Radiology in survivors of traumatic atlanto-occipital dislocation.

Traumatic atlanto-occipital dislocation is fatal, but survivals are reported. Six cases of survival after atlanto-occipital dislocation are presented. Lateral cervical spine radiographs demonstrated retropharyngeal swelling in all patients, and Powers' ratio was abnormal in five of six patients.

Fractures of the atlas vertebra. The two-part burst fracture of Jefferson.

Burst fractures of the atlas are usually diagnosed and treated as four-part fractures as described by Jefferson in 1920. Review of the literature, roentgenogram, computed axial tomography (CAT) scans, and laboratory studies, indicates that the burst fracture is usually, if not always, a two-part fracture. These findings are contrary to the accepted concept of burst fractures, and indicate that routine roentgenograms are not adequate for proper diagnosis.

Focal cortical dysplasia. Case report.

A histologically confirmed case of focal dysplasia of the cerebral cortex is presented. The computerized tomographic, electroencephalographic, pathological, and angiographic findings are discussed with respect to this rare developmental disorder. A review of the literature is presented with a possible etiology for this condition.

Radiographic evaluation of patients with cervical spine injury.

The radiographic evaluation of a patient with cervical spine injury should be prompt and efficient. Proper cooperation between the referring orthopaedic surgeon and the radiologist and shared knowledge of the circumstances of the accident results in rapid, accurate, and cost-effective assessment of the injury, which facilitates treatment planning.

An effective surrogate for impact studies.

Nineteen unembalmed (fresh) cadavers were used in 21 experiments to test restraint systems in automobile impact studies. Some were mounted in a rearward firing sled; others were placed in standard cars during collisions. Prior to and after testing, each cadaver was evaluated.

CT manifestation of ocular muscular dystrophy.

Common varieties of muscular dystrophy rarely involve the extraocular muscles, but several uncommon varieties do. In one of our patients with ocular muscular dystrophy (Von Graefe's disease), computed tomography demonstrated atrophy of the extraocular muscles, particularly of the lateral rectus muscles. Involvement of the extraocular muscles by muscular dystrophy has not been previously reported or demonstrated in the radiological literature.

An overview of CT based stereotactic systems for the localization of intracranial lesions.

Computed tomography, with its inherent accuracy in identifying and localizing intracranial lesions, has been adapted by several groups for use in stereotactic neurosurgical procedures. The systems range from the use of data obtained on conventional CT scans to installation of a dedicated CT scanner in the operating room equipped for stereotactic surgery. Although the GE-8800 scanner is used most frequently, others are also suitable.

Method of computed tomography-based stereotactic biopsy with arteriographic control.

A method for computed tomography (CT)-based stereotactic biopsy of intracranial neoplasms with arteriographic control is described. Stereotactic CT and digitized stereotactic arteriographic data are input to a three-dimensional computer matrix that corresponds to the coordinate system of a stereotactic frame located in the operating room. A site for biopsy is selected by cursor from the CT display screen.

Metrizamide enhanced computed tomography: an adjunct to myelography in lumbar disc herniation.

In our opinion, computed tomography of the lumbar spine with intrathecal metrizamide is a highly effective diagnostic method for the demonstration of herniated lumbar intervertebral disc. However, the method is too expensive and too time-consuming to be employed routinely. We have used CT scanning immediately following a normal or equivocal metrizamide myelogram in patients with strong clinical suspicion of lumbar disc herniation.

Stereotaxic laser ablation of intracranial lesions.

A technique is described which combines computed tomography-based stereotaxic localization and CO2 laser ablation of certain intracranial lesions with a high degree of accuracy. In 24 patients operated on with this technique, total ablation of the lesion was achieved in 19 and incomplete ablation in the other five. Though not perfect, this method is a new approach to intracranial lesions that promises to be more efficacious as future developments occur.

Precision resection of intra-axial CNS lesions by CT-based stereotactic craniotomy and computer monitored CO2 laser.

This report describes an open stereotactic technique by which a tumour volume reconstructed in stereotactic space from CT data is removed by stereotactic CO2 laser vaporization. The position of the laser beam in relation to the tumour outlines is monitored by computer and displayed to the surgeon on a graphics display terminal in the operating room. Twenty-six (26) of these procedures have been performed on twenty-four (24) patients with deep-seated intra-axial neoplasms (23) and arteriovenous malformation (1).

Neurosurgery in a different society: the People's Republic of China.

An interdisciplinary clinical neurosciences delegation representing the International Committee of the Congress of Neurological Surgeons visited the neurosurgical departments of major teaching hospitals in five cities of the People's Republic of China. This report describes the clinical and research activities observed, with reference to the unique social, political, economic, and cultural environment in China. Although facilities and equipment are limited, diagnostic accuracy and surgical technique are excellent.

A computed tomographic stereotactic adaptation system.

An adaptation to render an existing popular stereotactic apparatus compatible with computed tomography (CT) is described. A localization system attaches to the stereotactic head holder and a simple computer program allows considerable accuracy in the translation of CT data into stereotactic space in the operating room.

Computer-assisted stereotactic microsurgery for the treatment of intracranial neoplasms.

This paper describes a stereotactic CO2 laser system for the removal of intra-axial, intracranial neoplasms. The volume of the neoplasm is transferred into stereotactic space by computer reconstruction of data derived by computed tomography (CT) performed under stereotactic conditions. The tumor volume is sliced in a plane orthogonal to the surgical approach, and slices at specific distances from the focal point of the stereotactic frame are displayed on a graphics monitor in the operating suite along with a cursor representing the position of the surgical laser.

False positive dynamic imaging of the cerebral circulation due to a congenital anomaly.

False positive dynamic imaging of the cerebral circulation simulating vascular occlusive disease resulted from a clinically insignificant congenital variation in several patients at our institutions. The anomaly consisted of the asymmetrical caliber of the internal carotid and proximal anterior cerebral arteries. The 1 mm difference in the diameter of the internal carotid arteries was sufficient to be appreciated on dynamic imaging.

A stereotactic approach to deep-seated central nervous system neoplasms using the carbon dioxide laser.

This report describes a technique in which deep-seated CNS neoplasms, the volume and shape of which had been determined and stereotactically localized by computer reconstruction of CT data, were vaporized with a carbon dioxide laser attached to a stereotactic frame. The clinical results with 6 patients treated by this technique are presented.

Computed tomography of the orbit.

In less than a decade computed tomography (CT scanning) had a profound impact on diagnostic radiology. Radiology of the orbit is no exception. As early as 1973, reports published in the radiological literature indicated that this new noninvasive imaging method was a highly effective way of demonstrating intraorbital mass lesions.

Otogenic pneumocephalus secondary to chronic otitis media.

Spontaneous pneumocephalus is currently a rare manifestation of chronic otitis media. Although a rarity, the diagnosis must be considered when a patient has neurologic complaints and chronic otitis media. Despite the importance of early recognition and treatment in preventing potentially fatal complications, it has been noticeably neglected in recent otolaryngologic literature.

A method for stereotactic laser microsurgery in the treatment of deep-seated CNS neoplasms.

Intracranial tumors are reconstructed in stereotactic space by means of computerized axial tomographic data. The intracranial tumor is operated on with the patient in the stereotactic frame using a carbon dioxide laser to approach the lesion and vaporize it. Ultimately, a gas-filled cavity results which can be monitored on AP and lateral radiographs.

Computed tomography of the abdomen.

In a few short years, computed tomography has become an important diagnostic procedure in the examination of the abdomen and pelvis. Its forte lies in its ability to provide cross-sectional views of excellent anatomical detail. Imaging of deep-seated structures such as the pancreas, adrenal glands, and enlarged retroperitoneal lymph nodes is now possible.

Radiology of a large cisterna magna cyst. A case report.

A case of a large cisterna magna cyst presented a problem in differential diagnosis. Characteristic changes were shown on plain skull roentgenograms and on radionuclide brain scan. The diagnosis was established on the basis of pneumoencephalography and isotope cisternography.

High cervical spine and craniocervical junction injuries in fatal traffic accidents: a radiological study.

Postmortem radiographic examinations in 312 victims of fatal traffic accidents were analyzed with respect to injuries to the cervical spine. Most fractures and dislocations in this group were found to involve the craniocervical junction and the upper two cervical segments. Over half were flexion injuries, one-fifth caused predominantly by extension.