Neuroradiology 0028-3940

Vinters, H.; Galil, K.; Lundie, M.; Kaufmann, J.

doi: 10.1007/BF00339559pmid: 3900798

234 27 27 4 4 H. V. Vinters K. A. Galil M. J. Lundie J. C. E. Kaufmann Department of Pathology, Clinical Neurological Sciences, Health Sciences Centre University of Western Ontario London Ontario Canada Department of Anatomy, Health Sciences Centre University of Western Ontario London Ontario Canada Summary Cyanoacrylates, a group of rapidly polymerizing adhesives, have found widespread uses in oral and general surgery as well as surgical subspecialties, for example as hemostatic and anastomotic agents. They have been utilized most recently as materials for embolotherapy of complex cerebral and extra-cerebral vascular anomalies. The histopathology that results from their deposition in human tissues is thus an important consideration, and the subject of this review. Particular attention is given to the fate of cyanoacrylates in cerebral lesions after iatrogenic embolization procedures. The apparent toxicity of these plastics on blood vessel walls is discussed in relation to experimental observations. It is imperative that clinicians who use this group of substances evaluate their potential functions in the light of the pathologic findings.

Fawer, C.; Calame, A.; Perentes, E.; Anderegg, A.

doi: 10.1007/BF00339560pmid: 3900799

234 27 27 4 4 C. L. Fawer A. Calame E. Perentes A. Anderegg Unité Néonatale, Service de Pédiatrie CHUV Lausanne Switzerland Division Autonome de Neuropathologie CHUV Lausanne Switzerland Service de Radiodiagnostic CHUV Lausanne Switzerland Summary The aim of this study was to validate the accuracy of real-time ultrasound (US) in the diagnosis of periventricular leukomalacia (PVL). US changes of PVL were correlated with autopsy results. During a 12-month period, all premature infants of 34 weeks' gestation or less (group A) and all neonates of more than 34 weeks' gestation who presented with abnormal neurological signs (group B) were studied with an ATL mechanical sector scanner (5 and 7.5 MHz). The overall incidence of PVL was 13.3%. In group A ( n =83), 13 infants had PVL and 3 died. In group B ( n =36), three developed PVL and two died. Autopsy was performed in the five infants. US revealed the sequence of lesion:-the early stage with increased echogenicity in the periventricular white matter,-the late stage with area of reduced echogenicity appearing in the most echogenic zone and resulting in cystic cavitation. Autopsy confirmed PVL lesions in all five infants. The increased echogenicity corresponded to necrosis with either vascular congestion and/or secondary bleeding, the reduced echogenicity to cystic degeneration with gliosis. US scan be used for the detection of PVL.

Davidson, H.; Ouchi, T.; Steiner, R.

doi: 10.1007/BF00339561pmid: 4047385

234 27 27 4 4 H. D. Davidson T. Ouchi R. E. Steiner Department of Diagnostic Radiology Royal Postgraduate Medical School London UK Summary NMR images in five patients with surgically proved, congenital germinal layer intracranial neoplasms (two dermoid and three epidermoid tumors) were reviewed. The dermoids were typically midline (suprasellar or parapineal) masses with sharply-defined margins. Relaxation times were variable, but if fat was present, T 1 was decreased, and T 2 was increased. The epidermoids were off the midline (cerebellopontine angle, temporal lobe, frontal lobe) masses with generally long T 1 and T 2 relaxation times. Obstructive hydrocephaly was noted in one patient, and tumor to ventricular communication was demonstrated in another.

Artmann, H.; Grau, H.; Adelmann, M.; Schleiffer, R.

doi: 10.1007/BF00339562pmid: 3876520

234 27 27 4 4 H. Artmann H. Grau M. Adelmann R. Schleiffer Department of Radiology, Section of Neuroradiology University Clinics Johann-Wolfgang-Goethe-University Frankfurt/Main FRG Department of Psychiatry, Section of Child- and Youth-Psychiatry, University Clinics Johann-Wolfgang-Goethe-University Frankfurt/Main FRG Summary Brain CT studies of 35 patients with anorexia nervosa confirmed the observations of other authors: cerebral dystrophic changes correlate with weight loss and the reversibility of these changes also correlates with the normalization of body weight. Other corroborated facts are: the most numerous and most pronounced enlargements are of the cortical sulci and the interhemispheric fissure, moderate widening affects the ventricles and the rarest and most insignificant changes are those of the cerebellum. The reversibility of the changes showed a parallel to the extent of the changes themselves and to the duration of improvement of the body weight. The reversibility of the enlargement of the cortical sulci and of the distances between the frontal horns of the lateral ventricles was more often significant than that of the abnormal measurements of the cella media. This difference is based on minimal early acquired brain damage which occurs in 60% of our patients. This high incidence of early acquired minimal brain disease in patients with anorexia nervosa is here discussed as a nonspecific predisposing factor. Although there is no exact explanation of the etiology of the reversible enlargement of cerebrospinal fluid (CSF) spaces in anorexia nervosa, the changes resemble those in alcoholics. The mechanisms of brain changes in alcoholism, as shown experimentally, seem to us to throw light on the probable mechanism of reversible dystrophic brain changes in anorexia nervosa.

Colosimo, C.; Fileni, A.; Moschini, M.; Guerrini, P.

doi: 10.1007/BF00339563pmid: 4047386

234 27 27 4 4 C. Colosimo Jr A. Fileni M. Moschini P. Guerrini Institute of Radiology Catholic University Rome Italy Institute of Anaesthesiology and Intensive Care Medicine Catholic University Rome Italy Summary Cranial CT was performed in five patients with eclampsia: densitometric modifications were present in all cases. Only one patient, who later died, displayed multiple foci of cerebral haemorrhage; all others presented bilateral, symmetrical, nonenhancing hypodensities with mass effect interpreted as cerebral oedema. At CT performed 7–14 days after interruption of the pregnancy, these characteristic hypodense lesions were no longer present while neurological symptoms disappeared.

Sobel, D.; Baker, E.; Anderson, B.; Kretzschmar, H.

doi: 10.1007/BF00339564pmid: 4047387

234 27 27 4 4 D. F. Sobel E. Baker B. Anderson H. Kretzschmar Department of Radiology University of California San Francisco California USA Department of Radiology Letterman Army Medical Center Presidio San Francisco California USA Department of Radiology Pacific Medical Center San Francisco California USA Department of Pathology University of California San Francisco California USA Summary Characteristic computed tomographic, clinical and pathologic features are discussed in two patients with cerebral amyloid angiopathy (CAA) associated with massive intracerebral hemorrhage. Amyloid angiopathy should be considered in any elderly patient in whom intracerebral hemorrhage occurs at an atypical site. Cortical involvement, multiplicity of hemorrhages, bilaterality, and repeated episodes should further arouse diagnostic suspicion. Clinical management is confined to prevention of systemic hypertension.

Swartz, J.; Bazarnic, Margaret; Naidich, T.; Lowry, L.; Doan, H.

doi: 10.1007/BF00339565pmid: 4047388

234 27 27 4 4 J. D. Swartz Margaret L. Bazarnic T. P. Naidich L. D. Lowry H. T. Doan Department of Radiologic Sciences The Medical College of Pennsylvania Philadelphia Pennsylvania USA Section of Neuroradiology The Children's Memorial Hospital Chicago Illinois USA Department of Otolaryngology Thomas Jefferson University Hospital Philadelphia Pennsylvania USA Department of Radiology Thomas Jefferson University Hospital Philadelphia Pennsylvania USA Summary The CT signs of aberrant course of the internal carotid artery are presented and are contrasted against those of anomalously high jugular bulb, glomus tympanicum and cholesterol granuloma.

Chiras, J.; Marciano, S.; Molina, J.; Touboul, J.; Poirier, B.; Bories, J.

doi: 10.1007/BF00339566pmid: 4047389

234 27 27 4 4 J. Chiras S. Marciano J. Vega Molina J. Touboul B. Poirier J. Bories Department of Neuroradiology Hospital de la Salpetrière Paris France Summary Spontaneous dissecting aneurysm of the vertebral artery is an infrequent cause of vertebro basilar ischemic strokes. Previously reported cases concern essentially occlusion of the basilar artery. Only 14 cases of spontaneous dissecting aneurysm concern the extracranial vertebral artery among these eight were angiographically documented. In this study based upon 15 patients (20 dissecting aneurysms), the authors discuss etiological factors, such as hypertension or fibromuscular dysplasia: on clinical findings they insist upon the diagnostic value of preliminary symptoms, cervical pain or posterior headaches; the most frequent angiographic appearance was a long and irregular stenosis of one or two segments of the vertebral artery. The prognosis of these aneurysms most often appears favourable in this group.

Nakstad, P.; Sortland, O.; Wiberg, J.

doi: 10.1007/BF00339567pmid: 4047390

234 27 27 4 4 P. Nakstad O. Sortland J. Wiberg Department of Radiology (Section of Neuroradiology), Rikshospitalet The National Hospital Oslo Norway Department of Neurosurgery, Rikshospitalet The National Hospital Oslo Norway Summary Myelographic root sleeve deformities, uncovertebral spondylosis and myelopathy were correlated in 56 patients. Good correlation between root sleeve deformities and uncovertebral spondylosis was found. However, in some cases with spinal canal stenosis root sleeve deformities were found without corresponding bone changes. The correlation of radiculopathy to root sleeve deformity and uncovertebral spondylosis was 61 and 67%, respectively. Radiologic changes at an adjacent root level were often seen in patients without clinically correlated radiculopathy. The myelographic changes were verified at operation in all the 46 patients operated upon.

Hammer, B.; Deisenhammer, E.

doi: 10.1007/BF00339568pmid: 3900800

234 27 27 4 4 B. Hammer E. Deisenhammer Department of Radiology Wagner-Jauregg-Hospital Linz Austria Department of Neurophysiology Wagner-Jauregg-Hospital Linz Austria Summary The side effects associated with the use of Iotrol were determined in 100 patients and compared with metrizamide and iopamidol in two double-blind studies. The relevance of the distribution of the contrast medium in the CSF space to the occurence of headache is discussed. The low persistence of iotrol in the brain parenchyma is demonstrated on CT density profiles, compared with metrizamide and iopamidol. Iotrol seems to be the safest contrast substance for intrathecal use.