Computed tomographic evaluation of therapeutically induced changes in primary and secondary brain tumorsHyman, R.; Loring, M.; Liebeskind, A.; Naidich, J.; Stein, H.
doi: 10.1007/BF00418618pmid: 204882
234 14 14 5 5 R. A. Hyman M. F. Loring A. L. Liebeskind J. B. Naidich H. L. Stein Department of Radiology North Shore University Hospital Manhasset NY USA Department of Radiology Cornell University Medical College New York NY USA Summary A prospective study was initiated to evaluate computed tomography as a method for monitoring therapeutically induced changes in brain tumors. Early postoperative scans may be misleading in the evaluation of residual tumor because of trauma to the blood-brain barrier during operation. The size of the dominant mass (17/25), enhancement (11/25), edema (11/25), and ventricular distorition (14/25) were decreased in many patients after radiation therapy. Occasional tumors increased in size during radiation therapy (3/25). Enlargement of the lateral ventricles developed in 9 of 25 patients. Computed tomography offers definite advantages over nuclide brain scans, angiography and other diagnostic studies for evaluating therapeutically induced changes in brain tumors.
Occlusion of the intradural vertebrobasilar arteryThompson, J.; Simmons, C.; Hasso, A.; Hinshaw, D.
doi: 10.1007/BF00418619pmid: 634467
234 14 14 5 5 J. R. Thompson C. R. Simmons A. N. Hasso D. B. Hinshaw Jr. Department of Radiology Loma Linda University Medical Center Loma Linda Cal. USA Summary 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.
Amipaque myelography without late adhesive arachnoid changesAhlgren, P.
doi: 10.1007/BF00418620pmid: 634468
234 14 14 5 5 P. Ahlgren Department of Neuroradiology, Glostrup Hospital, Faculty of Medicine University of Copenhagen Glostrup Denmark Summary Sixty-three myelographies were performed with Amipaque. Remyelography after an interval of longer than 2 months showed that in one case there was progression of an arachnoiditis which had already been present during the first Amipaque study. In one other case there were minimal, unilateral nerve root changes caused by an intervening operation. Altogether 269 remyelographies without secondary late reactions are registered. Two cases of increased arachnoid changes from a previous myelography with another contrast medium hardly can be due to Amipaque.
Myelography in Guillain-Barré syndrome (acute inflammatory polyradiculoneuropathy)Hvidsten, K.; Larsen, J.; Nyland, H.
doi: 10.1007/BF00418621pmid: 634469
234 14 14 5 5 K. Hvidsten Dr. J. L. Larsen H. Nyland Department of Diagnostic Radiology and Neurology, School of Medicine University of Bergen Norway Department of Radiology Haukeland Sykehus N-5016 Norway Summary The Guillain-Barré syndrome has been studied by lumbar myelography with watersoluble contrast media in seven cases. Abnormalities, which consisted of widening of the nerve roots and obliteration of the root sleeves, were found in three of them. It is possible that myelography accentuated the symptoms in one case while the rest tolerated the examination well.
The diagnostic value of CT for radiotherapy of cerebral tumorsKretzschmar, K.; Aulich, A.; Schindler, E.; Lange, S.; Grumme, T.; Meese, W.
doi: 10.1007/BF00418623pmid: 634471
234 14 14 5 5 Dr. K. Kretzschmar A. Aulich E. Schindler S. Lange T. Grumme W. Meese Department of Neuroradiology and Radiology University Clinic of Mainz Mainz Germany Neurosurgical and Radiological Department, Klinikum Charlottenburg Free University of Berlin Berlin Germany Abteilung für Neuroradiologie Klinikum der Universität Langenbeckstr. 1 D-6500 Mainz FRG Summary The paper deals with CT followup studies on 73 patients with cerebral tumors who received radiotherapy. The value of CT for the indication of radiotherapy, for followup therapy and for the demonstration of therapeutic success are discussed. Since the cerebral tumors become visualized by means of CT in their entire extent and can be differentiated from perifocal edema, the question arises whether radiotherapy should consist of higher doses in the future. It is also suggested that the “clinical malignancy” may be used to compare the behavior of cerebral tumors when there is no exact histological classification. The possible histopathological effects of radiotherapy (edema, necrosis) and their demonstration by CT are discussed.
The effect of position of patient on the passage of metrizamide (Amipaque), meglumine iocarmate (Dimer X) and ioserinate (Myelografin) into the blood after lumbar myelographySpeck, U.; Schmidt, R.; Volkhardt, V.; Vogelsang, H.
doi: 10.1007/BF00418624pmid: 634472
234 14 14 5 5 Dr. U. Speck R. Schmidt V. Volkhardt H. Vogelsang Schering Research Laboratories Berlin/Bergkamen FRG Neuroradiological Department Medizinische Hochschule Hannover Hannover FRG Dept. Biodynamik Schering AG Müllerstraße 170–178 D-1000 Berlin 65 Summary 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.
Hypoglossal paralysis due to compression by a tortuous internal carotid artery in the neckScotti, G.; Melançon, D.; Olivier, A.
doi: 10.1007/BF00418626pmid: 634474
234 14 14 5 5 Dr. G. Scotti D. Melançon A. Olivier Montreal Neurological Institute Montreal Canada Neurological Clinic University of Milan Via F. Sforza 35 I-20122 Milano Italy Summary Severe hemiatrophy of the right half of the tongue in a 22 year old patient was demonstrated to be due to compression of the hypoglossal nerve by a tortuous internal carotid artery in the neck. The nerve was trapped between an abnormal loop of the internal carotid artery and the sternoclcidomastoid branch of the occipital artery. Although impairment of cranial nerve function with cases of tortuous and dilated vessels has been reported frequently, twelfth nerve palsy has never been demonstrated before.