Fredie P. Gargano

Transfemoral ascending lumbar catheterization of the epidural veins in lumbar disk disease. Clinical application and results in the diagnosis of herniated intervertebral disks of the lumbar spine.

Epidural venography via selective catheterization of the ascending lumbar vein is presented as a new technique for the evaluation of herniated lumbar intervertebral disks. The authors use it as a complementary examination in patients with suspected disease but normal or equivocal myelographic findings. The accuracy of the technique in general equals that of myelography and exceeds it in lateral disk herniations, especially at the L5-S1 level.

Schizencephaly: a Clinical Study and Review

Schizencephaly is a rare malformation in which symmetrical portions of the cerebral mantle fail to develop. It should be differentiated by angiography and pneumography from the porencephalies that follow destructive lesions and from the prognostically more favorable subdural hematomas and effusions. If the diagnosis of this anomaly can be firmly established short of surgical exploration, operation or further treatment of any kind is not, in the authors opinion, warranted.

Contrast radiography of the optic nerve sheath

To OUH KNOWLEDGE, contrast radiography of the pia-arachnoidal sheath of the optic nerve has not been reported. No illustrations or mention of such visualization has been encountered in reviewing standard references of neuroradiology,l-s and conversations with neuroradiologists have not stirred their memories to recollect similar demonstrations. For this reason, the following description seemed of interest.

Bilateral sixth nerve palsies in a patient with massive pituitary adenoma

A middle-aged man developed bilateral abducens weakness as the only symptom of a huge chromophobe adenoma of the pituitary gland. This unique presentation delayed diagnosis until exploration and biopsy. The patient, who recovered completely, was studied prior to the era of computerized tomography.

Unruptured aneurysm of the supraclinoid carotid artery A treatable cause of blindness

ONE OF THE MORE INSIDIOUS and potentially treatable causes of progressive visual loss is unruptured aneurysm of the supraclinoid portion of the internal carotid artery. Over the past six years we have encountered 5 intriguing examples of this syndrome and were constrained to review previously published descriptions, in view of our meager experience. Because of its relative rarity as compared to more common types of intracranial aneurysm, in which rupture causes classic subarachnoid hemorrhage, this survey of the problem seemed profitable. Each of the reported cases was seen by one of us. All were characterized by progressive visual loss in association with giant suprasellar aneurysms arising from the internal carotid artery.

Transverse Axial Tomography of the Cervical Spine

Transverse axial tomography of the spine is a radiographic technique in which one can portray any level of the spine in cross section in the living patient. The examination provides a nondistorted magnified axial view of a preselected area of the spine and is a valuable adjunct to standard radiographic techniques.

Spontaneous pneumoventriculogram following radiation of a pituitary adenoma

Three years after radiation therapy for an intrasellar tumor, a 42-year-old housewife presented with headache, lethargy, and remarkable plain skull roentgenograms, in which dilated lateral and third ventricles were filled with air. Air apparently had entered the cranium through the sphenoid sinus and eroded sellar floor, extending directly through intrasellar remnants of the chromophobe adenoma and into the floor of the third ventricle. Frontal exploration showed an empty sella turcica and no residual tumor. She made an excellent recovery and has done well for 5 years after operative closure of the defect.

The Role of Transverse Axial Tomography in Three-Dimensional Treatment Planning

The authors discuss the use of transverse axial tomography in target localization, treatment simulation, and computation of dose distribution, including three-dimensional display. This technique facilitates accurate and rapid treatment planning for the individual patient. Limitations encountered during the application of this method over a period of two years are described.

The Technique and Interpretation of Lumbar Myelograms

A technique is described for performing lumbar myelography that provides for patient comfort while decreasing patient risk and increasing accuracy of interpretation. A study of 205 myelograms performed at the University of Miami School of Medicine as well as a literature review made it apparent that meticulous attention to technique could decrease the complication rate of myelography and increase diagnostic acumen.