Arachnoiditis Ossificans.

This case shows the MRI and CT features of a rare entity, namely arachnoiditis ossificans, which should be recognized in patients with long-standing history of multiple spine surgery.

CT Features of Saba Senegalensis (a Tropical Fruit) in Patients with Abdominal Pain.

Saba senegalensis (SS) is a well-known and commonly eaten fruit in Western Africa, especially in the rainy season when it is abundant. The ingestion of its seeds may cause abdominal pain and bowel obstruction. This cause might not be recognized by radiologists who are not aware of SS CT features. We thus present the characteristic CT features of SS as found in patients presenting with abdominal pain and incidentally in others. We also discuss the differential diagnosis with the cowries (ornament) and other similar fruits as imaged on CT.

Traumatic intracranial hemorrhage in newborns.

INTRODUCTION: Neonatal traumatic head injuries (NTHI) can be life-threatening and require aggressive treatment. The indications, techniques, and results of brain decompression are not well defined in the literature. METHODS: We studied prospectively cases of NTHI with intracranial traumatic lesions; skull fractures without underlying lesions were not included. We treated 17 cases of NTHI: 7 patients had a subdural hematoma, 3 had an extradural hematoma, and the others had subarachnoid hemorrhage. Surgical evacuation of intracranial clots was performed in 7 cases, by needle aspiration in 5 and by craniotomy in 2 patients with extradural hematomas. RESULTS: The outcome was favorable in all but one patient, who had hemophilia A, and died of rebleeding at the age of 2 months. CONCLUSION: Surgical decompression of intracranial hematomas due to NTHI is often unnecessary; however, it may be required in emergency because of poor clinical tolerance. Whenever possible, percutaneous needle aspiration is the treatment of choice.

Imaging of head injuries in infants: temporal correlates and forensic implications for the diagnosis of child abuse.

OBJECT: The dating of inflicted head injuries in infants is a recurrent and difficult problem in the forensic evaluation of child abuse. The dating of hemorrhagic lesions when using magnetic resonance (MR) imaging is delicate because many confusing factors interact. In particular, infants frequently develop subdural hematomas (SDHs), which are generally composed of a supernatant, similar to cerebrospinal fluid (CSF), and a sediment, similar to blood clots. In the absence of a validated theoretical model predicting the evolution of blood signal in head-injured infants, clinical data are much needed; however, reliably dated information regarding head injuries in infants is scarce. METHODS: The authors prospectively studied infants who presented with dated and corroborated head injury to investigate the temporal modifications of computerized tomography (CT) and MR imaging in relation to the delay since trauma. In cases of SDH, the authors distinguished between sediment and supernatant based on their CT scanning appearance. They then studied the MR imaging signal of these two components in T1- and T2-weighted, fluid-attenuated inversion recovery (FLAIR), and gradient-echo sequences. Whereas the signal of the supernatant showed little difference from that of the CSF and did not yield information about the date of trauma, the signal in the sediment, especially on the T1-weighted and FLAIR sequences, showed time-related modifications that could be used to date the trauma. CONCLUSIONS: The authors propose a method by which to develop a time scale for the dating of head injuries in infants based on the modifications of signal and location of blood on CT and MR images.