[Value of tomodensitometry in the diagnosis of meningioma of the sphenoid wing].
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Biomedical subjects
Publications and source records attributed to D Baleriaux.
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Four patients suffering from brain metastases were studied by brain scintigraphy carotid angiography and rCBF measurement, before and after one week of treatment with dexamethasone. It was noted that the neurological signs and the blood perfusion around the tumor were improved but that the volume of the lesion, as judged from the angiogram was unmodified. It is suggested that the corticosteroids reduce tissue pressure before actually diminishing the volume of the brain oedema.
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CT and MRI are presently the most commonly used imaging techniques providing optimal visualisation of brain images. Normal aging is observed on CT and especially on MRI: these changes should be recognized and differentiated from pathological brain anomalies. The authors briefly describe changes demonstrated by CT and MRI in the most commonly encountered dementia: still emphasis is put on the fact that these anomalies are poorly specific and never pathognomonic. On the contrary, it must be prompted to perform CT and MRI in demented patients in order to rule out diseases curable by surgery such as normal pressure hydrocephaly, subdural hematoma, meningioma and so on especially well demonstrated by CT and MRI.
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Because of the nature and location of the lesion in central pontine myelinolysis, considerable difficulties in diagnosis may arise. Computed tomography (CT) and brainstem auditory-evoked potentials are useful in following the spread and regression of the pontine lesion. The correlation between clinical evolution, serial CT scans, and brainstem auditory-evoked potentials is considered in a patient with central pontine myelinolysis and subsequent complete recovery with special emphasis on the evolution of the CT scan after recovery.
Results of computed tomography and thermography examinations were compared in 80 patients with herniated disk lesions investigated by non-invasive radiological procedures. Thermography proved to be a very sensitive method but one of only relative specificity. The examination failed to contribute data in 10% of cases, and only one false-negative result was noted. Telethermography appears to be a reliable screening method enabling optimal selection of patients for scanning.
The authors report a second case of an original malformation of the atlas vertebra which consists in occipitalization of the anterior and lateral parts (anterior hemi-arch) and in vertebralization of the posterior parts (posterior hemi-arch).
A patient with acute pure dysautonomia also suffered from several episodes of transient diplopia and hemiparesthesiae which were related to an arteriovenous malformation in the pons. The clinical presentations and the radiological diagnosis of arteriovenous malformations of the brain stem are reviewed, as well as the semiology and etiopathogeny of acute dysautonomia. No relationship was found between these two rare affections.
Cerebral germinoma is a rare tumour reported most frequently in the pineal region or the floor of the third ventricle. Localization in the hemispheres may occur. In the reported case the tumour was situated in the right frontoparietal region. In view of the well-known radiosensitivity of germinomas the treatment of choice is radiotherapy. Precise histological diagnosis is therefore cardinally important for deciding on treatment and establishing the prognosis. CAT scanning allows progress to be monitored.
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