Benign cystic pineal lesions by magnetic resonance imaging.

In the course of examining 1,000 patients with various neurological complaints, 17 were found to have abnormalities in the region of the pineal gland. Fourteen had no hydrocephalus or symptoms referable to the region of the midbrain but a well-defined region of the high signal on T2 weighted images was demonstrated on magnetic resonance imaging. The other three patients proved to have pineal tumors. All patients had computed tomography examinations prior to magnetic resonance imaging. We believe that the pineal lesion in the 14 asymptomatic patients is a benign cyst not previously reported prior to the advent of magnetic resonance imaging. These benign lesions should be kept in mind in evaluating masses of the pineal region.

Magnetic resonance imaging of mesial temporal sclerosis: case reports.

Two patients with uncontrollable complex partial seizures had normal findings on pre- and postinfusion computed tomography scans. Magnetic resonance imaging demonstrated, in both patients, a lesion in the temporal lobe suggestive of mesial temporal sclerosis. One patient underwent temporal lobectomy, and the radiologic diagnosis was verified. In patients with complex partial seizures, magnetic resonance imaging appears to be able to noninvasively localize temporal lobe lesions in preparation for surgical intervention.

Magnetic resonance imaging in neuronal ceroid lipofuscinosis.

Neuronal ceroid lipofuscinosis is a group of neurodegenerative disorders characterized by accumulation of lipofuscin and/or ceroid within the tissues of the body. These entities are manifest by visual, intellectual, and motor deterioration as well as recurrent seizures. Computed tomography has been shown to demonstrate changes of cerebral atrophy in more severely affected patients. Seven patients with neuronal ceroid lipofuscinosis were examined with both computed tomography and magnetic resonance imaging, and the results were correlated with the clinical severity of the disorder. Two less severely affected patients had normal results on computed tomography and magnetic resonance imaging studies. Varying degrees of cerebral atrophy were seen in the remaining five patients with both computed tomography and magnetic resonance imaging. Severity of atrophy correlated with the severity of disability in these patients. Abnormal white matter was seen in the two most severely affected patients only with magnetic resonance imaging. Although the findings in patients with neuronal ceroid lipofuscinosis were nonspecific, the increased sensitivity of magnetic resonance imaging for subtle white matter abnormalities over computed tomography may prove helpful in monitoring the progression of this rare disorder.

Intracranial gyriform calcification associated with subarachnoid fat.

Intracranial convolutional or gyriform calcification simulating Sturge-Weber syndrome has been described in association with bacterial and viral intracranial infection as well as irradiation and intrathecal methotrexate for central nervous system leukemia. Reported is a case of gyriform calcification caused by chemical meningitis secondary to subarachnoid fat from an epidermoid tumor.

Intraprocedural passage of an obstructing ureteral calculus.

The passage of a urinary calculus during an enhanced computed tomography examination demonstrates the perplexing incongruity one may encounter when there is rapid dynamic change in an organ or part during the relatively slow acquisition of sectional images.

Magnetic resonance and CT imaging correlated with clinical status in SSPE.

Five patients afflicted with subacute sclerosing panencephalitis were studied with computed tomography and magnetic resonance imaging. Computed tomography documented changes of nonspecific cerebral atrophy and low attenuation in the subcortical white matter. Magnetic resonance imaging revealed bilateral, symmetric, and diffuse abnormal increased signal in the white matter of the cerebral hemispheres with normal posterior fossa structures in 4 of 5 patients. Magnetic resonance imaging was superior to computed tomography in demonstrating the total extent of abnormality and may be the imaging modality of choice for this childhood disease.

Aneurysmal rupture during computed tomography scanning.

A unique case in which a berry aneurysm was observed to rupture during computed tomography scanning of the brain is reported. Two earlier case reports of aneurysmal rupture during computed tomography scanning are reviewed, followed by a discussion of possible mechanisms of rupture during contrast studies. Contrast medium infusion may have the potential to cause aneurysmal rupture by a direct anticoagulant effect, by affecting the endothelial membrane, by interacting with platelet release of vasoactive substances, by inducing vasodilation, by removing the protective arterial spasm, or by other unexplored mechanisms. The information to be gained by infusion of contrast medium in cases of aneurysmal rupture can be significant and the rarity of rerupture during contrast medium infusion does not appear to pose a significant risk in the vast majority of cases.

Arterio-colonic fistula during scintigraphic evaluation of gastrointestinal bleeding.

The use of scintigraphic imaging in the evaluation of gastrointestinal (GI) hemorrhage has been established recently as a screening procedure prior to anigography. We report an unusual and previously unreported cause of acute GI bleeding which illustrates several technical factors to be considered during scintigraphic evaluation of GI bleeding.