Louis Wener

Computed tomography of spinal cord arteriovenous malformations.

Computed tomography (CT) of the spine after intravenous contrast enhancement has been used in 4 patients with arteriovenous malformation (AVM) of the spinal cord. The enlarged, contrast-filled vessels constituting the malformation are visualized on CT scans. There was good correspondence between CT and selective angiography. CT may be a useful screening and follow-up method for AVM of the spinal cord and a safe procedure for assessing the results of therapy.

MRI in autonomic failure.

A significant rank correlation between rigidity and putaminal signal dropout on magnetic resonance imaging (MRI) in patients with multiple system atrophy suggests that putaminal degeneration may cause this clinical finding. Absence of putaminal abnormalities on MRI in patients with pure autonomic failure may prove useful in differentiating these two autonomic disorders.

Selective arteriography of the spinal cord in posttraumatic paraplegia

THE RADIOGRAPHIC EXAMINATIONS that are generally carried out in patients with spinal cord injury are plain X-ray studies and sometimes myelography. Intraosseous spinal venography has been used in cases of compression fractures and vertebral luxations by Lessmann and Peresel and Vogelsang.2 We are not aware that spinal arteriography has been used i n cases of spinal cord injury. With the introduction of the selective technique,3 spinal cord angiography has been transformed into a reliable diagnostic method. By selective catheterization of intercostal and lumbar arteries a consistent demonstration of the vessels of the thoracolumbar segment of the spinal cord is possible. The recognition of the cervical and high-thoracic spinal cord vessels may be obtained by the selective technique (vertebral arteries and costocervical trunks) in a high percentage of cases-75 to 80%. Selective arteriography of the spinal cord is a safe diagnostic procedure.4 Following is the report of a case of posttraumatic paraplegia that w e studied by selective arteriography of the spinal cord.

Angiography of Cervical Cord Injuries

The cord vessels of 6 patients with cervical cord injury were demonstrated angiographically. Arteriography was carried out at different times after trauma, in 2 instances within six hours. In 2 patients, repeat angiography was done after corrective surgery. Retrograde filling of radiculomedullary arteries and displacement of the anterior spinal artery was shown in several cases. One patient with no fracture or dislocation but with evidence of vascular involvement showed marked improvement of neurological status on conservative therapy. Extravasation of contrast medium into the spinal meningeal spaces was evident in one case. A paired cervical anterior spinal artery was demonstrated in one case, and sulco-commissural arteries in another. Postmortem cord microangiography of one of the patients was also obtained.