Cutis verticis gyrata (case reports of rare causes).

Two cases of cutis verticis gyrata (CVG) one in association with a saccular aneurysm of the internal carotid artery and another with intraventricular ependymoma are reported. Not only is CVG rare, its association with intracranial aneurysms has not been reported in the literature. This paper documents those rare associations and gives a short review of CVG.

Cutis verticis gyrata: its computed tomographic demonstration in acromegaly.

A retrospective review of the 17 cases of acromegaly, recorded in the hospital and with available CT scans was undertaken in order to determine the presence and of cutis verticis gyrata (CVG) frequency, and the spectrum of other associated radiographic appearances of CVG. The hormone levels were analysed, and the histopathology of the surgical specimens reviewed. Five cases were uncovered. In these, the scalp in CVG was markedly thickened with convoluted, gyriform or cog-wheel appearances. There was no correlation in the age, sex, duration of symptoms or the hormone levels in these two groups of acromegalics: with or without CVG. All cases were histologically pituitary adenoma. It is concluded that CVG is not uncommon in acromegaly. Its presence on a CT scan should caution the radiologist to the presence of pituitary adenoma or any of the other neurological causes of CVG.

Radiological evaluation of complications of intestinal tuberculosis.

Complications of intestinal tuberculosis may be masked. This study aims to heighten awareness of these unusual clinical complications and the radiological findings in such cases. Over a period of 5 years, 21 patients with proven intestinal tuberculosis, 13 of whom presented with complications, are presented in this report. Radiological diagnosis was by barium gastrointestinal studies and computed tomographic (CT) evaluation. Surgical specimens and histopathology confirmed the diagnosis. The commonest complication was intestinal obstruction (N = 6). Others were esophagobronchial and duodenocolic fistulas (N = 2), significant gastrointestinal hemorrhage (N = 3) caused by ulcers in the small bowel and colon, and malabsorption syndrome (N = 3) caused by diffuse small bowel infiltration in 2 cases and duodenocolic fistula in the third case. None of the patients presented were immunocompromised. Though uncommon, tuberculosis should be considered in patients presenting clinically with intestinal obstruction, significant gastrointestinal hemorrhage and malabsorption state.

Ossification of the ligament flavum.

A total of 82 patients who underwent spinal computed tomographic scan, in an 8-month period at the King Khalid University Hospital, Riyadh, Saudi Arabia, were analyzed for age, sex, the presence/absence, site, and type of ossification of the ligamentum flavum (OLF) as well as associated diseases. The OLF was radiographically present (bilaterally or unilaterally) as linear (74.5%) or nodular types (25.5%). The linear type was especially seen at the inner aspects of the ligamentum flavum. OLF was present in 35.4% of patients, and was seen at single and multiple levels in 51% and 41% of them, respectively. OLF was identified in a total of 47 levels in the study group and was associated with other disease in the spine in 38 (81%) of these levels. In none of the patients was OLF the cause of myelopathy. The incidence of OLF and its pathogenesis and significance are discussed. This paper is the first report of OLF from the Middle East. OLF in this part of the world is usually asymptomatic.

Radiographic features of lobar agenesis of the liver.

PURPOSE: Our aim was to describe the radiographic features of lobar agenesis of the liver. MATERIAL AND METHODS: Six patients with lobar agenesis of the liver, 5 right- and one left-sided, are presented. CT was used to confirm diagnosis. Chest radiography, barium meals, and urograms were also analyzed. RESULTS: In right-sided agenesis, the following were observed: a) hammock or U-shaped deformity of the stomach; b) colonic interposition of the diaphragm (Chilaiditi's syndrome); and c) reversal of the cranial orientation of the colonic hepatic flexure compared to the splenic flexure. The right kidney was higher in position than the left in both right- and left-sided lobar agenesis. CONCLUSION: Our radiographic findings can provide a multidisciplinary approach in the identification of this anatomic anomaly.