Biomedical subjects
Publications and source records attributed to A Wackenheim.
Five anatomical and radiological observations of a spine protruding into the pituitary fossa are reported. This osseous spine, about 4 mm long, arises in the midline from the inferior part of the anterior aspect of the dorsum sellae and extends upward and forward. The possible origins of this malformation are discussed.
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A case of hemi-occipitalisation of the atlas is reported which appears to be the oldest case presently described in a Merovingian of the early Middle Ages, whose skeleton was discovered in 1974. This partial assimilation of the atlas was associated with marked hypoplasia of the basioccipital region producing a deep basilar depression.
Axial osteomalacia is an infrequent osseous disease, etiopathogeny of which is yet unknown. The authors report three cases of such affection and two cases of fibrogenesis imperfecta ossium. They stress the clinical, biological and radiological specific signs of these diseases. Biopsy is necessary for diagnose some doubtful cases, especially in order to exclude other causes of osteomalacia as fibrogenesis imperfecta ossium. The latter osteopathy which frequency may be underestimated has often similar radiological data.
A case of cerebellar atrophy detected by CT, and transverse deficiency of one hand, is reported.
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The radiographic findings of lumbar spinal stenosis are presented with special reference to the constitutional form and the cheirolumbar dysostotic form as well as the pathologic changes associated with diffuse developmental anomalies of the skeleton.
An indirect sign of cervical disc hernia is described, consisting of angulation of the alignment of the spinal apophyses of the cervical vertebrae above the site of the hernia in relation to the alignment of those of the vertebrae situated below the lesion.
The CT aspects of frontal horn coarctation by ependymal fusion in two cases are described with post-mortem verification. These ependymal fusions in the lateral ventricles are seen frequently on air ventriculograms, especially in the occipital horns. Ependymal fusions in the frontal horns are rare and not very well known. These fusions are clearly seen on CT and post-mortem examinations. The frontal horns appear asymmetrical on CT and this asymmetry evokes frontal horn compression (by an isodense tumour for instance), or contralateral frontal horn dilatation. Some CT details of ventricular coaractation makes it easy to differentiate tumoural compression from controlateral subcortical atrophy.
A case of membranous occlusion of the aqueduct of Sylvius with malformation of the skull and associated hydrocephalus is reported. The diagnosis was made with the help of CT, pneumoencephalography and ventriculography. In the literature membranous occlusion of the aqueduct has been considered to be a rare cause of hydrocephalus.
There now exist protocols for specific scanning which make it possible to obtain tranverse sections of a few millimetres in thickness of the orbits and their contents, with minimum sweep and with a very low dose of radiation for the lens. Normal scanner anatomical findings in the orbit may thus be defined for the eyeball (outer coats, vitreous, lens) as well as retrobulbar structures (optic nerve, oculomotor muscles in particular). Intraocular tumours (e.g. retinoblastoma) are visible on enlarged scan films. The value of scannings lies above all in the determination of the site, size and shape of orbital lesions and, where applicable, their relations with neighbouring extra- and intra-cerebral structures. In addition, certain conditions such as exophthalmos during hyperthyroidism have characteristic scan findings. It nevertheless remains difficult to attempt to predict a histological diagnosis on the basis of scan findings, the risk of a false positive being particularly significant. Particular emphasis must be placed upon the contribution of techniques of treatment of the films obtained (enlargement, contrast media, histograms, lateral views) as well as the complementary use of other methods of radiological investigation (in particular arteriography and phlebography) which scanning cannot replace but which it should usually precede since it is atraumatic and non-invase.
Following the publication of the first two cases reported of ossification of the transverse ligament, the authors describe three recent observations of this lesion. In contrast to the first two cases, in which ossification was reported at the level of the cervico-occipital articulation, which was normal, these three new cases were noted to have associated acquired or congenital abnormalities of the craniovertebral junction.
The authors describe the computer tomography appearances of intracranial epidermoid and dermoid cysts as demonstrated by three cases, and review the published literature. Dermoid and epidermoid cysts can be distinguished from each other by their topography (dermoid cysts are found more medially while epidermoid cysts occur on the base of the skull and in the pontocerebellar angle), by the presence or not of calcification (found almost exclusively in dermoid cysts), and by their computer tomography appearances. Both tumors have low densities, below that of the cerebrospinal fluid, but dermoid cysts have lower densities than epidermoid cysts, which can be easily explained by referring to the anatomo-pathological appearance.
Functional disturbances of arterial vertebrobasilar insufficiency may be correlated to anomalies of the origin of the vertebral arteries especially in young patients. The authors describe 1 case of right subclavian arteria lusoria with anomaly of the origin of both vertebral arteries (aortic on the left and from the primary carotid artery on the right).