Zoltan Patay

Early complications of petrous bone fractures

Petrous bone fractures are commonly encountered consequences of head trauma. Since the advent of high-resolution computed tomography (CT), their diagnosis has been considerably facilitated 2•10• However, even nowadays, petrous bone fractures are relatively often overlooked on the first emergency head scans and hence their possible complications 15•17•19•21 , which can potentially lead to more or less severe and sometimes permanent sequela, may remain undiscovered. Although, if the diagnosis of a petrous bone fracture by itself does not necessitate any urgent surgical intervention, some of its complications might do so. This is why a systematic CT evaluation of the temporal bone and of the neighbouring regions is mandatory in all (minor or major) head trauma cases, where clinical or radiological signs evoke a petrous bone fracture. If a petrous bone fracture is found, special attention should be paid to all the locus minoris resistentiae and to other delicate structures along the fracture line, in order to early diagnose the immediate or potentially evolving complications and indicate adequate therapeutic measures without delay. This preventive attitude and the knowledge of the most frequently detectable early complications may help to significantly reduce the number of the often irreversible and seriously handicapping sequela of the otherwise usually benign petrous bone fractures. CT examination of the petrons bone fractures in the acute phase of head trauma

Perisellar Lesions a Pratical Approach

Most of the books devoted to Neuroradiology or to MR imaging of the brain do have a chapter on sellar and perisellar lesions J-s . Many papers on this topic have also regularly been published in neuroradiological journals or in journals of neurology, neurosurgery, endocrinology and so on 6· 16• The purpose of this presentation is essentialy to provide guidelines about how to provide an optimal neuroradiological work-up of patients clinically suspected to harbour a perisellar lesion and discuss the important semiological neuroradiological signs to be aware of. In summary, what kind of examination should be performed and in which order? What are the important questions to be raised and preferably answered!?

MR Evaluation of Dural Venous Sinus Invasion by Intracranial Meningiomas a Combined MRI-MRA Approach

We established a standard, reproducible MRI-MRA imaging protocol for intracranial meningiomas and tested its feasibility and value in clinical settings. We then create a new, simplified classification, which is based only on criteria which are detectable by MRI and MRA.

Neuroradiological Work-up of Achondroplasia

Achondroplasia is an autosomal dominant skeletal dysplasia resulting from abnormal enchondral bone formation and leading to short limbed dwarfism 11•18• Although it is a primarily bony disease, neurological complication are frequently encountered in achondroplastic children already in early childhood 4• There are primarily two factors predisposing the achondroplastic children to neurological dysfunctions. The first one is the significantly reduced size of the foramen magnum, which may lead to cervicomedullary compression 7•22• The second one is a communicating hydrocephalus responsible for the head enlargement, usually associated with achondroplasia 8•12•22• Although the ventricular dilatation is often moderate and stable, it may be associated with increased intracranial pressure even in absence of clinical signs 19 and could therefore participate to the psychomotor delay observed in achondroplastic children 20• There is now considerable evidence that intracranial venous sinus hypertension, secondary to narrowing of the jugular foramina, plays a major role in the genesis of hydrocephalus in achondroplastic patients 5•10•13•19•22• The case reported here illustrates the neuroradiological work-up of achondroplasia with special emphasis on the role of magnetic resonance imaging including MR angiography.