Spread of blood in cerebrospinal fluid following craniotomy simulates spinal metastases.

Postoperative myelography with water-soluble contrast media was performed in 36 children with a diagnosis of posterior cranial fossa tumour. The myelograms were normal in 15. In 5 an intramedullary tumour was present and 3 of these had in addition subarachnoid changes as evidence of tumour spread.

A randomized study of chemotherapy with procarbazine, vincristine, and lomustine with and without radiation therapy for astrocytoma grades 3 and/or 4.

The authors undertook a controlled, prospective, randomized study of 171 patients with supratentorial astrocytoma grades 3 and/or 4 (classified according to Kernohan). All patients were given chemotherapy consisting of procarbazine, vincristine, and lomustine (CCNU) (PVC). Half of the patients received whole-brain irradiation (RT) to a dose of 5800 cGy in the tumor-bearing hemisphere and 5000 cGy in the contralateral hemisphere.

Volumes of chronic traumatic frontal brain lesions measured by MR imaging and CBF tomography.

The volumes (ml) of chronic traumatic frontal brain lesions were compared measured "morphologically" with MR imaging (T1 and T2 weighted images) and "functionally" with a tomographic rCBF technique (SPECT with 133Xe i.v.).

Reversible changes on computed tomography scans of the brain during induction therapy for acute lymphoblastic leukemia in children.

Children with acute lymphoblastic leukemia (ALL) have been shown to develop changes on computed tomography (CT) scans of the brain. These changes are seen both during and after therapy. Some of the results have been contradictory.

Lateral medullary infarction: prognosis in an unselected series.

We describe the acute and long-term prognosis in 43 patients with lateral medullary infarction (LMI) collected from a population-based stroke registry from 1982 to July 1988. Mean age was 63.9 years and median time of follow-up was 33 months.

Isthmic lumbar spondylolisthesis with sciatica. MR imaging vs myelography.

Seventeen patients with sciatica and isthmic lumbar spondylolisthesis were studied with magnetic resonance (MR) imaging. In 13, myelography was also performed: 5 had dural sac deformation and root sleeve shortening, 2 had deformation with unilateral root sleeve shortening, one had bilateral root sleeve shortening only, and one had sac deformation only. In 4, myelography was normal.

A long-term prospective study of optic neuritis: evaluation of risk factors.

Eighty-six patients with monosymptomatic optic neuritis of unknown cause were followed prospectively for a median period of 12.9 years. At onset, cerebrospinal fluid (CSF) pleocytosis was present in 46 patients (53%) but oligoclonal immunoglobulin in only 40 (47%) of the patients.

Intraventricular choroid plexus "arachnoid" cyst. MRI findings.

A young women presented with chronic headaches associated with a cyst of the right lateral ventricle. The diagnosis of intraventricular so-called "arachnoid" cyst was supported by CT scan, MRI and stereotactic puncture. MRI was of great value for demonstrating that the cyst was located within the lateral ventricule, that it was delineated by a thin wall adherent to the choroid plexus and that the cyst content was CSF-like.

Comparison of myelography, CT myelography and magnetic resonance imaging in cervical spondylosis and disk herniation. Pre- and postoperative findings.

Twenty-six patients with cervical radiculopathy and/or myelopathy caused by spondylosis or disk herniation were examined with myelography, CT myelography and MR. Fourteen of the patients were operated upon and 11 of them underwent postoperative MR and CT. The three radiologic methods provided comparable information about narrowing of the subarachnoid space and compression of the spinal cord.

Repeated cranial computed tomographic and magnetic resonance imaging scans in two cases of eclampsia.

In two cases of eclampsia with consumptive thrombocytopenia, the maximum increase in blood pressure and the lowest platelet count coincided with the maximum degree of neurologic and neuroradiologic abnormality. Computed tomograms showed decreased attenuation, and T2-weighted magnetic resonance images showed increased signal intensity focally in the cerebral cortex and the deep gray and white matter. Blood pressure, platelet count, clinical status, and roentgenograms normalized completely in both cases.

Clinical and radiologic features of lacunar versus nonlacunar minor stroke.

We determined the angiographic presence of extracerebral and intracerebral arterial disease in 122 patients with minor stroke within the carotid territory; we excluded patients with a recognized cardiac source of emboli. Based on clinical features and computed tomographic findings, patients were classified as having lacunar infarcts (n = 61), nonlacunar infarcts (n = 53), and infarcts of indeterminate type (n = 8). Severe carotid bifurcation disease (greater than or equal to 50% stenosis or occlusion) was significantly more common in nonlacunar than in lacunar infarcts, on both the ipsilateral (p less than 0.

MR imaging of the cervical spine in rheumatoid arthritis.

The cervical spine was examined with MR imaging and conventional radiography in 23 patients with severe rheumatoid arthritis. All patients had neck pain and 17 also had neurologic symptoms. MR provided detailed information about soft-tissue lesions, vertebral dislocation, and narrowing of the spinal canal.

Emergency magnetic resonance examination of patients with spinal cord symptoms.

Eighteen consecutive patients with spinal cord symptoms of sudden or relatively sudden onset were examined with magnetic resonance imaging (MRI). The examinations were performed on a 0.3 tesla permanent/resistive imaging system using solenoidal surface coils.

Arterial occlusion due to Listeria meningoencephalitis in an immunocompromised boy.

Sequential CAT scan studies of the brain were performed in a 7-year-old boy with Listeria monocytogenes serotype 1 meningoencephalitis. The infection occurred while he was receiving maintenance chemotherapy for T-cell non-Hodgkin lymphoma. A lesion in the right hemisphere during the infection resulted in an excessive enlargement of the right ventricle 10 months later, most probably caused by arterial occlusion.

Regional differences in the proton magnetic resonance relaxation times T1 and T2 within the normal human brain.

The proton magnetic resonance (MR) relaxation times T1 and T2 were determined in autopsy specimens from 13 different regions of normal human brains. One hundred and seventy-four tissue samples from 25 brains were examined in a pulsed MR analyzer of 0.25 T and were then also studied histologically.

Proton magnetic resonance relaxation times T1 and T2 related to postmortem interval. An investigation on porcine brain tissue.

In order to establish the validity of in vitro determination of the proton magnetic resonance (MR) relaxation times T1 and T2 in brain tissue at increasing time delay after death or operative excision, 81 brain tissue samples from 23 pigs were analyzed repeatedly. These samples, representing cortex, caudate nucleus and white matter, were studied microscopically after MR measurements. The T1 values exhibited no time dependence and the T2 values decreased slightly during the interval 2 to 90 hours after death.

Postoperative CT findings in acoustic neurinomas operated upon by a translabyrinthine approach.

The findings at CT examinations, performed on 46 patients with acoustic neurinomas about 6 months after translabyrinthine surgery, were analyzed and compared with preoperative findings. Direct as well as indirect signs of expansion had disappeared postoperatively. Bulging of cerebellar tissue towards the operative defect in the petrous bone, a finding not connected with local adhesions, was notable.

Young stroke patients. An angiographic study.

In 59 young stroke patients without predisposing conditions (thromboembolic mechanisms, diabetes, cardiac disease, coagulation disturbances), the angiographic findings and the clinical observations in combination make arterial dissection the most probable diagnosis in 45 patients. In an additional 7, this diagnosis remains as a possible diagnosis. It is suggest that in patients under 40 years of age with no predisposing disease and with sudden onset of neurologic deficits, preceded or accompanied by headache and/or neck pain and often associated with physical strain, arterial dissection should be regarded as the most likely diagnosis.

Non-invasive detection of carotid bifurcation disease by continuous-wave Doppler with spectral analysis.

The diagnostic accuracy of 5 MHz continuous-wave (C-W) Doppler with spectral analysis for detecting carotid bifurcation disease was evaluated. In a first phase of the study, normal confidence intervals for peak frequency data and spectrum width were established and Doppler spectrum abnormalities were separated into three types (spectral broadening with preserved window, spectral broadening without window, sequence of abnormalities including inverted Doppler spectrum). In a second phase the diagnostic accuracy of these variables was tested on 86 carotid arteries as independently compared with angiography.

Contrast enhanced brain CT comparison between iohexol and metrizoate.

The commonly used contrast medium metrizoate (Isopaque Cerebral) or the new nonionic iohexol was injected intravenously for enhancement of cranial CT in a randomized double blind study. Each group consisted of 105 patients. No serious reactions occurred.

Outcome in 60 consecutive patients treated with early aneurysm operation and intravenous nimodipine.

Sixty consecutive patients with a ruptured supratentorial aneurysm underwent operation during the acute stage, 56 of them within 72 hours after the first bleed, one on the 4th day, and three on the 5th day. Six patients were classified preoperatively in Hunt and Hess neurological Grade I, 39 in Grade II, 11 in Grade III, and four in Grade IV or V. Nine patients had severe intracerebral hematomas, and one patient had a subdural hematoma.

Psychic changes following myelography with metrizamide and iohexol. A comparative investigation with psychologic tests.

Based upon the results of repeated psychologic tests, psychic impairment following myelography has been studied in 60 patients. Thirty of these had lumbar myelography with metrizamide and 30 with iohexol. Psychic impairment was noted in both groups, although with a higher frequency and much more marked in the group which had metrizamide myelography.