Basal ganglia involvement in subacute sclerosing panencephalitis: CT and MR demonstration.

We describe a case of subacute sclerosing panencephalitis (SSPE) with clinical parkinsonian features and neuroradiologic abnormalities of the basal ganglia. Prominent basal ganglia involvement may occur in SSPE.

A simple method to form an open loop with the sidewinder catheter for cerebral angiography.

Reforming an open loop in the ascending aorta is the first step in performing selective catheterization of the aortic arch branches, using a sidewinder catheter. An alternative method for forming the open loop is described. The method is simple and safe. No failures were encountered in over 150 consecutive cases, thirty of which were by transaxillary approach.

Imaging sacral nerve root cysts.

Sacral nerve root cysts usually are an incidental finding but may be found in patients with a history of pain. On computed tomography they are demonstrated as a soft tissue mass, possibly with associated bony erosion. Demonstrating the fluid-filled nature of these masses is important in establishing the diagnosis. The imaging of these cysts in two patients, including magnetic resonance, is described.

Magnetic resonance imaging of a spinal extradural arachnoid cyst.

A case of extradural arachnoid cyst in the spinal canal of a 16-year-old male was diagnosed by magnetic resonance imaging. The diagnosis was verified by a metrizamide-enhanced computed tomographic myelogram. An operation with a favorable outcome followed. The noninvasive advantages of magnetic resonance imaging in such a diagnosis are demonstrated by this case.

Spinal cysticercosis.

A case with cysticercosis cysts in the spinal subarachnoid space with unique myelographic features is discussed. One of the cysts moved within the spinal subarachnoid space during the myelographic examination. Recognition of the possibility that mobility of the cyst may occur between the time of the myelographic study and laminectomy is important for the surgeon.

Silicone encircling bands for retinal detachment: CT appearance.

Silicone encircling bands are placed around the eyeball routinely during retinal detachment surgery. We present two cases that show the characteristic appearance of such a band on CT.

Control of swallowing by use of topical anesthesia during digital subtraction angiography.

Involuntary swallowing and other forms of patient motion are the greatest source of image degradation in digital subtraction angiograms of the extracranial carotid and vertebral arteries. If a patient gargles with a recommended dose of 2% viscous lidocaine, the urge and ability to swallow are reduced and image quality is improved.

Spinal leptomeningeal infiltration by systemic cancer: myelographic features.

Five cases of spinal leptomeningeal infiltration by systemic cancer are presented and myelographic features are discussed with a review of the literature. Common characteristic features are parallel longitudinal striations due to thickened nerve roots in the cauda equina and bizarre irregular filling defects with varying degrees of blocks, resembling arachnoiditis. Another pattern described in the literature consists of multiple nodular filling defects along the nerve roots of the cause equina.

Anomalous origin of the ophthalmic artery in a patient with amaurosis fugax.

Ectopic origin of the ophthalmic artery from the middle meningeal artery was found in a patient with amaurosis fugax. The origin of the external carotid artery on the symptomatic side was markedly stenotic. The patient's symptoms disappeared after external carotid endarterectomy. We review the ectopic sites of the ophthalmic artery and discuss atheromatous disease of the external carotid system as a cause of transient ischemic attacks.

Intracranial complications of pediatric hematologic disorders: computed tomographic assessment.

Computed tomography (CT) findings in the intracranial complications of leukemia, hemophilia, and sickle cell anemia were reviewed in 19 children with these hematologic disorders. CT demonstrated intracranial hemorrhage, infarction, intracerebral mass, and post-therapeutic atrophy and leukoencephalopathy in leukemic children. Intracerebral, subarachnoid, subdural, and epidural hemorrhage was documented in patients with hemophilia. Bland and hemorrhagic infarctions were identified in children with sickle cell anemia. CT proved valuable in documenting the presence and extent of these abnormalities, titrating factor replacement in hemophiliac patients, and monitoring therapeutic toxicity in leukemic patients.

Unilateral enlargement of the internal auditory canal: a developmental variant.

Marked asymmetry of the petrous pyramids as seen on plain skull roentgenograms is reported in 3 patients with no clinical findings related to the region of the cerebellopontine angle. Polytomograms of the enlarged internal auditory canal in these patients demonstrated in intact crista falciformis and absence of cortical destruction. These roentgenographic features suggest that the asymmetry represents a developmental variant. When contrast enchanced computed tomography fails to demonstrate an abnormality in asymptomatic patients with an enlarged internal auditory canal, it is unnecessary to proceed with further neuroradiological study.

Diastematomyelia in an adult.

Surgical treatment of diastematomyelia, with removal of the spur and dural septum, is indicated in adults with progressive symptoms. The patient may improve, or at least the progression of the neurological damage may be halted. The utilization of microneurosurgical techniques was found to be of value in decreasing the danger of spinal cord or nerve injury during the procedure. The seventh case reported in the literature of diastematomyelia with onset of symptoms in adult life is presented.

Sphenoid sinus mucoceles presenting as intracranial masses on computed tomography.

Two cases of mucocele of the sphenoid sinus that presented as sellar and parasellar masses on computed tomography (CT) are presented. One mucocele was isodense while the other was hyperdense (100 Hounsfield units). Neither lesion demonstrated contrast enhancement. By delineating the total extent of the lesions, CT facilitated pre-operative diagnosis and surgical management.