Gabriel Wilson

Steroids and apparent cerebral atrophy on computed tomography scans.

Computed tomography scans of 15 long-term steroid users showed varying degrees of apparent cerebral atrophy, not expected at their ages (8 to 40 years). Most were suffering from autoimmune diseases. There appeared to be some correlation between dosage and degree of apparent atrophy. There was surprisingly little clinical evidence of cerebral dysfunction associated with this apparent atrophy. In two of the cases, the appearance of the brain improved following decrease or cessation of steroid use. Speculations are made on possible causes.

Cerebral venous drainage pattern of the Sturge-Weber syndrome.

Carotid angiographies of 11 patients with Sturge-Weber syndrome revealed cerebral venous abnormalities in each. An abnormal cerebral venous drainage pattern was found, consisting of lack of superficial cortical veins and associated nonfilling of the superior sagittal sinus, enlargement and tortuosity of the deep subependymal and deep medullary veins, and occasionally bizarre courses of cerebral veins. The basis of the pattern appears to be nonfunction or absence of cortical veins beneath the Sturge-Weber leptomeningeal angiomatosis, with collateral flow centrally to the subependymal veins.

Venography of the Cavernous Sinus, Orbital Veins, and Basal Venous Plexus

The dural sinuses about the base of the skull have received little attention in radiological literature. When opacified, the cavernous sinus together with the intercavernous sinuses offer intimate information about the configuration of the pituitary gland. In addition, free communication with the ophthalmic veins allows investigation for orbital mass lesions. The purpose of this report is to outline a technic for passing a catheter percutaneously via the internal jugular vein into the inferior petrosal sinus to visualize the cavernous sinus and orbital veins. Anatomy Free communication exists between the many rich venous plexuses about the base of the skull. Relatively large channels, the superior and inferior petrosal sinuses, unite the sigmoid sinus with the cavernous sinus. The superior ophthalmic vein drains directly into the cavernous sinus through the superior orbital fissure. The inferior ophthalmic vein may drain posteriorly directly into the cavernous sinus or to the pterygoid plexus. The pterygo...

The Anterior Inferior Cerebellar Artery: Its Radiographic Anatomy and Significance in the Diagnosis of Extra-axial Tumors of the Posterior Fossa

The anterior inferior cerebellar artery traverses the cerebellopontine angle cistern in close association with the seventh and eighth cranial nerves and supplies the lower pons, medulla, and anterior portion of the cerebellum. In spite of the known anatomic relationships of this artery, angiographic diagnosis of cerebellopontine angle tumors has depended upon presence of tumor vessels (4, 7, 11, 14, 18), superior displacement of the superior cerebellar artery (5, 8, 11, 13), and displacement or obliteration of the petrosal veins (5, 15). This is in part due to the fact that lateral and half-axial projections routinely obtained during vertebral angiography are not suitable for visualization of the anterior inferior cerebellar artery. It has been our practice to obtain straight anteroposterior roentgenograms which permit visualization of the anterior inferior cerebellar artery with the use of the subtraction technic (6). In a review of 250 catheter vertebral angiograms on 227 patients there were 9 cases wit...

Angiographic Findings in 16 Patients with Juvenile Nasopharyngeal Angiofibroma

Juvenile nasopharyngeal angiofibroma is a benign, highly vascular, fibrous tumor originating in the nasopharynx of young boys and reputed to undergo spontaneous regression at puberty (5). Angiography has shown clearly that these tumors penetrate through normal fissures and foramina to extend into the regions adjacent to the nasopharynx. The angiographic appearance is characteristic enough for a histological diagnosis. Angiography is also valuable in planning a surgical attack and in evaluating the therapeutic results (6). Material Over a period of approximately two years, 18 patients were studied by extensive angiography, and later the radiographic findings were verified by surgical excision. The ages at which these patients first sought medical attention ranged from seven to twenty years, but the thirteen- to sixteen-year-old group was predominant. Two of the 18 were females, but their clinical course and angiographic appearance are sufficiently different to exclude juvenile nasopharyngeal angiofibroma, ...

The Significance of the Petrosal Vein in the Diagnosis of Cerebellopontine Angle Tumors

The venous systems in the posterior fossa have received little attention in the radiologic and anatomic literature (7, 15) in spite of the awareness of their diagnostic significance (10). The petrosal vein is one of the three major venous drainage systems in the posterior fossa and runs within the cerebellopontine angle, draining the anterior aspect of the cerebellum and the venous plexus of the pons. In a review of 234 catheter vertebral angiograms, it has become apparent that the petrosal vein is constantly visualized on angiograms of good quality and has an important diagnostic significance in the evaluation of cerebellopontine angle tumors. The purpose of the authors is to describe the radiographic anatomy of the petrosal vein and its tributaries as well as its diagnostic significance in posterior fossa tumors. Material and Methods This study was based on 234 vertebral angiographic studies performed over a period of five years, beginning March 1962, at the UCLA Medical Center, Los Angeles, Calif. From...

Neuroradiology of the Sphenoidal Region

The neuroradiological techniques employed in diagnosing a series of 54 lesions involving the superior orbital fissure and cavernous sinus (sphenoidal region) were reviewed in order to compare the value of sphenoidal tomography, pneumoencephalography, cerebral arteriography and sphenoidal venography. The patients included in the series exhibited clinical syndromes of sphenoidal region cranial nerve deficits. Confirmation of the sphenoidal region disorder was obtained in all cases. Of the four procedures, sphenoidal venography and basal tomography yielded the highest rate of positive studies.

Complication rate of selective cerebral angiography in infants and children. A comparison with a similar adult series.

Abstract In 100 cerebral angiographies in 100 children, a 5% complication rate was observed; in a similar series in 100 adults, complications were seen in 7%. Three deaths were not directly attributable to angiography. Four of the complications in adults consisted of formation of a neck hematoma. Bilateral carotid angiography is no more dangerous than study of a single vessel. The risk of complications does not seem to increase with an increase in the volume of contrast material. Selective cerebral angiography, if carefully performed by the femoral artery route, appears to be as safe in children as in adults.

Partially thrombosed giant aneurysm simulating an arteriovenous malformation on MR imaging.

A case of a partially thrombosed giant intracranial aneurysm with a magnetic resonance appearance simulating an arteriovenous malformation is presented. Causes for the similarity in signal pattern are discussed.

Comparison of Amniography and Pelvic Angiography in the Diagnosis of Hydatidiform Mole

Hydatidiform mole is a pathologic pregnancy which may present problems in diagnosis. The clinician is faced with a dilemma: he desires to make an early diagnosis but is fearful of interrupting a normal gestation. The purpose of this paper is to compare the findings of the combination of pelvic arteriography and amniography performed in patients with hydatidiform moles. Hydatidiform mole occurs with a frequency of 1 in 2,000 pregnancies in the United States. A slightly higher incidence is noted in the Mexican and Oriental populations. Its early diagnosis is desirable to allow early termination of the abnormal pregnancy and avoid the later complications of hemorrhage associated with spontaneous unattended evacuation, the development of subsequent cancer, or early toxemia. Heretofore, the diagnosis of molar pregnancy has been based on presumptive signs and symptoms such as severe hyperemesis, an early toxemia, persistent uterine spotting or bleeding, uterine enlargement beyond that expected for the gestation...