Estimation of patient age based on plain chest radiographs.

Patient age is an essential part of a clinical history, but it is not always provided by referring physicians. We assessed the ability of four radiologists with different levels of expertise (first-year resident to professor emeritus) to predict patient age based on postero-anterior and lateral chest radiographs from 171 patients. All four were able to predict age with a mean error of less than 15 years, but there were statistically significant differences among them. Surprisingly, observer experience did not correlate with accuracy of patient age estimation. While many factors probably operate, the estimation of patient age relies heavily on "gestalt."

External carotid-vertebral artery anastomosis for vertebrobasilar insufficiency.

Surgical treatment of vertebrobasilar insufficiency has long lagged behind that of carotid disease. However, as more aggressive microsurgical techniques have been developed, surgical intervention in vertebrobasilar occlusive disease is seen with increasing frequency. The authors describe three cases of external carotid vertebral artery anastomosis, a rarely reported operative procedure, in which blood flow was successfully restored to the diseased vertebral artery. Awareness of this new technique will be useful to the radiologist servicing an active neurosurgery practice. The clinical, radiologic, and pathologic manifestations of vertebrobasilar insufficiency are also briefly reviewed.