[Diagnosis of infratentorial aneurysms (author's transl)]. / Zur Diagnostik infratentorieller Aneurysmen.

Within a period of two years ten infratentorial aneurysms have been diagnosed. Seven have been operated on. Only rarely the diagnosis of an aneurysm of the posterior fossa can be postulated on clinical grounds or by means of computerized tomography alone. Selective catheter angiography proves to be superior to retrograde brachial angiography in five cases investigated by both methods. In those cases visualisation of an aneurysm could only be achieved by selective catheterisation. Retrospective comparison of angiographic with operative findings shows the junction of the cerebellar inferior posterior artery with the vertebral artery to be the most crucial region for diagnosis.

[Diagnosis of cerebral atrophy on the basis of the cerebral angiogram (author's transl)]. / Die Diagnose der Hirnatrophie auf der Basis des zerebralen Angiogramms.

An increased distance between the brain surface and the skull causes the appearance of a broad avascular band in the carotid angiogram, which -- apart from other criteria -- has been valued as a sign of cerebral atrophy. 54 patients (60 to 79 years old), suffering from cerebrovascular diseases, were examined. Carotid angiography of the afflicted hemispheres were carried out within 4 to 90 days after the stroke. The initially mentioned distance between the skull and the brain surface, represented by the terminal arterial branches, was measured in frontal and lateral projection. The influence of alterations of the wall of extracranial vessels, of the number of attacks, of the severity of the stroke as well as of the patient's age on the distance was statistically evaluated. The results were compared with those of cranial computerized tomography. Only limited correlations between the mentioned parameters and the distance between the vessels and the skull have been found. Thus the distance is only of limited diagnostic value for the verification of senile cerebral atropy on a vascular basis.

[Indications for neuroradiological investigations using contrast media in patients with psychiatric disorders (author's transl)]. / Indikationsstellung zur neuroradiologischen Kontrastuntersuchung bei Patienten mit psychiatrischen Erkrankungen.

The results are presented of neuroradiological investigations using contrast media in 100 patients hospitalized in a psychiatric department. The existence of neurological disturbances or the psychoorganic syndrome, as well as the results of screening methods such as EEG and brain scan are important factors in the decision for or against the performance of cerebral angiography or pneumoencephalography. The significance of the "brain atrophy syndrome" accompanying psychotic diseases is discussed. In addition, some cases are demonstrated of organic neurological brain diseases with predominantly psychiatric features, where the diagnosis was reached on the basis of only neuroradiological methods using contrast media.

[Cerebral angiography with the contrast medium vasobrix 32 (ioxitalamate) (author's transl)]. / Zerebrale Angiographie unter Verwendung des Kontrastmittels Vasobrix 32 (Ioxitalamate).

On the basis of angiograms carried out 168 patients, the contrast qualities achieved with the contrast medium, Vasobrix 32 were compared with those of other contrast media used so far. In the case of carotid angiography, Vasobrix 32 allowed better visualisation in the arterial phase than achieved with the contrast media used so far. The superiority of Vasobrix 32 over other substances was even more evident in the venous phase. As regards visualisation of the branches of the small arterial vessels such as the striothalamic branches, the results achieved with Vasobrix 32 were better than with the contrast media used so far and, therefore, a general improvement in visualization can be expected from Vasobrix 32 (Ioxitalamate). Complications with neurological sequelae were not observed, subjective complaints occurring to a slightly lesser extent than in the case of contrast media with a high sodium salt content.

[Conventional contrast media examinations and computer tomography in space-occupying processes (author's transl)]. / Kontrastmittel-Untersuchungen und Computer-Tomographie bei intrakraniellen Raumforderungen.

In 1977, more than 2,000 patients were examined in our department of neuroradiology by means of angiography, computed tomography, and in some cases also by pneumoencephalography. The value of the various neuroradiological examinations is discussed taking as an example two patients suffering from intracranial space-occupying processes of different etiologies. Consequently, the differential diagnostic problems occurring are discussed casuistically. It is demonstrated that correct diagnosis can often be achieved only by use of all the results of the different neuroradiological methods, together with precise knowledge of the course and the clinical symptoms.

The diagnosis of cerebral atrophy on the basis of cerebral angiogram.

An increased distance between brain surface, represented by the terminal arterial branches, and skull causes the appearance of a broad avascular band in the carotid angiogram, which--apart from other criteria--has been valued as a sign of cerebral atrophy. We investigated 54 patients (ages 60-79 years) suffering from cerebrovascular disease. Carotid angiographies of the afflicted hemispheres were carried out within 4 to 90 days after the stroke. The distance between vessels and skull was measured in frontal and lateral projection. We evaluated statistically the impact on this distance of alterations in extracranial vessel walls, number of attacks, severity of stroke, and patient's age. The results are compared to those of CAT. Only limited correlations have been found between the above-mentioned parameters and the distance between vessels and skull. Thus the distance is only of limited diagnostic value for the verification of senile cerebral atrophy on a vascular basis.

[Scope and limitations of cranial computerized tomography (author's transl)]. / Möglichkeiten und Grenzen der kranialen Computertomographie

Cranial computerized tomography (CT) has revolutionized the scope of diagnostic procedures in intracranial diseases. The method is based on the quantitative registration of x-ray absorption and enables many different pathological features within the skull to be directly visualized for the first time on the tomogram. Cerebral haemorrhage and encephalomalacia can be immediatley differentiated on the basis of the totally different appearance on CT. In the case of tumours, the additional administration of the contrast medium intravenously provides enhancement of the diagnostic evidence. Atrophic processes can be diagnosed by means of CT without recourse to additional neuroradiological methods and this facilitation is of particular value in neuropaediatrics. Orbital processes can be easily spotted due to the high definiation matrix of image. The limitations of CT are based on physical conditions.

[Angiocinematography of cerebral circulatory disturbances using angiografin (author's transl)]. / Angiokinematographie zerebraler Durchblutungsstörungen unter Verwendung von Angiografin.

The arterial flow rate in the three superficial groups of branches of the middle cerebral artery was determined angiocinematographically in 37 hemispheres of 24 patients. In 10 hemispheres of patients with cerebrovascular diseases the arterial flow rate in the corresponding group of branches was lowered to a statistically significant extent. The importance of the choice of contrast medium is emphasized and that used in our investigations, Angiografin, dealt with in more detail. The diagnostic value of conventional determination of cerebral circulation time from serial angiograms is questioned and compared with the results of angiocinematographic investigation.

[Tumours of the corpus callosum in the anglogram (author's transl)]. / Balkentumoren im Angiogramm.

On account of the median location of tumours of the corpus callosum, serial angiography reveals displacements only at an advanced stage. In many cases there is no lateral displacement of the anterior cerebral artery and a lateral angiogram of the pericallosal artery does not reveal tumours of the corpus callosum, especially if they are associated with a vascular pattern characteristic of arteriosclerosis or hydrocephalus. The deep mid-line veins are not consistently displaced. A differentiation of the vascular pattern associated with small tumours of the corpus callosum from normal variations may be problematic. The inner veins cannot be visualised sometimes on account of increased intracranial pressure and a slowing of the circulation.

[Foramen retroarticulare atlantis and the vertebral angiogram (author's transl)]. / Foramen retroarticulare atlantis und das Vertebralisangiogramm

The incidence of a foramen retroarticulare atlantis in a group of 380 patients was investigated and put in relation to the frequency of headaches, migraine and Meniere's syndrome. These complaints are found more frequently in patients with a retroarticular foramen. Angiograms of the vertebral artery show vascular constrictions in the region of the foramen retroarticulare in the majority of patients examined. In 5 patients, the clinical symptoms of a mechanical irritation with changes in blood flow through the vertebral artery in the region of a foramen retroarticulare atlantis have been described.