Fred J. Hodges

Neuroradiological Manifestations of Intracranial Sarcoidosis

Six cases of sarcoidosis involving the central nervous system are reported with the neuroradiological findings and appearance on computed tomography. Communicating hydrocephalus with sarcoid arachnoiditis is the most common finding, but arteritis and masses have also been reported. Two rare cases of intracerebral masses are included. The radiological findings and clinical histories are reviewed with emphasis on the use of CT and complete neuroradiological studies for patients with possible central nervous system sarcoidosis.

Angiography and Cisternography in Acute Meningitis due to Hemophilus influenzae

Two cases of Hemophilus injluenzae meningitis in infants are presented. In both cases, narrowing of vessels at the base of the brain and mUltiple small vessel occlusions of the middle and callosal systems were demonstrated at angiography, and acute communicating hydrocephalus was demonstrated by cisternography. Cisternography is a safe diagnostic technique that will demonstrate bulk movement of cerebrospinal fluid and changes associated with acute meningitis, thereby aiding in the selection of patients who may benefit from diversionary shunts.

Comparison of the cerebral angiogram and the brain radionuclide image in brain abscess.

Abstract To demonstrate the complementary nature of cerebral angiography and radionuclide imaging, a retrospective study was made of 20 cases of proved brain abscess. The nuclide study is more sensitive; the first examination following the onset of symptoms was positive in every case. While less sensitive, the angiogram has the advantage of specificity. The ring-like stain, the sudden appearance of a mass, and the mass effect associated with a small arterial branch occlusion are all strongly suggestive of abscess.

Radiographic Exhibit: Internal Auditory Canal Enlargement in Neurofibromatosis without Acoustic Neuroma

Acoustic neuroma has always been reported to accompany neurofibromatosis in patients with enlargement of the internal auditory canal. The authors describe a case in which the internal auditory canal was enlarged but there was no tumor. This may represent a normal variant or a manifestation of the bony dysplasia of neurofibromatosis.

MICROANGIOGRAPHY IN EXPERIMENTAL CEREBRAL EDEMA IN RATS.

While microradiography was employed as early as 1913 by Pierre Goby, the first attempts at its use in the demonstration of minute blood vessels in animals were made in 1935 (Grechiskin-Prives, in Leningrad), withThorotrast (1). The effects produced in the brain and spinal cord of animals by chronic intoxication with alkyl tin compounds, specifically triethyl tin hydroxide and sulfate, have been described in detail by several authors. Stoner et al. (19) and Magee et al. (13) investigated the edematous changes in the central nervous system of rats by light microscopy, and later Torack, Terry, and Zimmerman (20) reported the alterations in the brain as seen by electron microscopy. As described by these investigators, progressive neurological deterioration was observed with decreased activity, and paralysis of the hind limbs and later of the fore limbs and weight loss due to low food intake were apparent. Within a period of three weeks generalized rigidity and coma developed. The histologic changes in edema i...

Small-Bowel Tumors1

Small-intestinal lesions, excluding peptic and postoperative jejunal ulcers, are not common; neoplasms supposedly are rare. When repeated examinations of the gallbladder, the esophagus, stomach and duodenum, and the colon fail to provide an explanation for persistent gastrointestinal symptoms, however, the possibility of small-bowel disease deserves careful consideration and investigation. Inflammatory processes involving the small bowel commonly produce early and severe symptoms and well defined clinical signs, while neoplasms, unless they obstruct, frequently cause only vague and insidious abdominal disturbances. This relative quiescence, coupled with infrequent occurrence, commonly results in delay in diagnosis. Furthermore, nonobstructive tumors may escape recognition even when specific radiologic search is made, because the resultant deformity may be slight and is characteristically limited to a short segment of gut. The frequency with which symptomatic tumors remain undiagnosed prior to operation or...

Roentgenologic examination of the colon and rectum for cancer

IN THE consolidated experience with cancer for 15 years, 1936 to 1950, at the University Hospital of the University of Michigan, during which period 21,523 patients who had cancer were observed, 4,828, or 22.5 per cent presented mal ignant tumors of the gastro-intestinal tract. Of these, 49 per cent (2,353) were found to have cancers of the large intestine, including the rectum. This represents 11 per cent of all patients with cancer seen. Beyond the fact that cancers of the colon and rectum are numerically important , they represent unusual problems of recognition and are attended by gratifying results of treatment. Unlike the so-called visible tumors, cancers of the colon are detectable only by purposeful search, which begins with questioning for evidences of bleeding and recent change in bowel habits, followed by digital rectal examination, sigmoidoscopy, examination of the stools and the circulating blood for signs of bleeding, and the use of roentgenologic methods. Examinat ion after the use of a bar ium enema is simple and effective, if well performed. In the experience of many radiologists, cancer of the colon often is apprehended by this method, even in the absence of bleeding, history or signs, a fact which strongly suggests the importance of the method in persons after the age of 40 years as a precaut ionary means. \.ghen roentgenologic technics are used, the colon can be investigated rapidly

RADIOLOGY OF THE CHEST.

The value of chest roentgenograms is subject to physical limitations of radiography, temporal limitations of the pathologic processes, and physiologic limitations of the observer. Routine radiologic examination of the chest, special positioning and projections, contrast materials as aids in delineating disease, and specialized technics are described. Image intensification should be used for chest fluoroscopy when possible, especially in infants and children. Survey photofluorography of hospital and clinic patients is still a valuable procedure.

Common errors in x-ray diagnosis.

A number of factors, both technical and clinical, operate to determine the over-all accuracy of x-ray diagnostic efforts. While repeated mistakes which stem from incorrect technic are not to be tolerated, those errors which represent well intended but incorrect clinical judgment are very difficult to control and sometimes are amusing.

The practical value of cholecystography in surgery of the gall-bladder

Abstract Since its introduction by Graham and Cole in 1924, cholecystography, which is now very widely used throughout this country and abroad, has brought to the surgeon interested in the diseases of the gall-bladder a very practical and reliable means of pre-operative diagnosis. Not only is cholecystography valuable in gauging gall-bladder function, but also in determining the presence or absence, the character and number, the location and the behavior of gallstones. The method is also of practical importance in differentiating gallstones from other calculi in the right abdomen which might otherwise be misinterpreted.