John N. Joslyn

Magnetic resonance imaging in neuronal ceroid lipofuscinosis

Neuronal ceroid lipofuscinosis is a group of neurodegenerative disorders characterized by accumulation of lipofuscin and/or ceroid within the tissues of the body. These entities are manifest by visual, intellectual, and motor deterioration as well as recurrent seizures. Computed tomography has been shown to demonstrate changes of cerebral atrophy in more severely affected patients. Seven patients with neuronal ceroid lipofuscinosis were examined with both computed tomography and magnetic resonance imaging, and the results were correlated with the clinical severity of the disorder. Two less severely affected patients had normal results on computed tomography and magnetic resonance imaging studies. Varying degrees of cerebral atrophy were seen in the remaining five patients with both computed tomography and magnetic resonance imaging. Severity of atrophy correlated with the severity of disability in these patients. Abnormal white matter was seen in the two most severely affected patients only with magnetic resonance imaging. Although the findings in patients with neuronal ceroid lipofuscinosis were nonspecific, the increased sensitivity of magnetic resonance imaging for subtle white matter abnormalities over computed tomography may prove helpful in monitoring the progression of this rare disorder.

Subdural hematoma secondary to ruptured intracranial aneurysm: computed tomographic diagnosis

This case report illustrates a cerebral aneurysm that bled into the subdural space without any clinical or radiographic evidence of subarachnoid hemorrhage. Both the aneurysm and the subdural hematoma were easily demonstrated on computed tomography scan. The incidence of this lesion and its possible etiology are discussed.

Lissencephaly: Computed tomographic diagnosis

Lissencephaly is a rare congenital condition with distinctive brain changes. Most of these changes were demonstrated on computed tomography, and include lack of cortical sulci and gyri; calcification in the region of paraphysis; wide, shallow sylvian fissures; colpocephaly; poor development of white matter; and persistent cavum septum pellucidum and cavum vergae.

Differentiation of herniated lumbar disc from bulging annulus fibrosis use of reformatted images

Abstract Over 500 lumbar spine CT examinations were evaluated and compared with surgical findings. The use of reformatted sagittal images is important in differentiating the bulging from herniated disc. The extension of the disc material above or below the disc space is more easily seen with this technique. The accuracy of CT interpretation is increased by routine utilization of sagittal reconstruction images.

Intracranial gyriform calcification associated with subarachnoid fat

Intracranial convolutional or gyriform calcification simulating Sturge-Weber syndrome has been described in association with bacterial and viral intracranial infection as well as irradiation and intrathecal methotrexate for central nervous system leukemia. Reported is a case of gyriform calcification caused by chemical meningitis secondary to subarachnoid fat from an epidermoid tumor.

Aneurysmal rupture during computed tomography scanning

A unique case in which a berry aneurysm was observed to rupture during computed tomography scanning of the brain is reported. Two earlier case reports of aneurysmal rupture during computed tomography scanning are reviewed, followed by a discussion of possible mechanisms of rupture during contrast studies. Contrast medium infusion may have the potential to cause aneurysmal rupture by a direct anticoagulant effect, by affecting the endothelial membrane, by interacting with platelet release of vasoactive substances, by inducing vasodilation, by removing the protective arterial spasm, or by other unexplored mechanisms. The information to be gained by infusion of contrast medium in cases of aneurysmal rupture can be significant and the rarity of rerupture during contrast medium infusion does not appear to pose a significant risk in the vast majority of cases.

Arterio-colonic fistula during scintigraphic evaluation of gastrointestinal bleeding

The use of scintigraphic imaging in the evaluation of gastrointestinal (GI) hemorrhage has been established recently as a screening procedure prior to anigography. We reprot an unusual and previously unreported cause of acute GI bleeding which illustrates several technical factors to be considered during scintigraphic evaluation of GI bleeding.