[Neuroradiologic therapy of stroke].

Cerebrovascular disease with consecutive stroke is the third leading cause of death, behind only heart disease and cancer. The cost to society, both directly in health care and indirectly in lost income, amounts to 15 billion Dollar in the USA. The leading cause of stroke is focal cerebral ischemia.

[Intra-arterial thrombolysis of vessels supplying the brain].

Intraarterial thrombolytic therapy can be life-saving in patients with vertebrobasilar occlusion. Thrombotic occlusions of the internal carotid artery or middle cerebral artery often result in disabling ischemic cerebral infarctions. Local fibrinolysis may help to minimize the neurological sequelae.

[Whole-body MRT studies--the results of the "Multicenter study on the evaluation of magnetic resonance tomography"].

In a nation-wide multicentre study, the use of MRI was examined in its clinical context and in relation to other imaging methods and as a routine examination. It was found that examinations of the brain and spine were predominant. MRI is accurate for certain problems affecting the extremities, the pelvis and the liver.

[Cervical myelopathy in mucopolysaccharidosis type II (Hunter's syndrome). Neuroradiologic, clinical and histopathologic findings].

A moderately severe spasticity affecting all four limbs, but especially the legs and the right side, developed in a 36-year-old man with mucopolysaccharidosis II (Hunter syndrome) who for 6 months had suffered from pain in the neck radiating into the shoulder. Myelography, computed tomography and magnetic resonance imaging revealed thickening of the cervical meninges as the cause of the symptoms. A laminectomy was performed and the foramen magnum enlarged by an occipital craniotomy.

[Evaluating magnetic resonance tomography studies of the extremities--results of a multicenter study for evaluating nuclear magnetic resonance tomography].

MR examinations of the extremities occupy the first place in whole body examinations via MR. Highest accuracy quotas in this area with an average of 93.8% were obtained for tumours, trauma and necroses of the bones.

[Obstacles to the routine use of magnetic resonance imaging--results of a multicenter study for evaluating nuclear magnetic resonance tomography].

Within the framework of this study, the factors that impair the value of MR scans were also investigated and analysed. It was found that artifacts occurred in a large number of examinations that exercised a negative effect on the results. Artifacts are particularly seen in the thorax (54%) and upper abdomen (57%), but they have also been reported in 23% of the CNS examinations.

[NMR studies of the whole body--results of a multicenter study for evaluating nuclear magnetic resonance tomography].

Within the framework of a national multi-centre study the spectrum of application and the ranking of magnetic resonance tomography were investigated. Although scans of the brain and vertebral column still dominate the scene, it has become evident that whole body scanning via MR can be very accurate for certain indications. This is particularly true for examinations of gynaecological diseases (95%) and for lesions of the liver (97%).

[Dilatation of the supra-aortic arteries--a catheter with blockade and rinsing potential].

Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries is not generally accepted, mainly because of the fear of brain embolism. The design of a new catheter offers four conduits and permits (1) guidewire conduct, (2) tip occlusion; (3) PTA; and (4) rinsing between occluded tip and dilational balloon. Thus, any particles that might otherwise cause brain embolism could be washed out after PTA and before opening of the tip occlusion.

MRI in cranial tuberculosis.

A case of multiple intracranial tuberculomas is presented. CT and MRI findings are discussed and compared. MRI showed multiple tuberculomas characterised by the same signal intensity as the surrounding brain parenchyma.

[Plain imaging of meningioma in NMR tomography--retrospective contrast optimization by image synthesis].

Synthetic images of the tumour region were computed in the case of ten meningiomas for the purpose of determining retrospectively pulse sequences and sequence parameters supplying an optimal contrast between tumour and adjacent tissue in plain imaging. It was found that best results were obtained via the partial saturation/spin-echo sequence with a long recovery time (TR approximately greater than 2,000 msec) and a long maximum echo delay (TE max approximately greater than 200 msec). A comparable contrast quality can be attained by using the inversion-recovery sequence with an inversion time T1 approximately 450 msec.

[Can transcranial Doppler sonography replace cerebral angiography?].

Transcranial Doppler ultrasound is a noninvasive method of recording the flow velocity of larger intracranial vessels. The impact on diagnosis of cerebravascular occlusive disease is not yet evaluated. We present 15 patients, age range 39-73 years, who suffered from completed stroke.

[Operations to improve hearing in auricular malformations. A catamnestic study of 89 operations].

In the last 20 years 89 middle ear operations were performed on 71 patients with unilateral or bilateral microtia (grade II or III). The methods and the results are described and discussed. In 79.

[Clinical aspects and diagnosis of acoustic neurinomas].

The application of microsurgical techniques for the removal of acoustic neuromas has evidenced greatly improved postoperative results. Therefore the early detection of an acoustic neuroma is a special need for every neurologist. The development of new electrophysiological and radiological procedures now allows a far better approach in the diagnosis of acoustic neuromas.

The growth rate of acoustic neuromas: a report of three cases.

Until the present time, only a few CT air-cisternographic studies have been done to define the growth rate of acoustic neuromas. By using this method of study, we were able to observe a slow growth rate fo acoustic neuromas in a 41- and a 50-year-old woman over periods of 6-10 months. In contrast, we were unable to find any increase in tumor size during a period of 22 months in a 70-year-old woman.

[Thin-layer NMR-imaging with a new T2-weighted 3-D-procedure].

Presentation of first experience with a new 3-dimensional data acquisition method. The new method yields sets of 120 continuous images of the head and brain in all 3 dimensions (slice thickness and spatial resolution both being 1.7 mm.

Neuro-otological findings in patients with small acoustic neuromas.

The method of choice for the diagnosis of even the smallest acoustic neuromas is CT gas cisternography. Lumbar puncture and gas insufflation, however, is an intervention demanding strict indication. Neuro-otological examinations should lead to this indication.

[Clinical NMR tomography with sequential T2 images (Carr-Purcell spin-echo sequences)].

Advantages of the Carr-Purcell spin-echo sequence in NMR tomography are discussed. It is pointed out that this method generates complete information about relaxation time T2 with only one measurement per slice as compared with the classic spin-echo method.

Clinical experience with iopamidol for myelography.

Within 20 months 145 ascending thoracocervical myelographies and 155 lumbar myelographies with the nonionic water-soluble contrast medium iopamidol were performed. The iodine concentration given was 250 mg I/ml or 200 mg I/ml respectively. The total iodine never exceeded 2.

Percutaneous transluminal angioplasty in arteriosclerotic internal carotid artery stenosis.

Percutaneous transluminal angioplasty (PTA) of carotid arteries has been rarely reported. Dilatation of internal carotid artery stenosis has so far been performed only for fibromuscular dysplasia. Because of the risk of cerebral embolization the technique has not been used for arteriosclerotic stenosis, particularly since endarterectomy is known as a safe procedure.

[Catheter dilatation of arteries supplying the brain].

Stenoses of the extracranial cerebral arteries can be successfully treated with percutaneous transluminal dilatation (PTD). Early and late results of PTD are comparable to those of vascular surgery, but are not accompanied by its morbidity and mortality rates. In 32 patients with subclavian steal syndrome PTD showed a technical success rate of 88% and a clinical cure rate of 72%.

[Differential diagnostic problems in cerebellopontile angle tumors? A case report].

A patient, suffering from otosclerosis of the right ear, was stapedectomized in 1977. Due to bleeding into the oval window during surgery, a persistent deficit of inner ear performance occurred, causing vertigo and hearing loss of high frequencies, in the right ear. As vertigo increased over the years, the patient underwent extensive otological and neurological examinations without result.

[Brain stem audiometry and metrizamide-meatocisternography in diagnosis of small neurinomas of the acoustic nerve (author's transl)].

Reviewing the newest literature, an acoustic neuroma can be detected in 96% of the cases, employing brainstem audiometry. The present study aims to answer the question how good small acoustic neuromas can be detected using this method. Fifty patients with an asymmetric hearing loss, with unilateral caloric deficit and short lasting periods of dizziness when changing position were investigated.