Management of problematic intracranial hydatid cysts.

The authors report four patients with intracranial hydatic cysts. One patient had a pontine lesion which was punctured and aspirated and the cyst wall removed with a satisfactory outcome. The second patient had multiple cysts which was comparable to meningeomatosis. She had a rapidly deteriorating neurologic condition which proved to be fatal in spite of two consecutive surgical interventions. The third patient had nine lesions although only six were evident on the MRI. All of the cysts were removed, while two cysts ruptured. Multiple paracardial cysts of this patient were surgically removed shortly after the craniotomy. The last patient, again with multiple intracranial hydatid cysts had safe, total removal of all cysts. The first postoperative control CT raised the possibility of recurrence since the CT was highly suggestive of a hydatid cyst. However, this was not confirmed in the follow-up CT examination. Problems and the solutions of management are discussed.

CT and angiography in a patient with three intracranial giant aneurysms.

A patient with multiple giant aneurysms all located in the circle of Willis was treated conservatively. Literature pertaining to neuroradiologic features, especially dealing with the CT appearance of this entity, is scrutinized.

CT findings and surgical treatment of double intracranial echinococcal cysts.

The authors present a young male patient with two intracranial lesions, one in the left occipital lobe, the other in the left temporal lobe. These masses were totally removed and both proved to be alveolar hydatid cysts. Surgery for a large hepatic mass, diagnosed after the first craniotomy, was refused by the patient.

Rare causes of hemifacial spasm. Report of two cases.

Two patients are presented whose sole symptom was hemifacial spasm. Cerebellar arachnoid cyst was diagnosed in one patient who was treated effectively by removal of the cyst and decompression of the facial nerve. The second patient had an AVM of the posterior fossa. Surgery was withheld in this case.

Association of von Recklinghausen's neurofibromatosis and aqueduct stenosis.

We present 6 patients with a definite diagnosis of von Recklinghausen's neurofibromatosis. All of them had aqueductal stenosis and hydrocephalus requiring surgical intervention because of clinical signs of increased intracranial pressure confirmed by pressure measurements.

Tension pneumocephalus after transsphenoidal surgery: case report.

The authors present a patient who underwent transsphenoidal surgery for a pituitary adenoma and afterward developed late, severe rhinorrhea and tension pneumocephalus. The patient was treated conservatively.

[Cisterna megamagna. Dimensions and relations to cerebral atrophy. Clinical and x-ray computed tomographic demonstration]. / La méga grande citerne. Ses dimensions et ses rapports avec l'atrophie cérébrale. Une mise au point clinique et tomodensitométrique.

Polaroids of 9,400 consecutive unselected computed tomography (CT) scans are reviewed and 31 cases with Mega Cisterna Magna (MCM) are detected. The incidence is 0.33% (31/9,400). Clinical and radiological data relating to these 31 cases shows that none of the patients presented neither any clinical sign of a posterior fossa space occupying lesion nor any radiological image such as hydrocephalus or forward displacement of the fourth ventricle. The dimensions of the cistern ranged as follows: width between 22.2-92.5 mm, depth between 22.2-37.0 mm, height between 26.0-39.0 mm. The authors propose 20 mm as the limit value of width and depth of a normal cisterna magna and 26 mm for its maximal height, these dimensions being the most frequently encountered ones of these 31 patients. The correlation between the magnitude of the cistern (the sum of the width and depth of the cistern: w + d) and the severity of cerebral atrophy (the sum of the maximum and minimum widths of the anterior horns of the lateral ventricles which is the most reliable atrophy index defined by Hirashima: a + b) is illustrated in figure 5. The authors conclude that Mega Cisterna Magna which has a constant incidence in routine CT examinations is predominantly a consequence of cerebral atrophy and does not have any specific clinical pathological correlate and does not require any form of treatment.

Intracerebral hemorrhage and hematoma in Behçet's disease: case report.

The authors describe a patient with Behçet's disease who suffered from intracerebral hemorrhage 2 1/2 years after the initial diagnosis. There is strong evidence that this situation is not merely a coincidence; rather, these two abnormalities have a cause and effect relationship.

Mega cisterna magna: a constant variation of the cerebellomedullary cistern associated with cerebral atrophy.

Data relating to 31 cases of mega cisterna magna studied by computed tomography are presented. The incidence and the relation of this condition to cerebral atrophy are examined. Mega cisterna magna has a constant incidence in routine CT material and is closely associated with cerebral atrophy.

Chronic extradural haematoma: a late complication of head injury.

Three cases of chronic extradural haematoma are presented. The patients who were admitted with neurological signs, were fully conscious at the time of diagnosis. They were operated on 9, 14 and 29 days after the initial trauma. The necessity for adopting a generally accepted chronological criterion of chronicity for extradural haematoma is emphasized. A distinction between conscious and comatose patients with chronic extradural haematoma is made.

Orbital echinococcosis. Report of two cases studied by computerized tomography.

Two cases of orbital echinococcus cysts studied by computed tomography are presented. Incidence of orbital hydatidosis in Turkey is reported. Computed tomographic findings of orbital hydatid cysts are reviewed and summarized. Medial displacement of the orbital plate of the ethmoid bone is emphasized as a frequent finding in the reported cases.