Neuroradiology of sellar and parasellar lesions with emphasis on computerized tomography (CT).
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Biomedical subjects
Publications and source records attributed to A A Chambers.
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Two cases of neurofibromatosis and intracranial arterial occlusive disease are reported. The radiographic and clinical features of these and twelve previously reported cases are reivewed.
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Two giant thrombosed aneurysms of the middle cerebral artery are reported with a review of the pertinent literature. A tortuous channel through the thrombus results in an unusual and characteristic angiogram. Mechanisms involved in the formation of this lesion are discussed.
Central nervous system sarcoidosis and its varied neuroradiological manifestations are reviewed. Two cases of mechanical obstruction secondary to sarcoid granulomata at the outlet of the fourth ventricle are described.
An example of the internal carotid artery supplying the posterior inferior cerebellar artery directly is reported. The direct PICA supply comes from a trigeminal trunk. There was no basilar artery opacification. An embryological explanation is given.
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The authors' experience using the Debrun detachable balloon catheter system in occluding surgically-created carotid-jugular fistulas is described. Useful technical points in preparing and using the system are outlined. Technical failures were encountered both in creation of the fistula model and in use of the system, and their occurrence is documented. It is concluded that, when familiarization with the system's operation is attained, the detachable balloon catheter system promises to offer a valuable method of treatment of traumatic carotid-cavernous fistulas in humans.
Anterior atlas clefts (AACs) are rare developmental variants that may mimic fractures. Due to the potential severe implications of craniocervical junction trauma, expeditious differentiation between a Jefferson burst fracture and a congenital cleft is essential in trauma patients. Three cases of AAC are presented. Two cases demonstrated incidental AACs; the third case was associated with a Jefferson burst injury. Computed tomography is most helpful in evaluating the integrity of the atlas; however, plain radiography or pluridirectional tomography are best for evaluating displacement of the lateral masses of C1 in relation to C2.
Demonstration of traumatic lumbosacral root avulsion is a rare clinical entity because the bony pelvis offers support and protection to the nerve roots against stretching and rupture. Major vehicular trauma producing unstable pelvic fractures allows lumbosacral root avulsion to occur, and the 18th well-documented case is reported. Delay in diagnosis of several months is common. Demonstration of traumatic meningoceles is important, and metrizamide offers better visualization of the root than does iodophendylate. Absence of the root in the meningocele is equated with avulsion.
The characteristics of various types of collimators have been studied systematically for the EMI Mark I brain scanner. The degree of collimation ranged from the 13-mm adjacent A and B slices to 3-mm separated slices. Multiple phantom studies (including variable density immiscible liquid interfaces) have been performed to evaluate the effect of collimation on (a) the line-spread function, (b) the change in effective absorption number, and (c) volume averaging. Effects associated with the technique settings involving the kVp, the mA, and the scan time were also investigated. The results of TLD dose measurements as a function of collimation are presented. The significance of collimation in specific clinical studies involving small, fairly well-circumscribed lesions is discussed.
Carotid arteriograms on three patients with unilateral pulsatile tinnitus demonstrated an ipsilateral atypical trigeminal artery extending from the cavernous portion of the internal carotid artery to form the posterior inferior cerebellar artery. Illustrations and a dissection of a human fetus with a similar finding show this artery crossing the cochlear nerve near its insertion in the pons. Evidence is presented suggesting that neurovascular compression of the eighth nerve is the source of pulsatile tinnitus in these patients.
Using seven illustrative cases, the authors discuss the computerized tomographic (CT) appearance of cranial epidermoid tumors. These tumors are of low density (-2 to +10 EMI units), seldom show calcification, and do not enhance with contrast medium. Their differentiation from dermoid tumors and craniopharyngiomas is also discussed.
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