Incidental pituitary macroadenoma: a population-based study.

Epidemiologic analysis of incidental macroadenoma is limited to autopsy studies and case series. There are no published data about prevalence of incidental pituitary macroadenoma in living patients. The objective of this study was to determine the prevalence of incidental pituitary macroadenoma.

Intracranial Wegener's granulomatosis.

We describe an atypical neurologic presentation of Wegener's granulomatosis (WG) with striking meningeal and cerebral involvement, responding to immunosuppressive therapy. WG may cause treatable intracranial complications in the absence of nasal or renal disease and without cerebral angiographic abnormalities, CSF pleocytosis, or a positive assay for antineutrophil cytoplasmic antibodies.

Use of the delayed mask for improved demonstration of aneurysms on intraarterial DSA.

Purpose: We retrospectively explored the use of the delayed mask technique for intraarterial digital subtraction angiography (IADSA) to demonstrate the anatomy of aneurysm necks.

Methods: The delayed mask technique was utilized in 22 patients who had craniotomies for aneurysms demonstrated at angiography. The operative notes were compared to the angiographic findings of both the traditionally masked IADSA and the delayed mask IADSA.

Postinfarction seizures. A clinical study.

We retrospectively studied 90 patients with postinfarction seizures to determine the clinical features (onset, number, type), prognosis, and electroencephalographic and computed tomographic findings; we included infarctions of all etiologies. Thirty-three percent of the 90 seizures appeared early (within 2 weeks after the infarction), and 90% of the 30 early seizures appeared within 24 hours after the infarction. Seventy-three percent of the 90 seizures occurred within the first year, and only 2% occurred greater than 2 years after the infarction.

Anomalous branches of the cervical internal carotid artery: two cases of clinical importance.

Anomalous branches of the cervical portion of the internal carotid artery are rare. Reports in which these anomalous branches are of any clinical importance are even more rare. We are reporting two cases in which the anomalous branch maintained patency of the cervical portion of the proximally occluded internal carotid artery.

The relation of retinal artery occlusion and carotid artery stenosis.

We retrospectively studied 46 patients with symptomatic retinal artery occlusion and assessed the pattern and extent of carotid artery disease ipsilateral to the retinal artery occlusion. Ipsilateral internal carotid artery atherosclerotic lesions were virtually limited to the cervical arterial segment; 50% of such lesions were plaques or stenoses of less than or equal to 60%, whereas 15% of the angiograms were normal. No clinical features were significantly associated with a flow-limiting carotid stenosis of greater than 60%.

Periventricular white matter changes and dementia. Clinical, neuropsychological, radiological, and pathological correlation.

Forty-three patients with computed tomographic scan findings of decreased attenuation in the periventricular white matter (PVWM) region were studied. Clinical evaluation revealed presence of hypertension in 36 patients (84%) and cerebrovascular risk factors in 41 patients (95%). Unilateral or bilateral neurological deficits were present in 40 patients (93%).

MRI and CT of sellar and parasellar disorders.

Discussion of the anatomy of the parasellar region focuses on the optic chiasm and its relationship to surrounding structures. CT and MRI are valuable tools in the imaging of these regions. This article provides a brief review of the technique of CT and MRI with visualized anatomic structures of these areas.

Optic nerve tumors: role of magnetic resonance imaging and computed tomography.

Localization and pathologic diagnosis of optic nerve tumors have been greatly improved by high resolution computed tomography and magnetic resonance imaging. Radiologic differentiation of the most common tumors of the optic nerve (meningioma and glioma) can be made by using these new imaging modalities. Early diagnosis of optic nerve lesions has resulted in better prognosis and surgical outcome.

Hydrocephalus following iophendylate injection myelography with spontaneous resolution: case report and review.

A 62-year-old patient developed severe adhesive spinal arachnoiditis and hydrocephalus with papilledema following iophendylate injection myelography. Papilledema and hydrocephalus resolved spontaneously. The possible mechanism for hydrocephalus is discussed and the literature reviewed.

Importance of metrizamide CT for evaluation of the thoracic spine.

Post-metrizamide myelographic CT of the area of interest is indicated in cases in which myelography is normal, and also in cases in which myelographic findings alone cannot explain the patient's symptoms. Obtaining early and 4-6 hour delayed CT is of great importance for the detection of syringomyelia and cystic lesions of the cord. In cases of congenital anomalies, additional information can be obtained by this method.

Toxemia of pregnancy: cerebral CT findings.

Four patients with pregnancy-induced hypertension (preeclampsia-eclampsia) and neurological dysfunction unrelated to intracranial hemorrhage, cerebral venous thrombosis, or preexisting neurological disorder had cranial CT performed during their hospitalization. Three patients had diffuse white matter hypodensities with associated mass effect. The fourth patient had bilateral, asymmetric hypodensities confined to the basal ganglia.

Long survival of primary cerebral lymphoma with progressive radiation necrosis.

A 56-year-old man lived 8 years after excision and irradiation of a primary cerebral lymphoma. Delayed radiation necrosis caused progressive neurologic deterioration and probably his steroid-responsive episodes of obtundation. Vasogenic edema induced by radiation may account for the latter.

Cranial subdural hematoma following lumbar myelography.

A case of cranial subdural hematoma after lumbar myelography is reported. The literature of this unusual complication of lumbar myelography is reviewed and the possible mechanism is discussed briefly.

Cerebrospinal fluid rhinorrhea with bilateral intradiploic epidermoid tumors: a case report.

Bilateral large intradiploic epidermoid tumors of the occipital bone presented clinically with CSF rhinorrhea are presented.

Computed tomography of the face and paranasal sinuses: Part I. Normal anatomy.

Computed tomographic (CT) scanning of the face and sinuses has improved markedly with modern equipment and methods. Expertise in facial and sinus anatomy as seen by CT is invaluable to the clinician. A review of normal CT anatomy is presented as a basis for diagnosing pathologic conditions.

Radiology of anterior cerebral artery infarction.

Twenty patients with anterior cerebral artery infarction are reviewed. Usual and unusual clinical presentation and radiographic findings (angiography and computed tomography) are correlated.

Rhinocerebral mucormycosis with CT scan findings: a case report.

A case of rhinocerebral mucormycosis in a diabetic patient is presented. The radiologic findings of the disease with differential diagnosis are reviewed. Almost complete cure with surgical excision and Amphotericin B was accomplished.

CT demonstration of a dural arteriovenous malformation.

A case of dural arteriovenous malformation with intracranial and subdural hemorrhage is presented. The computed tomographic scan with contrast injection demonstrated nodular enhancement adjacent to intracerebral hemorrhage, suggesting an underlying vascular malformation. Angiography confirmed this suggested diagnosis.

Prolonged retention of contrast medium in an hypoxic neonatal brain.

A neonate with hypoxic damage to the brain from a complicated pregnancy and delivery demonstrated a prolonged retention of contrast medium in her cerebral dural veins and brain substance after cardiac catheterization. Myoclonic status epilepticus began during injection of the contrast medium and persisted until its clearance as noted by CT scan. A postmortem examination did not reveal any vascular or congenital abnormalities that would account for these effects.

Radiologic evaluation of tuberculous meningitis.

Five cases of primary tuberculous meningitis are presented. In three cases of acute meningeal process, the classic computed tomographic (CT) scan findings of basal meningeal enhancement, hydrocephalus and arteritis on angiography were found. These radiologic findings suggested the diagnosis, and antituberculosis treatment was therefore instituted at an early stage of the disease.