[Neuroradiology of the sellar region].
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Adenoma↗
Biomedical subjects
O Schubiger
Publications and source records attributed to O Schubiger.
Computed tomography of the intervertebral foramen.
52 cases with pathologic lesions in the intervertebral foramen, studied with CT, are analyzed. The most frequent lesions are intraforaminal disc herniations. These are characterized by their hyperdensity in comparison to the dural sac (34 of 34 cases) and their broad contact with the intervertebral disc space (31 of 34 cases). Foraminal size and contour are usually normal. In contradistinction to disc herniations, benign tumors often show bone erosion of the pressure-type with enlargement of the foramen. Bone infiltration was seen only in malignant lesions and in the single case of Echinococcosis. Preoperative diagnosis of vascular lesions which present with foraminal enlargement is most important for the choice of the appropriate operative approach. Correct CT diagnosis of such vascular lesions is only possible with dynamic CT.
Diagnosis, Differential↗
[Indication-related neuroradiology].
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Brain Diseases↗
Dense suprasellar epidermoid cyst. A case report.
A case of a dense epidermoid cyst of the suprasellar cistern is presented. The clinical symptoms were headache radiating to the left eye and a quadrant anopsia on the left eye. The density of the epidermoid was 62 HU and no significant contrast enhancement occurred after contrast application. The main feature which allows differentiation from other hyperdense suprasellar lesions seems to be the lack of contrast enhancement.
Brain Neoplasms↗
Meningioma of the foramen magnum. Report of a case.
The authors present a typical case of a meningioma of the foramen magnum. Because of the unspecific nature of the patient's symptoms, the present illness had a course of more than seven years. During the last two years of the illness, the diagnosis of multiple sclerosis was assumed. The final diagnosis was established by computed tomography followed by vertebral angiography. The tumor removal was followed by dramatic recovery of the patient. The value of axial and direct coronal computed tomography is emphasized.
Adult↗
[Computed tomography of the spine (author's transl)].
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Humans↗
CT differentiation between recurrent disc herniation and postoperative scar formation: the value of contrast enhancement.
A study for the evaluation of the reliability of contrast enhanced CT in the differentiation between recurrent disc herniation and hypertrophic scar formation was undertaken. From the retrospective analysis of 36 surgically verified cases it became evident that hypertrophic scar tissue shows definite contrast enhancement, whereas recurrent disc herniation remains unenhanced. A possible explanation for this phenomenon is given. It is concluded that contrast enhancement should be performed in cases being studied by CT for recurrent symptoms after operation for disc herniation.
Cicatrix↗
[High resolution computerized tomography for the determination of fractures of the base of the skull, particularly the petrous bone].
Using high resolution CT, the high spatial resolution is comparable to conventional pluridirectional tomography. The small pixel size allows visualization of minute fractures of the skull base or the petrous bone. High resolution CT clearly demonstrated 32 fractures of the skull base, 14 of them passing through the petrous pyramids. The CT examination with the high resolution mode can be performed at the same time as the regular CT examination of the brain. This procedure is less time consuming and safer for the traumatized patient than the separate examination of the brain and the skull base with regular CT and conventional tomography respectively. As with conventional radiologic methods, the fractures are best demonstrated if they are oriented at right angles to the scanning plane. Fractures parallel to the scanning plane be missed. Therefore, additional direct coronal scans may be necessary for the accurate demonstration of fractures of the skull base.
Adult↗
[Superior sagittal sinus thrombosis is the newborn--diagnosis by computerized tomography].
The case of a newborn with a superior sagittal sinus thrombosis is reported. The clinical symptoms are difficult to differentiate from other cerebral conditions in the neonatal period. Sudden appearance of signs of raised intracranial pressure, however, is characteristic. Main predisposing factors are infection, dehydration and polycythemia. Before computed tomography (CT) became available, the diagnosis could be made only by means of invasive examination techniques. Today CT, in many cases, allows a rapid diagnosis of this condition.
Cerebrospinal Fluid Shunts↗
[Stroke--neuroradiological diagnosis (author's transl)].
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Arteriovenous Malformations↗
Direct drainage of extracranial arteries into the superior sagittal sinus associated with dementia.
A 62 year-old-man suffered from progressive dementia for the last 5 years of his life. Angiography disclosed draining of multiple extracranial, galeal arteries directly into the superior sagittal sinus with retrograde filling of cerebral veins. At necropsy there was arterialization of the walls of the sinus and a multichannelled lumen in its middle third. The sinus was not distended, the dura normal, and no angioma was found. The leptomeninges and the cerebral white matter contained excessively distended veins, some with thickened fibrotic walls. Many arteries in the arterial white matter were mineralized. There were widespread patches of incomplete demyelination about these abnormal vessels. The lesion was classified as a developmental anomaly with direct shunting of extracranial arteries into the superior sagittal sinus.
Brain↗
CT of meningiomas on the Posterior surface of the petrous bone.
A detailed analysis of the CT findings in 16 surgically verified cases of meningioma of the posterior surface of the petrous bone is presented. The results indicate that a correct preoperative diagnosis is possible in almost every case. Frequently occurring specific CT criteria for meningioma of the posterior surface of the petrous bone include: hyperdense, homogeneously enhancing, extra-axial, CPA mass; inverse relationship between precontrast attenuation value and degree of contrast enhancement of the tumor; oval shape; obtuse angle between lateral tumor border and posterior surface of petrous bone, and evidence of transcisternal supratentorial tumor extension. Infrequently occurring specific CT criteria include: tumor calcification; hyperostosis or exostosis of the posterior surface of the petrous bone; a comma-shaped tumor configuration in cases with transcisternal tumor extension and evidence of transtentorial tumor extension. Oxygen CT cisternography is the most sensitive and reliable technique for detecting small tumors. The CT differential diagnosis of meningioma of the posterior surface of the petrous bone is discussed.
Bone Neoplasms↗
Computed tomography in neuronal ceroid lipofuscinosis.
The computed tomography (CT) findings in a verified case of neuronal ceroid lipofuscinosis (NCL) are presented. CT revealed diffuse and severe cerebral atrophy, reflected by generalized subarachnoid space enlargement and symmetric ventricular dilatation. There was no evidence of abnormalities of the white matter. The CT features in our case of NCL correspond perfectly with the neuropathologic changes of the disease mentioned in the literature. Furthermore, CT is of considerable help in differentiating between those inherited metabolic brain diseases characterized primarily by white matter involvement and those presenting predominantly with changes of grey matter.
Ceroid↗
Computed tomography in cerebral aneurysms with special emphasis on giant intracranial aneurysms.
The computed tomography (CT) findings of 105 patients with a total of 139 intracranial aneurysms are analyzed. The rate of detection of subarachnoid and intracerebral hemorrhage in relation to time since bleeding episode agreed well with previously reported results. Direct visualization of small intracranial aneurysms using 5 mm sections in the postcontrast scan was possible in 58% of the cases. Ten cases of giant intracranial aneurysms (GIA) more than 25 mm in diameter are analyzed in depth. Diagnostic criteria for differentiation of GIA from tumors are discussed. Ring shaped postcontrast enhancement of the outer margin of the aneurysm or curvilinear interrupted calcifications were found in totally or partially thrombosed GIA; central or peripheral homogeneous enhancement of the aneurysm's lumen (target sign) was typical of partially thrombosed GIA; and nonthrombosed GIA usually presented as homogeneously enhancing lesions. Differential diagnostic criteria are discussed.
Adolescent↗
[Neurinoma of the cauda equina (author's transl)].
A rare case of a mobile neuroma of the cauda equina is presented. Myelography, first done by lumbar puncture, showed the tumor at the L1 level. A second myelography, done by suboccipital puncture, showed the tumor at the L3 level, 7 cm more caudal as in the first myelography. Reviewing the literature, 2 similar cases were found. The so-called redundant nerve root is discussed as a possible explanation of the mobility of the tumor. The importance of the precise preoperative tumor localisation is stressed.
Adolescent↗
Neuroma of the cavernous sinus.
A case of a surgically verified parasellar neuroma is presented. Despite clinical and radiological evidence for the origin of the tumor to be the trochlear or oculomotor nerves, an operation revealed a neuroma originating from the cavernous sinus, but exact identification of the origin of the tumor was not possible. The radiologic findings including polytomography, angiography and computed tomography are presented. The clinical and radiological differentiation between this case and typical neuromas of the gasserian ganglion are discussed.
Adult↗
[The collateral circulation due to cerebral arterio-venous malformation and occlusions of major cranial vessels (author's transl)].
Arteriovenous malformations (AVM) of the brain are diagnosed mostly in the early adult life. With the come up of Computerized Tomography (CT) which often is done without the strong indications as postulated for the conventional neuroradiologic examinations, asymptomatic AVM in the elderly population may be found. Since May 1977 4 asymptomatic arteriovenous malformations were diagnosed in our institution using CT. 2 of these patients had severe degenerative changes of the great cerebral vessels and an unusual collateral circulation developed probably because of the steal-phenomenon in the vascular malformation. These 2 cases allow to study all possibilities of cerebral collateral circulation. Uncommon in one of the cases was a capillary anastomotic network through the thalami, in the other case an extensive dural rete mirabile developed. The problems of collateral circulation are discussed.
Cerebral Angiography↗
Cerebral toxoplasmosis in the adult.
We report a case of cerebral toxoplasmosis in an adult patient. The diagnosis was established by demonstration of Toxoplasma gondii in the cerebrospinal fluid, and the patient was evaluated by computed tomography.
Adult↗