Harold O. Peterson

Orbital Dysplasia in Neurofibromatosis

A dysplasia of the bony walls of the orbit is one of the congenital anomalies associated with generalized neurofibromatosis (1–6). Orbital dysplasia may be mistaken clinically and radiographically for neoplasm or chronic subdural hematoma within the middle cranial fossa unless its characteristic plain film and angiographic findings are appreciated. Plain Skull Film Findings The plain skull film findings of 7 patients with neurofibromatosis and orbital dysplasia, ranging in age from eighteen months to fifty-seven years, are summarized in Table I. All 7 showed obvious stigmata of neurofibromatosis, e.g., cafe au lait spots, subcutaneous tumors, or skeletal anomalies. The major presenting complaint in all cases was pulsating exophthalmos. Radiographs of the skull in all 7 patients demonstrated a dysplastic sphenoid bone complex. This consists of hypoplasia of the greater and lesser sphenoid wings, resulting in (a) elevation of the lesser sphenoid wing, (b) widening of the superior orbital fissure, and (c) la...

The Hazards of Myelography

The history of myelography and reactions to various contrast media is reviewed. Air is completely absorbed without producing long-term side effects. Lipiodol and Pantopaque are not absorbed and residual medium in the spinal canal can cause arachnoiditis. Other agents as Diodrast and Thorotrast never gained widespread acceptance. The water-soluble Dimer-X and Conray 60 have come into prominence but they are not totally without reactions. Recently a new water-soluble nonionic contrast medium has been developed in Norway. Metrizamide (Amipaque) has the same overall density as other water-soluble media but produces fewer reactions.

Evaluation of Dilute Pantopaque for Large-Volume Myelography

Abstract Fifty patients undergoing routine myelography were examined with dilute forms of Pantopaque and the results compared with those of an additional 50 patients examined using standard 30% Pantopaque. The more dilute forms flowed more slowly, but, based on all parameters evaluated, a 22% concentration of iodinated ethyl-p-phenylundecanoate may be the ideal form of Pantopaque for thoracic and cervical myelography.

Large-Volume Myelography: An Aid in the Evaluation of Curvatures of the Spine

Abstract The authors injected 12 to 88 ml Pantopaque in the myelography of 32 patients with varying degrees of kyphoscoliosis. The amount of contrast medium must be sufficient to completely fill the subarachnoid space at the site of curvature, allowing complete evaluation of the dural sac and spinal cord at that site. Intraspinal pathology such as tumors and syringomyelia can be excluded and the degree of compression of the dural sac and spinal cord evaluated. In this series 4 unsuspected abnormalities were defined by myelography: 2 syringomyelias, 1 diastematomyelia, and 1 intraspinal lipoma.

Single-Sweep Rotation Tomography in Coronal and Lateral Planes: Its Value in Pneumoencephalographic Diagnosis

Body-section radiography can be accomplished in several ways. In the most widely used method, the x-ray tube and the film move simultaneously in various motions while the subject remains stationary. In another method, generally known as autotomography, the tube and film remain stationary and the subject is rotated. This latter approach to laminagraphy was originally described by Vallebona (1) in 1930 but was not widely accepted. Its use during pneumoencephalography was originally suggested by Ziedses des Plantes (2) in 1950. In recent years, autotomography in the lateral plane for demonstration of midline structures, including the fourth ventricle and aqueduct, has met with wide acceptance from neuroradiologists (3). The head is rotated around its natural axis, the odontoid process. The overlying mastoid regions, being remote from the axis of rotation, are blurred by the motion (Fig. 1). This approach, although useful in clinical work, has several disadvantages. As it is usually performed, the head is eit...