Multiple spinal canal meningiomas.

Three cases of multiple spinal canal meningiomas are presented, bringing the total number of documented cases in the American literature to nine. While the exact incidence of multiple spinal meningiomas is difficult to determine, their possible occurrence warrants careful myelographic examination of the whole spinal canal, particularly if multiple clinical levels are present. When a complete block to the contrast agent is encountered, myelography should also be carried out via an upper cervical puncture. The radiograhic appearances of multiple meningiomas are nonspecific.

An analysis of 113 intracranial infections.

The location, source of infection, and CT characteristics of 90 intracerebral abscesses and 23 subdural empyemas are reported with special regard to capsule enhancement and surrounding cerebral edema.

Anterior pontomesencephalic vein and basilar artery in exophytic brainstem gilioma.

The angiographic differentiation of an intrinsic exophytic brainstem glioma from an extra-axial posterior fossa tumor is not always easy. The location of the basilar artery alone may not be significant. Displacement of the anterior pontomesencephalic vein anterior to the basilar artery appears to be a reliable indicator of an intrinsic exophytic brainstem glioma.

Tumours aneurysms.

Intracranial aneurysms commonly present with subarachnoid hemorrhage. Rarely, they may attain a large size and manifest exclusively as intracranial space-taking lesions. We have collected a series of 48 cases of large aneurysms; 47 of them have been previously unpublished. To our knowledge, this is the largest series on this subject.

Growing intracranial aneurysms.

Cerebral angiography is the best means by which an intracranial aneurysm can be demonstrated and studied in vivo. In 16 cases clinical deterioration paralleled a variable degree of enlargement of the aneurysms. In all patients the aneurysms were irregular and/or bior multilocular. Possible factors causing aneurysmal enlargement are discussed.

Intracranial hemangiopericytomas. Angiography, pathology and differential diagnosis.

Intracranial hemangiopericytomas are tumors which angiographically and histologically can mimic other vascular intracranial masses. The term angioblastic meningioma has been applied to this tumor and to other vascular tumors. However, hemangiopericytomas have a unique biological behavior and prognosis as they tend to recur or metastasize and are insensitive to radiation. Hence, the importance of their specific recognition is emphasized. This is a report of the roentgenologic and pathologic fidings in five cases of histologically verified intracranial hemangiopericytomas. The angiographic findings common to these tumors include a myriad of tiny irregular feeding vessels springing from a main trunk, an intense fluffy type of stain, lack of early veins, and prolonged tumor circulation time. The major arterial supply is from the internal carotid or vertebral circulation rather than from external (meningeal) vessels. Differentiation from other vascular tumors particularly supratentorial hemangioblastoma, glioblastoma multiforme, as well as from vascular meningothelial meningioma is important from both the angiographic and histologic aspects.

Metastases to the medulla of the spinal cord: myelographic features.

Intramedullary metastases to the spinal cord of non-neurogenic origin are exceedingly rare, comprising fewer than 1.6% of all metastases affecting the spinal canal and its contents. Plain films are normal. Irregular fusiform widening of the spinal cord is the most common myelographic feature, although nodularity is also present. Complete blockage is very rare. The authors describe the radiological features in 4 cases of intramedullary metastases of non-neurogenic origin. The differential diagnosis is discussed, and some pathogenetic mechanisms are postulated. It is important to recognize intramedullary metastases in order to plan the proper management.

Relapsing juvenile chronic subdural hematoma in adult life.

Two cases of relapsing juvenile chronic subdural hematoma with late relapse in adult life are presented and the literature reviewed. Both patients contracted subdural hematoma early in life; its persistence resulted in characteristic skull deformitites. The patients led an asymptomatic life until a second head trauma caused rebleeding into the old hematoma sac with recurring symptoms and signs. The source of rebleeding is the outer subdural membrane. Radiographic features vary, depending on the location and size of the subdural hematoma. The significance of localized thickening of the cranium is stressed in refining the differential diagnosis.

Cerebral angiographic changes associated with tuberous sclerosis.

Two patients with tuberous sclerosis were examined angiographically. In one, direct left carotid angiography showed a contralateral shift of the anterior cerebral artery and lateral displacement of the middle cerebral artery. On the lateral series, increase in the sweep of the anterior cerebral artery as well as stretching of the opercular branches of the middle cerebral artery were noted in the early arterial phase. In the later arterial phase, there was marked hypervascularity, with the contrast substance temporarily pooling in small, rounded collections. In the mid-arterial phase of the second case, pooling of the the contrast medium within the tumor and many small, berry-like outpunchings were noted. There was no evidence of early venous drainage in either case.

Radiological diagnosis of mass lesions within and adjacent to the foramen magnum.

Masses within or adjacent to the foramen magnum may present difficult clinical problems. They may sometimes be misdiagnosed as degenerative disease of the central nervous system, cervical spondylosis, or even cervical disk disease. In most cases, roentgenographyis necessary for proper diagnosis. The anatomy of the region of the foramen magnum is reviewed and 13 cases representing various diseases are presented. Alterations in the regional arterial and venous anatomy are emphasized.

Neonatal craniopharyngioma. Case report.

The authors report a case of craniopharyngioma in a newborn infant. Marked hydrocephalus of the fetal head was recognized in the pelvimetric roentgenograms of the mother and massive suprasellar calcification was seen in the plain skull films.