George Wortzman

Microadenomas of the Pituitary and Abnormal Sellar Tomograms in an Unselected Autopsy Series

PROLACTIN-SECRETING microadenomas of the pituitary gland have been diagnosed on the basis of elevated serum prolactin concentrations and abnormal tomograms of the sella turcica.1 , 2 This diagnosis...

The clinical significance of radionuclide bone and gallium scanning in osteomyelitis of the head and neck

Osteomyelitis of the head and neck remains a difficult clinical problem both in diagnosis and treatment evaluation. The purpose of this manuscript is to review our clinical experience with 25 cases of osteomyelitis distributed evenly among the temporal bone and skull base, the paranasal sinuses, and the mandible. Radionuclide bone and gallium scan images accurately depicted the biologic activity of the disease process and permitted accurate treatment evaluation and patient monitoring. This work demonstrates the potentials and limitations of radionuclide imaging with bone and gallium scan agents and attempts to define a role for their contemporary use in the management of osteomyelitis of the head and neck.

Computerized tomography (ct) in otolaryngology

Computerized tomography (CT) of the brain has been available since 1973 and has changed neurological, neurosurgical and radiological practice beyond recognition. A rapid growth of literature has documented its role in the diagnosis of intracranial hematoma, cerebral atrophy, brain tumor, orbital lesions and postoperative tumor evaluation.

Avulsion of Lumbar Roots Complicating Fracture of the Pelvis

Four cases of avulsion of lumbar-nerve roots complicating fractures of the pelvis are reported, in which myelographic evidence of diverticula at the roots or dural scarring, or both, were found. In each case, the pelvic injury included dislocation of or fracture adjacent to a sacro-iliac joint. In contrast to fraction injuries of the cervical-nerve roots, the presence of a diverticulum in a lumbar myelogram does not usually mean complete avulsion of the nerve root, and some recovery may be anticipated. The neurological deficit in two of the four cases did not correspond segmentally to the location of the diverticula.

Contrast medium extravasation from aneurysmal rupture during cerebral angiography

The radiographic demonstration of contrast medium extravasation from a rupturing intracranial aneurysm is rare. We have detected this occurrence a mere thrice in 15 years, a period in which angiography was routinely used for the investigation of subarchnoid haemorrhage. We have added these three cases to 14 others that were previously reported in the literature and summarised the total. There does not appear to be a common aetiological factor, though further experimental studies on intracaratid pressures distal to the site of injection seem to be warranted. Ventricular opacification during cerebral angiography occurred in five of the 17 cases: in our most recent case the contrast medium outlined intraventricular haematomata, a finding not hitherto reported in the literature and a feature of prognostic significance. Mortality in this series was extremely high and in excess of that usually found either with an aneurysmal re-bleed or an intracerebral haematoma or both. However, although a combination of these two lesions is notoriously hazardous, perhaps the added insult of the contrast medium extravasation is the cause for the inordinately high fatality rate. Only three of the 17 cases survived, two of whom had a significant residual neurological deficit.

Clinically-directed ct in occult disease of the skull base involving foramen ovale†‡

Occult disease of the skull base may present as an isolated neurogenic symptom in the absence of physical signs or radiologic findings. It therefore often remains undiagnosed until advanced. Computed tomography (CT) provides the potential for diagnostic imaging far beyond conventional radiology. Not only do current generation scanners provide exquisite bone detail, they also provide the capability of soft tissue imaging.