K. F. Lee

Meningioma of the paranasal sinuses.

SummaryMeningiomas originating in the paranasal sinuses are rare. These tumors are thought to arise from embryonal arachnoid nests which were pinched off and left behind during embryonic development. We have described various radiographic findings of two patients with meningioma arising in the paranasal sinuses (frontal sinus origin in a 65-year-old female, and sphenoid sinus origin in a 26-year-old female). The paranasal origin of meningioma was accurately determined on the basis of CT and arteiography. A review of the 11 cases previously reported and our cases indicates that there are no specific clinical or radiographic findings of meningiomas of the paranasal sinuses.

Computed tomographic findings in cerebral hemiatrophy.

SummaryThe clinical, plain skull radiographic, brain scan, and CT findings of four patients with cerebral hemiatrophy are described. CT scanning is the most innocuous and most sensitive diagnostic method available to confirm the clinical diagnosis when plain skull radiographic changes are not confirmatory.

The vasculature of the diaphragma sellae. A postmortem injection study.

SummaryThe postmortem injection study demonstrated that the main blood supply to each quadrant of the competent diaphragma sellae appears to come from the following vessels: posterior quadrant, inferior hypophyseal arteries; right and left marginal quadrant, tributaries of the intracavernous portion of the carotid artery; anterior marginal quadrant, anterior capsular arteries. When the diaphragm is incomplete or absent the inferior hypophyseal arteries are the main source of blood supply. Microscopic analysis of the vascular bed in the diaphragma sellae reveals that there are fine arterial filaments mostly in the superior layer, while venules are situated in the inferior part of the diaphragm.

The vasculature of the diaphragma sellae

The postmortem injection study demonstrated that the main blood supply to each quadrant of the competent diaphragma sellae appears to come from the following vessels: posterior quadrant, inferior hypophyseal arteries; right and left marginal quadrant, tributaries of the intracavernous portion of the carotid artery; anterior marginal quadrant, anterior capsular arteries. When the diaphragm is incomplete or absent the inferior hypophyseal arteries are the main source of blood supply. Microscopic analysis of the vascular bed in the diaphragma sellae reveals that there are fine arterial filaments mostly in the superior layer, while venules are situated in the inferior part of the diaphragm.

The value of computed tomography in delineating suprasellar extension of pituitary adenomas.

Pituitary tumors commonly produce suprasellar extension. We have found that in assessing lateral suprasellar extent, the pneumoencephalogram and arteriogram are least accurate. CT scanning significantly increases the accuracy, and it is recommended that all patients with pituitary tumors have an initial CT scan.

The Role of Ultrasonography in the Diagnosis of Certain Neurologic Disorders

Ultrasonography is the most innocuous and noninvasive procedure, ideally suited for screening patients suspected of having cerebrovascular insufficiency. The Doppler ultrasound and real-time techniques complement each other. The latter can actually display a two-dimensional dynamic image of the carotid artery. B-scan can also be used in fetuses, infants, and young children for precise assessment of the size of the ventricular system. It can be used for serial follow-up evaluation of hydrocephalus. Ultrasound can be utilized in determination of the depth and width of the lumbar spinal canal. Differentiation of cystic from solid masses in the spinal canal may also be made by this modality.

The value of radionuclide myelography in the evaluation of spinal arachnoiditis.

SummaryOn the basis of myelographic findings, spinal adhesive arachnoiditis was classified into three types: type I (peripheral or marginal), type II (central), and type III (advanced). Depending on its location and extent, it may be divided into group A (lumbar), group B (thoracic), and group C (cervical). In view of the fact that intrathecal injection both of oily and of water-soluble contrast media tends to produce spinal arachnoiditis, we have been using radionuclides for pre-and postoperative myelography to evaluate arachnoiditis. Radionuclide myelography with 131I-HSA or 111In-DTPA is a safe modality which provides useful information regarding spinal arachnoiditis.