Hemiplegia following mandibular fracture.
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Biomedical subjects
Publications and source records attributed to M Banna.
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Preliminary results indicate that simultaneous cerebral angiography with computed tomography may be a decisive investigation in the diagnosis of small intrasellar neoplasms.
This paper is based on a retrospective study of 230 tumours in the sellar area. All, except a few, were examined with the EMI 160 x 160 matrix and verified histologically. The main features of each pathological entity are described and most of the previous literature is reviewed. The degree of resolution of the scanner used precludes its reliability for detecting tumours less than one centimetre in diameter. Out of 30 microadenomas, only two were detectable on CT. This reflects an incidence of false negative results in 93% of microadenomas or 22% of all adenomas in the series. CT was also negative in 6% of craniopharyngiomas and 30% of chordomas. These findings emphasize the need for further neuroradiological tests in patients with clinically evident disease in the pituitary area. Many CT appearances are shared by more than one pathological entity; few are specific. However, if the CT findings are viewed in the light of the clinical presentation, a pathological diagnosis is possible in a large proportion of cases. Angiography is valuable; not only to exclude lesions of vascular origin, or show neovascularity, but also to demonstrate the relationship of the internal carotid arteries to the sphenoidal sinus prior to transsphenoidal surgery.
An osseous spinal angioma presented with severe back pain and cord compression. Severe hemorrhage occurred during surgical decompression, but after preoperative embolisation of the feeding vessels a second operation was successful. Osseous spinal angioma seldom presents backache of a severe nature or medullary compression. In such case, surgical intervention may be attempted without pre-operative embolization of the feeding vessels.
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In a 64-year-old female patient with verified dural venous thrombosis, postcontrast computed tomography showed dilatation of the transcerebral medullary veins, a feature that is probably pathognomonic.
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With computed tomography, dilated tortuous carotid and/or basilar arteries appear as tubular, fusiform or ring-shaped densities on the non-enhanced scan, or they may only be apparent after iodine injection. They can be differentiated by their shape and anatomic location. They may be multiple and are mostly seen in patients with a long history of atherosclerosis and hypertension.
A retrospective clinicoradiological study of 80 patients with amenorrhoea and/or galactorrhoea showed: 1. Of 60 patients, in whom prolactin levels were estimated, 28 (47%) had hyperprolactinaemia (serum prolactin levels greater than 20 ng/ml). 2. Hyperprolactinaemia was present in 85% of patients with amenorrhoea and galactorrhoea, 35% of those with galactorrhoea only, and 12.5% of those with only amenorrhoea. 3. Pituitary adenomas were surgically removed from six patients; all but one had prolactin levels over 100 ng/ml. The level was 53 ng/ml in the sixth patient. 4. There is a considerable degree of observer variation in the interpretation of borderline sellar changes. 5. Minor abnormalities of the pituitary fossa were noted in 64% of patients with hyperprolactinaemia and 36% of those with normal prolactin levels. 6. The highest incidence of perfectly normal sellae was among patients with either amenorrhoea or galactorrhoea and normal serum prolactin.
The computed tomography scans of patients who had frontal leukotomy show bilateral cysts in the frontal lobes that have attenuation values similar to cerebrospinal fluid, and are not contrast enhanced.
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Two malignant intracranial tumors that originated in the paranasal sinuses are described. The patients in both cases were investigated for neurological disorders and had no relevant history of sinus disease. Cerebral angiography demonstrated tumor vascularity identical to meningioma.
A simple method to describe the size of the cerebral ventricules on CT scans is presented.
This paper presents a case of bone destruction of the walls of the sphenoid sinus including the floor of the sella turcica from benign nasal polyps.
A case is reported where the appearance of acute, diffuse, disseminated sclerosis on computer tomography (Ct scan) is described and the literature is reviewed. This disease may give rise to multiple, small areas of diminished X-ray absorption which may decrease in size during the course of the disease. The histological features of one of the lesions was correlated with the radiological findings. It is suggested that, perhaps, only during the active stage of demyelination can the lesions be detected on the Ct scan.
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