ABSTRACT
We report a unique case of metastatic craniopharyngioma. Initially, the patient had a right frontal craniotomy for resection of a suprasellar mass, which was determined to be an adamantinomatous craniopharyngioma. Seven years later, an MR study of the brain showed two peripheral enhancing lesions adjacent to the dura and contralateral to the craniotomy site. Pathologic examination again showed adamantinomatous craniopharyngioma. Although recurrence, both local and along surgical tracts due to implantation of craniopharyngioma tissue, has been reported, this case raises the possibility of meningeal seeding to remote sites.
Subject(s)
Craniopharyngioma/secondary , Pituitary Neoplasms/pathology , Aged , Brain Neoplasms/diagnosis , Brain Neoplasms/pathology , Brain Neoplasms/secondary , Brain Neoplasms/surgery , Craniopharyngioma/diagnosis , Craniopharyngioma/pathology , Craniopharyngioma/surgery , Craniotomy , Dura Mater/pathology , Dura Mater/surgery , Humans , Magnetic Resonance Imaging , Male , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/pathology , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/surgery , ReoperationABSTRACT
Four patients with intracranial aneurysm clips made from a variety of alloys were studied without incidence by MR imaging at field strengths ranging from 0.35 to 0.6 T. Knowledge of the type of alloy used in the manufacturing of an aneurysm clip is important in determining whether the clip will or will not deflect in a magnetic field. Ferromagnetic clips show deflection and torque in a magnetic field and have the potential to dislodge from the aneurysm. Nonferromagnetic or weakly ferromagnetic aneurysm clips such as the Sugita (Elgiloy), Yasargil (316 LVM stainless steel), Heifetz (Elgiloy), Yasargil (Phynox), and Vari-Angle McFadden (MP35N) do not deflect or deflect weakly in the magnetic field and therefore would not be expected to dislodge during MR. The option of imaging many patients with intracranial aneurysm clips with MR extends the usefulness of the technique to a previously excluded population.
Subject(s)
Alloys , Intracranial Aneurysm/surgery , Magnetic Resonance Imaging , Stainless Steel , Vascular Surgical Procedures/instrumentation , Adult , Aged , Brain/pathology , Female , Humans , Male , Middle AgedABSTRACT
Thirteen patients with cervical spondylosis and high compressive myelopathy between C-3 and C-5 presented with a distinctive clinical syndrome of "numb, clumsy hands" and stereoanesthesia of the hands. Loss of position and vibration sense was much more severe in the hands than in the legs. Relative sparing of primary sensory modalities and motor and bladder functions were other features. Most patients were incorrectly diagnosed at first and cervical myelography was the critical diagnostic test. Pathology was confirmed surgically or at autopsy. Early recognition and treatment resulted in lessened disability. The syndrome is a distinctive and unusual manifestation of high cervical myelopathy, and it has seldom been reported associated with cervical spondylosis.
