Yuji Numaguchi

Periosteal chondroma of the cervical spine: One more cause of neural foramen enlargement

A case of cervical periosteal chondroma presenting with an enlarged neural foramen is described. Review of the literature showed that cervical chondromas are rare but that their characteristic clinical and computed tomographic findings aid in their diagnosis. The computed tomographic findings of two previously reported cases of cervical periosteal chondroma resembled those of the present case. On computed tomographic scanning, an iso-or high-density mass containing stippled calcifications and originating in a posterior cervical neural arch was observed in all three cases. Extensive spinal canal and extradural involvement was observed in five of the seven reported cases, including the one reported here.

Cerebral blood flow mapping using stable Xenon-enhanced CT in sickle cell cerebrovascular disease

SummaryThe cerebral blood flow (CBF) of 25 patients with sickle cell cerebrovascular disease (SCCVD) was examined using a Xenon-CT flow mapping method. Brain CT and MR findings were correlated with those of the Xenon-CT flow studies. CBF defects on Xenon-CT correlated reasonably well with the areas of cortical infarctions on the MR images, but in 27% of the cases, flow defects were slightly larger than the areas of infarctions on the MR images. In deep watershed or basal ganglia infarctions, abnormal CBF was noted about the cerebral cortex near infarctions in 72% of the patients, regardless of infarction sizes on the MR images. However, decreased CBF was recognized in 4 of the 9 children whose MR images were virtually normal. Thus, the extent of flow depletion cannot be predicted accurately by MR imaging alone. Xenon-CT flow mapping proved a safe and reliable procedure for evaluation of the CBF of patients with SCCVD. Although this study is preliminary, it may have a potential in selecting patients for hypertransfusion therapy, as a noninvasive test and for following children with SCCVD during their therapy. Careful correlation of results of CBF with those of MR imaging or of CT is important for objective interpretations of flow mapping images.

Magnetic resonance imaging of post-surgical pseudomeningocele

Three cases of post-surgical pseudomeningocele (PSPM) are presented. MR imaging proved useful in diagnosing PSPM because, in the orthogonal planes, it demonstrated precisely the leakage site and the extent of the PSPM. MR imaging was also useful in demonstrating the presence of communication between the PSPM and the subarachnoid space.

Giant aneurysms of bilateral internal carotid arteries in a child

Aneurysms in the petrous or cavernous portion of the internal carotid artery in childhood are extremely rare. Only two such cases have been previously reported. We present a case of bilateral giant intrapetrous aneurysms in a young female. CT was especially helpful in evaluating the absolute size of these aneurysms. This case is unique in that we demonstrated the temporal evolution of internal carotid aneurysms on follow-up angiography.

Large asymptomatic noncolloid neuroepithelial cysts in the lateral ventricle: CT and MR features

SummaryTwo cases of large asymptomatic cysts of the lateral ventricle are presented. The cyst walls or cyst contours were demonstrated well by proton density-weighted or T2-weighted spin echo images. These cysts are being detected as incidental findings in increasing frequency with the increasing use of MR imaging. Our data and review of the literature suggest that surgical intervention is not necessarily warranted, but that careful clinical evaluation is indicated. The diagnostic problem of intraventricular cysts is also discussed.

Magnetic resonance imaging of calvarial eosinophilic granuloma

A small calvarial eosinophilic granuloma is demonstrated with T2 weighted magnetic resonance imaging.

Eosinophilic granuloma of the cervical spine without vertebrae plana

A case of eosinophilic granuloma of the cervical spine is described. Cervical radiography and computed tomography demonstrated destruction of pedicles and posterior portions of the neural arch. Vertebral body heights were essentially preserved and the importance of this finding is underscored. Computed tomography played an important role in evaluating the extent of this disease.

Degenerative lumbar spine disorders in gradient refocused echo axial magnetic resonance images

The axial images of 58 lumbar disks having degenerative disorders imaged by gradient refocused echo (GRE) and spin echo (SE) magnetic resonance imaging (MRI) pulse sequences at high field strength were compared for diagnostic quality. The vacuum phenomenon, calcified disk, and bony hypertrophic changes were better demonstrated by GRE images than by SE images due to magnetic susceptibility effect. Axial GRE images are therefore useful adjuncts to SE images for effective MRI of degenerative lumbar spine disorders at high field strength.

Superior sagittal sinus thrombosis with intracerebral hematoma.

Intracranial hematoma secondary to superior sagittal sinus thrombosis is a well described, but rare event. We present a case of interval resolution of a intracerebral hematoma in a patient with thrombosis of the sagittal sinus.

Tension pneumocephalus five years after intracranial resection of pituitary adenoma—A case report

A case of spontaneous pneumocephalus with progression to tension pneumocephalus is presented. It is unique because it occurred spontaneously via a sellar defect 5 years after resection and irradiation of a pituitary adenoma, without tumor recurrence. Computed tomography clarified the extent of the pneumocephalus and its progression to tension pneumocephalus.