Mannie M. Schechter

A CASE OF SPONTANEOUS DISSECTING ANEURYSM OF THE INTERNAL CAROTID ARTERY

Dissecting aneurysm of the internal carotid artery, without preceding trauma, is a rare event. We have been unable to find a previous case report. One case of dissecting aneurysm of the internal carotid artery following head injury has been reported (Dratz and Woodhall, 1947), and two cases after carotid puncture for arteriography (Sirois, Lapointe, and Cote, 1954; de Grood, 1954) where the common carotid dissection extended into the internal carotid arteries. As an extension of a dissecting aneurysm of the aorta Shennan (1934) reported five cases. The following case, apart from its rarity, is of both radiological and pathological interest.

Aneurysms and Arteriovenous Fistulas of the Superficial Temporal Vessels

Abstract Four cases of aneurysm of the superficial temporal artery and one of arteriovenous fistula are presented, and the literature is extensively reviewed. Certain conclusions in respect to the classification, pathogenesis, incidence, clinical and angiographic diagnosis, and treatment of these lesions are reached.

Colloid Cysts of the Third Ventricle

The clinical and roentgenographic features of 25 cases of colloid cyst of the third ventricle are described. Of all brain tumors, the colloid cyst is one of the most favorable for surgical removal, hence the need for an exact preoperative diagnosis is emphasized. The differential diagnosis is discussed and 2 cases presented to illustrate some pitfalls in the radiological diagnosis of these cysts.

Aneurysms of the internal carotid artery in the carotid canal of the petrous temporal bone.

Aneurysms of the internal carotid artery in the carotid canal of the petrous temporal bone are relatively uncommon lesions. Those arising in the lateral portion of the carotid canal often present with the signs and symptoms of a glomus tumor. A review of the literature indicates that several such aneurysms have been biopsied prior to the correct arteriographic diagnosis. Carotid arteriography is strongly advised in patients in whom the tympanic membrane is deformed by a pulsatile mass.

Growing intracranial aneurysms

Cerebral angiography is the best means by which an intracranial aneurysm can be demonstrated and studied in vivo. In 16 cases clinical deterioration paralleled a variable degree of enlargement of the aneurysms. In all patients the aneurysms were irregular and/or bior multilocular. Possible factors causing aneurysmal enlargement are discussed.

The radiology of aqueductal stenosis.

The entity, aqueductal stenosis, includes a variety of lesions affecting the aqueduct of Sylvius. It is not surprising, therefore, that the range of clinical and radiologic features within the group is hard to define in simple and precise terms. It was with the aim of understanding the variations in radiologic features within the group of lesions causing aqueductal stenosis that we reviewed the clinical, radiologic, and pathologic (when available) features in 88 patients with aqueductal stenosis hospitalized at the National Hospital for Nervous Diseases, London, England, and at the Atkinson-Morley Hospital, Wimbledon, England. To these cases were added several others collected from the Bronx Municipal Hospital Center and from St. Vincents Hospital, New York, N. Y. The radiological features of these cases are the subject of this communication. The ages of the patients at the time of presentation are given in Table I. It is obvious that frequently aqueductal stenosis presents relatively late in life. The a...

Torn meningeal vessels: an evaluation of a clinical spectrum through the use of angiography.

Modern medical knowledge of the clinical and pathological aspects of epidural hematoma dates from the nineteenth century (Jacobson, 17). Reference to head injuries, however, may be found in much earlier medical writings (5). As reports of this entity have accumulated in the literature, an analysis of the cases has led to the formulation and promulgation of rather rigid clinical diagnostic criteria. Today it is generally accepted, however, that the clinical spectrum seen with epidural hematomas is wide. Thus, although classical descriptions of the symptomatology include the “lucid interval,” such a history is obtained less than 50 per cent of the time...and although the classical description includes progression to a fatal outcome within hours, exceptions are fairly common in our experience and in that of others (16, 31, 36). The explanation for this variability is complex. Certain anatomic factors may be responsible in part. One such factor is the strength of attachment of the dura to the skull. The dura ...

Unusual segmental cerebrovascular changes.

Nonatherosclerotic causes of segmental vascular narrowing were demonstrated by cerebral angiography in three quite unrelated disorders: sickle-cell anemia, reticulum-cell sarcoma, and tertiary syphilis. Sickle-cell anemia and reticulum-cell sarcoma have not previously been shown to be associated with diffuse segmental narrowing.

Metastases to the Medulla of the Spinal Cord: Myelographie Features1

Intramedullary metastases to the spinal cord of non-neurogenic origin are exceedingly rare, comprising fewer than 1.6% of all metastases affecting the spinal canal and its contents. Plain films are normal. Irregular fusiform widening of the spinal cord is the most common myelographic feature, although nodularity is also present. Complete blockage is very rare. The authors describe the radiological features in 4 cases of intramedullary metastases of non-neurogenic origin. The differential diagnosis is discussed, and some pathogenetic mechanisms are postulated. It is important to recognize intramedullary metastases in order to plan the proper management.

Cortical Venous Rerouting in Parasagittal Meningiomas

Twenty-two patients with parasagittal meningiomas and superior sagittal sinus involvement were examined. All had angiography and surgical confirmation of partial or complete occlusion of the superior sagittal sinus (SSS). A constellation of findings indicated the presence of venous flow rerouting in the SSS: (a) nonvisualization of a segment of the SSS; (6) failure of cortical veins to reach the SSS; (c) delayed emptying of veins in the region of obstruction; and (d) reversal of normal venous flow with collateral venous channels connecting the SSS with other channels such as the lateral sinus or the middle cerebral vein. These findings also support the presence of a slowly growing tumor, usually a meningioma. Other conditions that may mimic SSS occlusion are also described.