Syringomyelia: myelography, computed tomography, and magnetic resonance imaging.

Seventeen patients with cervical spinal cord cavities were studied with myelography, postmyelographic computed tomography scanning, and magnetic resonance imaging. The three diagnostic techniques were compared for accuracy, patient comfort, and ease of procedure. Magnetic resonance imaging was the best diagnostic and most comfortable procedure. There is no need for myelography or postmyelographic computed tomography scanning for the evaluation of cervical syringomyelia.

Callosomarginal infarction secondary to transfalcial herniation.

To evaluate the prevalence of anterior cerebral artery infarcts in the context of transfalcial herniation, 1100 cerebral CT scans were reviewed. Three patients had acute intracranial hemorrhages resulting in transfalcial herniation and subsequent focal ipsilateral paracentral lobule or superior frontal gyrus infarcts. The infarcts are presumed to have resulted from compression and compromise of the terminal portions of the callosomarginal artery against the falx. Callosomarginal infarcts are reflective of severe, acute hemispheric insult. As such, they seem to portend a declining clinical condition, and thus may provide another CT indication of a poor clinical outcome.

Trauma oblique radiographs of the knee.

Special trauma oblique radiographs of the knee were designed for the purpose of demonstrating the patella radiographically in a manner that would free it from the shadow of the distal end of the femur. These radiographs are made by directing the x-ray tube at an angle of 45 degrees and making two exposures, with the film placed first on the lateral and then on the medial side of the injured knee. These two radiographs have been found to be useful for delineating the extent of fractures of the patella as well as abnormalities of the tibial plateau.

Diagnosis of sacral perineural cysts by computed tomography.

Three cases of sacral perineural cysts associated with chronic low-back pain are described with their myelography, computed tomography, and plain film findings. Significant findings include multiple cystic dilatations of lumbosacral nerve root sheaths, enlargement of the sacral foramina by masses isodense with cerebrospinal fluid, and asymmetric epidural fat distribution. Recognition of these findings on unenhanced computed tomography scans should preclude further evaluation by myelography and intrathecal metrizamide (Amipaque) computed tomography. These cysts are usually not the primary cause of back and leg pain.

Beneficial actions of imidazole in endotoxin shock.

The effects of imidazole were studied in anesthetized cats during endotoxin shock. Imidazole (25 mg/hg/hr) was administered 30 minutes after intravenous injection of E. coli endotoxin (5 mg/kg). The degree of the severity of the shock state was assessed by mean arterial blood pressure (MABP), and by plasma cathepsin D and MDF activities. Analysis of thromboxane B2 concentrations during shock was also performed by radioimmunoassay. Administration of imidazole to cats given endotoxin partially prevented the decrease in MABP of endotoxin shock. Imidazole significantly prevented the increase in plasma cathepsin D and MDF activities. Thus, infusion of imidazole resulted in metabolic and hemodynamic improvement during endotoxin shock. The mechanism of imidazole protection appears to be via lysosomal membrane stabilization, stimulation of cardiac function and possibly by antagonizing the biochemical effects of endotoxin administration, rather than by inhibition of thromboxane synthesis. Data obtained using imidazole to block thromboxane synthesis in shock states must be interpreted with caution.