Spontaneous healing of basilar artery dissection: MR findings.

We report a case of a dissecting basilar artery aneurysm, which presented with subarachnoid hemorrhage in a 34-year-old woman. Although the natural history has been described as severe with mortality approaching 80%, this patient did well and spontaneous healing was demonstrated on MR and angiography.

Postoperative dissemination of fat particles in the subarachnoid pathways.

A case of postoperative dissemination of fat particles into the cerebrospinal fluid pathways is reported. Following removal of a foramen magnum meningioma, a postoperative MR scan showed fat droplets in the basal cisterns and in the frontal horns of the lateral ventricles. The patient was asymptomatic and a repeat MR scan 7 months later was normal, with resolution and clearing of the previously noted cerebrospinal fluid fat.

The value of CT in genetic counseling in tuberous sclerosis.

The families of two patients with known tuberous sclerosis were electively evaluated by computed tomography. The CT positive (and negative) examination proved to be valuable for the genetic counseling of family members without overt clinical manifestations of tuberous sclerosis. Two patients had evidence of smaller enhancing lesions (minimal demonstrable mass without hydrocephalus) following intravenous contrast enhancement. We, therefore, suggest the use of contrast enhanced scans in addition to the plain scans to identify what may represent occult neoplasms. Abdominal CT scans can prove useful in identifying the frequently associated renal hamartomas.

Computed tomography of the spinal canal and cord.

Selective cases have been presented to demonstrate the usefulness of computed tomography in disorders of the spine and spinal cord. The osseous structures are more readily demonstrated than the soft tissues. The cord is difficult and inconsistently identified. However, cystic lesions (syringomyelia) may, at times, be demonstrated. The transverse projection of the CT scan is an added benefit in demonstrating bony spinal lesions. The use of metrizamide with faster scanners should improve the usefulness of this technique in evaluating intraspinal lesions.

Pontine arteries in brainstem glioma.

Five cases of brainstem tumor are presented. In each case, hypertrophied and stretched transpontine arteries could be identified in the Towne projection of the vertebral angiogram. The abnormal pontine vessels clearly indicated the transverse enlargement of the brainstem. The identification of enlarged transpontine arteries indicates a brainstem mass and helps to exclude extrinsic lesions even when confusing paradoxical vascular displacements are present.

Myelography in patients with medulloblastoma.

Unsuspected metastatic medulloblastoma involving the spinal cord was detected by myelography in 2 of 3 patients with newly diagnosed medulloblastoma. Myelography revealed unsuspected spinal cord metastases in an additional patient with recurrent medulloblastoma in the posterior fossa. The authors suggest that myelography be performed prior to radiotherapy in all patients with either primary medulloblastoma or recurrence in the posterior fossa.

Cerebral venous angioma.

A case of venous angioma involving the frontal lobe is presented with surgical and histological confirmation. Only two other angiographically diagnosed cases have been reported previously in the literature. This case tends to support the entity of cerebral venous angioma as a distinct, though rare, type of cerebral vascular malformation.