525 East 68th Street 10021 New York New York USA Summary Two verified cases of combined nervous system tumors are presented, each with a meningioma and a glioma. Review of previous publications shows that this combination is unusual. The histogenesis cannot be stated with certainty. The cases presented appear to have occurred by coincidence. Correct angiographic diagnosis can be made. The same angiographic criteria apply to meningiomas and gliomas in combination as are used to identify either separately.
Postural protection against complications in radiculography with Dimer XCécile, J.; Regnier, G.; Guaguière, A.; Doffiny, L.; Cuvelier, A.
doi: 10.1007/BF00344323pmid: 4367135
234 7 7 3 3 J. P. Cécile G. Regnier A. Guaguière L. Doffiny A. Cuvelier Service de Radiologie Hôpital St. Antoine Lille France Summary Neuroradiological studies were made on 305 patients after lumbar subarachnoid injection of 5 ml or less of Dimer X. Immediately after the examination 140 patients were kept in a semi-sitting (vertical) and 165 in the supine (horizontal) position for 8 h and X-rays were made hourly to determine the absorption time of the opaque medium. The immediate and late effects were studied in each group by observation in the department for at least 3 weeks after the examination, and subsequently by questionaire. Immediate or delayed headache occurred in 76.8% of those kept in the sitting position and in 25% of those supine. The cause of the headache is considered to be an inflammatory reaction, “meningismus”, which depends on the concentration of and delay in absorption of the contrast medium. A comparative study of the two groups revealed that the absorption time was halved, and headache occurred only 1/3 as often, in the supine patients compared with those sitting. It is concluded that the use of Dimer X as routine is not completely harmless and no more than 5 ml of it should ever be used for an examination. The incidence of arachnoiditis after radiculography has been increasing and is always localized in the lumbosacral region. Thus it is considered due to the concentration and slow absorption of the contrast medium at the bottom of the cul-desac while the patient is in the sitting position. It is recommended that the patient should be kept in the supine (horizontal) position for 24–48 h after the examination since, by this measure, the prevention of secondary effects has been demonstrated by this study.
Persistent trigeminal arterySchmid, A.
doi: 10.1007/BF00344324pmid: 4842039
234 7 7 3 3 A. H. Schmid Abteilung für Neuropathologie Institut für Pathologie der Universität Basel Basle Switzerland Summary The anatomical features of a left persistent trigeminal artery, found incidentally at autopsy, are reported. In spite of the close relationship to the Gasserian ganglion and to the cavernous sinus no mutual effect upon of from these structures can be shown. However, penetration of the anastomosis through the clivus under the left posterior clinoid process of the sella caused a conspicuous atrophy of that process.