Local experience in the diagnosis of avascular necrosis of the femoral head in adults using magnetic resonance.

We analyzed MRI results from 36 patients referred for testing to assess the degree of advancement of non-traumatic avascular necrosis (AVN) of the femoral head in adults (24 cases) or for diagnosis in difficult cases (12 cases). 32 patients were found to have AVN of the femoral head with various degree of advancement, mostly stages III and IV. In three cases the MRI did not show any pathology within the hip joint, and in one case the MRI picture was consistent with a metastatic lesion. This suggests that the value of the MRI as a sensitive diagnostic tool in the early diagnosis of AVN in adults is underestimated.

Agenesis of corpus callosum: clinical description and etiology.

In 135 children (aged 3 months to 15 years) with structural defects of the central nervous system found on magnetic resonance imaging, agenesis of the corpus callosum was evident in 7. The etiology of agenesis of the corpus callosum has been established in four children: partial trisomy of chromosome 13, partial duplication of the long arm of chromosome 10, Aicardi's syndrome, and intracranial bleeding during the fetal period as a result of injury. Agenesis of the corpus callosum coexisted with a Dandy-Walker malformation in one other patient, which suggests a genetic etiology. In spite of these variable etiologies, dysmorphic features were identified in all seven patients, as was psychomotor retardation. Epileptic seizures had occurred in six patients, and all manifested abnormalities on neurologic examination.

[Cerebral tumors as a cause of refractory epilepsy in children]. / Procesy rozrostowe wewnatrzczaszkowe jako przyczyna padaczki lekoopornej u dzieci.

Cerebral tumours are a cause of seizures in less than 1-2% of children epilepsy. Seizure symptoms usually precede the diagnosis by several years and are often the only symptoms of an ongoing process. The symptomatology of the seizures often correlates with localization of a neoplastic lesion. The authors present six children aged 3 to 18 in whom epileptic seizures not susceptible to treatment were caused by cerebral tumours. The duration of epilepsy until the determining of the aetiology was various--from half a year to 13 years. In each of our six patients focal epilepsy occurred with simple or complex seizures with secondary generalization. It was only one patient in whom the tomography of the head turned out to be sufficient enough to establish the diagnosis of a brain tumour; in the other ones MR was necessary. The final diagnosis in four of the children was supported by histopathologic examination carried out during a neurosurgical procedure, whereas in one of them--by means of biopsy of the brain.

[The evaluation of selected factors in the prognosis of drug-resistant epilepsy in children with brain malformations]. / Ocena wybranych czynników w prognozowaniu padaczki lekoopornej u dzieci z wadami mózgu.

Brain malformations are important and frequent epilepsy reason in children and adolescents. During the last six years in neurological department of Pediatrics Clinic in Katowice were treated 106 children with brain malformations demonstrated in magnetic resonanse imaging. The main clinical symptoms in these patients were following: mental retardation, epilepsy, abnormalities in neurological examinations, dysmorphic features. Epilepsy were observed in above 3/4 of patients (84 children). In most of them there was intractable epilepsy (55 children). The aim of study was evaluation of selected factors in prognosis of epilepsy intractibility. The children with brain malformations and epilepsy were divided into two groups: with intractable epilepsy and with good response for pharmacotherapy. The type of malformation, the pre- i perinatal history, an age at which the first seizures appeared, abnormalities in neurological examination and IQ were compared in both groups. The differences weren't significant statistically apart two data. Normal pre- and perinatal history and early manifestation of seizures (during the first half of life) were confirmed significant statistically more often in group of patients with intractable epilepsy. There was limited value of most of the analysed parameters in prognosis of epilepsy intractibility. Further accumulating of data and increasing of number of the patients group with different types of malformations as well as progress in diagnostics, particularly molecular genetics, may be helpful in correct prognosis.

[Vascular compression syndrome of the vestibulocochlear nerve--otolaryngologic and radiologic diagnosis]. / Konflikt naczyniowo-nerwowy nerwu przedsionkowo-slimakowego--diagnostyka otolaryngologiczna i radiologiczna.

Vascular compression syndrome is the term used to classify a group of conditions though to be caused by the compression of cranial nerve by vessel. In the most cases the contact of vascular loop formed by the anterior inferior cerebellar artery (AICA) with the eight and facial nerve correlated with unilateral auditory symptoms or hemifacial spasms. The vascular compression syndrome of vestibulocochlear nerve in 8 patients treated in I ENT Clinic of Silesian Academy and MRI Department in Katowice was observed. All patients were otologic findings such as a tone audiometry, ENG, ABR and radiological diagnostics included MRI and angio MRI. The prospective analysis was performed. The results suggest that the unilateral sensorineural hearing loss, tinnitus, vestibular disorders and positive findings on magnetic resonance imaging are the most reliable evidence for the presence neurovascular compression syndrome of the eight cranial nerve. The MRI and otologic studies provided quite detailed information about topography of relationship between the blood vessels and cranial nerves in the crebellopontine cistern.

[Pineal cyst in MRI: clinical symptoms and analysis]. / Analiza i symptomatologia torbieli szyszynki w badaniach rezonansu magnetycznego.

Application of magnetic resonance imaging (MRI) in radiology allows to estimate and analyse pineal gland and pineal region pathology more precisely. We report 47 MRI brain studies of patients in whom pineal cyst was recognized as the only pathologic finding. MRI of the brain was performed because of clinical symptoms as headaches (32%), vertigo (26%) and altered behaviour (13%). Because of the common occurrence of pineal cyst in MRI brain imaging it seems to be important to decide whether these patients need neurosurgical intervention, especially if together with morphologic abnormality definite clinical symptoms exist.

[Radiological evaluation of pineal pathology and its regions]. / Diagnostyka radiologiczna patologii szyszynki i jej okolicy.

Contemporary neuroimaging procedures facilitate the differential diagnosis of pineal region pathology. They are of particular importance in malignant pineal tumours which may have non characteristic clinical presentation. Computed tomography and magnetic resonance imaging with intravenous infusion of paramagnetic contrast allow to determine tumour size and localization as well as its morphologic features and growth dynamics. The diagnosis obtained is a valid basis for treatment strategies.

[Gigantic liposarcoma of the lower extremity--case report]. / Olbrzymi tluszczakomiesak konczyny dolnej--opis przypadku.

A case of gigantic liposarcoma of the lower extremity in 42 years old female is presented. The tumor grew extremely fast and reached gigantic size. Over one year follow-up did not reveal any local recurrence or metastases.

[Selected problems of neurofibromatosis with presentation of a case of multiple intracranial and intramedullary tumors]. / Przypadek nerwiakowlókniakowatosci typu II z mnogimi guzami wewnatrzczaszkowymi i sródrdzeniowymi.

A case of neurofibromatosis type II in a 19-year-old man is described with clinical and neuroimaging (MRI) findings. The diagnostic criteria of neurofibromatosis type I (NF1) and type II (NF2) and the optimal management options are still controversial. The authors suggest that this patient fulfills criteria of neurofibromatosis type II as well as partially neurofibromatosis type I. At present, without molecular analysis of DNA, this assumption can not be verified.

[Post-radiation cervical myelopathy after radiotherapy of laryngeal carcinoma]. / Mielopatia szyjna popromienna jako pózne powiklanie radioterapii raka krtani.

The authors report a case of postradiotherapy cervical myelopathy after treatment of laryngeal cancer. The patient aged 61 was referred to a neurological hospital department with suspected metastasis of laryngeal cancer to the spine with symptoms indicating cervical cord lesion. During observation and after imaging examinations of the cervical spine cancer recurrence was excluded. History data and imaging methods served a basis for the diagnosis of postradiation myelopathy. The authors warn against too ready diagnosis of cancer in such cases and a repetition of radiotherapy.