Neuroradiology
-
Case Reports
Calcified convexity dura mater and acute epidural haematoma mimicking calcified chronic subdural haematoma.
We report a patient with calcification of the convexity dura mater and an acute epidural haematoma. CT revealed a calcified layer between the haematoma and brain parenchyma, which mimicked acute bleeding into a calcified chronic subdural haematoma. The appearance of a calcified haematoma does not always mean a "chronic" lesion, and that emergency operation should not be foregone, when there is a history of acute head trauma and progressive impairment of consciousness.
-
We describe thickening and contrast enhancement of the intracranial pachymeninges, revealed by MRI in a patient with presumed low-pressure headache following dural puncture and a blood patch. The clinical and radiological abnormalities resolved within 2 weeks.
-
We studied 63 patients between the ages of 20 and 81 years undergoing lumbar myelography, using a 25-gauge pencil-point (Whitacre) spinal needle. With the use of a questionnaire, the incidence and severity of post-dural-puncture headache (PDPH) was investigated. There were three patients who complained of PDPH (4.7%), two of whom described their headache as moderate and one as mild on a visual analogue scale. ⋯ There were three other patients who experienced a post dural-puncture-related headache which, unlike PDPH, was not postural. Four patients had ordinary mild headache. The quality of the myelograms was good.
-
Case Reports
MRI of peripheral nerves and pathology of sural nerves in hereditary motor and sensory neuropathy type III.
We investigated two patients with hereditary motor and sensory neuropathy type III, one with Déjérine-Sottas disease and the other with congenital hypomyelination neuropathy based on nerve pathology and MRI of the sciatic nerve. On biopsy of the sural nerve of the patient with Déjérine-Sottas disease, myelin debris, indicating demyelination, was observed in an onion-bulb pattern surrounding myelinated fibres. In the patient with congenital hypomyelination neuropathy, onion bulbs were formed of two parallel layers of basement membrane. ⋯ On axial T2-weighted MRI, a severely hypertropied sciatic nerve containing multiple rounded lesions, suggesting inflammation or demyelination, was observed in the patient with Déjérine-Sottas disease. In contrast, the sciatic nerve of the patient with congenital hypomyelination neuropathy showed slight hypertrophy without demyelination. MRI of the sciatic nerve may represent a useful tool for characterisation of demyelinating disease and its prognosis.
-
Between August 1991 and December 1992, CT was performed on 154 patients who had suffered missile head injury during the war in the Republic of Croatia. In 54% CT was performed 1-24 h after injury, and in 27% follow-up CT was also obtained. The wounds were penetrating, tangential or perforating (45%, 34% and 21%, respectively). ⋯ Such lesions were found in penetrating injuries only. CT proved very useful for assessing the extent and type of lesions. Although different mechanisms of brain damage in missile head injury are known, here they are, to the best of our knowledge, shown for the first time by CT.