Cortical tuber count: a biomarker indicating neurologic severity of tuberous sclerosis complex.

The relationship between the number of cortical tubers observed by magnetic resonance imaging (MRI) and the severity of cerebral dysfunction of tuberous sclerosis patients has been examined in a meta-analysis of the published literature. The literature review has identified five independent studies for examining the association. These studies consistently reveal that the cortical tuber count detected on MRI scans is increased among those with more severe cerebral disease.

Sarcoidosis presenting as a central nervous system mass lesion.

Neurosarcoidosis occurs in approximately 5% of patients with systemic sarcoidosis. A review of medical literature shows that intracranial mass-like lesions secondary to sarcoidosis are quite rare. CT and MRI scanning would suggest that this manifestation of neurosarcoidosis may be more common than previously realized.

Cervical disk prolapse.

Objective: To correlate the findings on computed tomographic myelography (CTM) with surgically and pathologically proven prolapsed cervical disks, mention other pertinent cross-sectional imaging studies, and note the clinical relevance of certain CTM features.

Design: We retrospectively reviewed the medical and radiologic records of Mayo patients with suspected degenerative cervical disk disease during a 4-year period.

Material And Methods: Between January 1986 and December 1989, 734 patients with possible cervical disk disease underwent assessment by CTM.

MR findings in tuberous sclerosis complex and correlation with seizure development and mental impairment.

Purpose: To correlate the findings on MR scans of the brain in patients with tuberous sclerosis complex with mental disability and the type and age at onset of the first seizure.

Methods: Patients with tuberous sclerosis complex who had MR brain scans were identified. The diagnosis was confirmed, and the clinical information on each patient was updated.

Cervical spondylotic stenosis and myelopathy: evaluation with computed tomographic myelography.

Objective: To determine which components of cervical spondylosis are most frequently present in patients with myelopathy.

Design: We reviewed the findings in 93 patients who underwent surgical decompression for cervical spondylotic myelopathy between January 1986 and December 1989 at Mayo Clinic Rochester.

Material And Methods: All 93 patients (72 men and 21 women) underwent computed tomographic (CT) myelography.

Angiographically occult vascular malformations: a correlative study of features on magnetic resonance imaging and histological examination.

With reference to vascular malformations, the term cavernous has architectural as well as histologic connotations. It refers to a compact pattern of growth wherein no intervening brain parenchyma is evident, as well as to the histological nature of the vessels, which are hyaline and collagenous in appearance, lacking the microscopic features of arteries or veins. Historically, cavernous angioma has been defined as exhibiting both features.

Cervical neural foraminal canal stenosis: computerized tomographic myelography diagnosis.

The surgical and computerized tomographic myelography (CTM) features of 134 stenotic foraminal canals were correlated retrospectively in 95 patients. The myelographic site of stenosis was the entrance to the foraminal canal in 70 cases (52%) and the canal itself in 37 (28%); the site was not identified definitively in 27 (20%). At the entrance to the foraminal canal, encroachment on the adjacent nerve root was by a cartilaginous cap in 10 cases (8%), a bony osteophyte in 17 (13%), a synovial cyst in one (1%), and a combination of a bony and cartilaginous osteophyte in 42 (31%).

CT and MR imaging of intracranial tuberous sclerosis.

CT and MR have permitted radiology to play a greater, but not definitive, role in detecting the pathologic components of tuberous sclerosis. SEN may be identified in only 80% of patients. Tubers are more ubiquitous and readily identified by MR in children and adults when the brain is myelinated.

Iopamidol myelography: morbidity in patients with previous intolerance to iodine derivatives.

The records of 1005 patients who underwent iopamidol myelography between January and September, 1988, were reviewed. In this group, 50 patients had histories suggestive of untoward sequelae associated with iodine intake, contact, or administration. The charts of these patients were carefully reviewed, and none of them had any reactions or sequelae suggestive of toxicity or an allergic response after iopamidol myelography.

Prospective study of the effectiveness and durability of carotid endarterectomy.

In a series of 252 consecutive patients who underwent 282 carotid endarterectomies, we conducted clinical and angiographic follow-up for 2 to 6 years (mean, 3.2 years). Digital subtraction angiography (DSA) was done postoperatively in 95% of cases.

Arterio-inferior sagittal sinus fistulae: case report.

The management of the case of a 9-year-old boy with progressive cognitive impairment due to arteriovenous fistulae at the apex of the inferior sagittal sinus is reported. This represents a unique location for an extraparenchymal deep central arteriovenous malformation. The patient underwent staged ablation of the lesion by surgery.

Brief loss of consciousness in bilateral carotid occlusive disease.

Loss of consciousness is rare in the absence of transient or persistent insult to the diencephalon or mesencephalon. We found three patients with severe atherosclerotic stenosis or occlusion of both internal carotid arteries who experienced brief loss of consciousness. Common characteristics were the absence of clinical or electroencephalographic seizure activities, significant cardiovascular disease, or a history suggestive of vasovagal syncope.

Angiographic frequency of anterior circulation intracranial aneurysms.

A retrospective angiographic analysis was designed to extrapolate the frequency of angiographically defined asymptomatic intracranial aneurysms in the anterior circulation from a relatively unbiased clinical series. A total of 9295 angiograms were reviewed from January, 1980, to January, 1987, and, based on these, 278 patients with minimal bias for the presence of an aneurysm were selected. Three patients were found to have incidental aneurysms; thus, the angiographic frequency of patients with asymptomatic aneurysms in this series was 1%.

Cerebral tuberous sclerosis: MR imaging.

Nineteen patients with a clinical diagnosis of tuberous sclerosis were examined with high-field-strength magnetic resonance (MR) imaging. Their ages ranged from 6 months to 12 years. In 17 cases, the MR examinations showed both subependymal nodules and multiple peripheral gyral lesions consistent with cortical tubers.

Spontaneous dissections of the vertebral arteries.

Clinical and angiographic features and outcome in 25 patients with spontaneous dissections of the vertebral arteries are described. Most patients were in their fourth or fifth decade of life, and women predominated. Forty-eight percent of the patients were hypertensive.

Traumatic dissections of the extracranial internal carotid artery.

Traumatic dissections of the extracranial internal carotid artery (ICA) in 18 patients aged 19 to 55 years were studied. All had suffered blunt head or neck injury of marked or moderate severity; motor-vehicle accidents were the leading cause of the injury. Delayed focal cerebral ischemic symptoms were the most common presenting symptoms.

Comparison of magnetic resonance imaging and computed tomography in the preoperative evaluation of pituitary adenomas.

Twenty surgically verified pituitary adenomas were imaged in a systematic comparative fashion with high field strength magnetic resonance imaging (MRI) and computed tomography (CT) before operation. The study group included 11 microadenomas, 4 macroadenomas, 2 recurrent microadenomas, and 3 recurrent macroadenomas. The MRI and CT examinations were evaluated for lesion detection, pituitary stalk displacement, cavernous sinus displacement or invasion, hemorrhage, cystic degeneration within the adenoma, bony erosion, detection of suprasellar extension, and displacement of suprasellar structures.

MR findings in normal-pressure hydrocephalus: significance and comparison with other forms of dementia.

This study was undertaken to identify findings on magnetic resonance (MR) imaging that might possibly differentiate among several dementia states in the elderly or predict response to shunt therapy in patients with normal-pressure hydrocephalus (NPH). The MR findings were retrospectively reviewed in 54 patients who were divided into four clinical categories: NPH (17 patients), obstructive hydrocephalus (eight patients), Alzheimer disease (eight patients), and non-Alzheimer dementia (21 patients). Three MR findings were evaluated in each case: increased periventricular (PVS) and white matter (WMS) signal on T2-weighted images, CSF flow void sign (CFVS) in the aqueduct, and corpus callosum thinning.

Imaging of cranial chordomas.

The clinical, pathologic, and imaging characteristics of clival chordomas in 14 patients who underwent magnetic resonance examinations were evaluated. Magnetic resonance imaging (MRI) was compared with skull series, tomography, computed tomography (CT), and magnification angiography in the diagnosis of clival chordomas. Although all examinations were highly sensitive for the detection of clival chordomas, MRI was the best single study because of its ability to image in orthogonal planes, its excellent soft-tissue contrast, and its demonstration of the relationship between the neoplasm and regional vital structures, particularly the brainstem, cavernous sinus, cranial nerves, and neighboring vessels.

Trapped fourth ventricle in an adult: radiographic findings and surgical treatment.

Trapped fourth ventricle is a rare entity that has most often been reported mainly in children as a late complication of lateral ventricle shunting. We report a case in a previously normal adult who developed symptoms several months after bacterial meningitis. Unique radiographic and surgical findings are discussed, and recommendations are made for the classification and treatment of fourth ventricular enlargement.

Arterial fibromuscular dysplasia.

Fibromuscular dysplasia is a nonatherosclerotic, noninflammatory vascular disease that involves primarily the renal and internal carotid arteries and less often the vertebral, iliac, subclavian, and visceral arteries. Although its pathogenesis is not completely understood, humoral, mechanical, and genetic factors as well as mural ischemia may play a role. The natural history is relatively benign, with progression occurring in only a minority of the patients.