Neuroradiology
-
Descending tentorial herniation (DTH) can be diagnosed by computed tomography. Encroachment upon the lateral aspect of the suprasellar cistern is an early sign of impending tentorial herniation. ⋯ Aqueductal compression secondary to the herniation will cause increased intraventricular pressure with widening of those parts of the lateral ventricles that are not exposed to the compression by the mass; a characteristic finding is widening of the temporal horn on the side opposite the space-occupying lesion. Infarction in the territory of the posterior cerebral artery may complicate DTH.
-
CT scans have been made on 39 of 41 patients who presented with subarachnoid hemorrhage. Blood could be visualized in the cisterns of 18 of 32 examinations performed within five days of the hemorrhage all having aneurysms. ⋯ Much other information was obtained, for instance about rebleeding and infarction. CT should routinely be the primary examination, followed by selective angiography.
-
Forty-seven cases with intrasellar cisternal herniation (empty sella) examined by plain X-ray of the skull and pneumoencephalography have been reviewed. Although the diagnosis may frequently be anticipated from the plain X-ray findings, further studies are necessary to establish the diagnosis. Also the type of herniation, whether horizontal, anterior or complete, may be anticipated from the appearance of the sella. Signs attributable to increased intracranial pressure, mainly erosion of the dorsum sellae, were found in about half of the cases.
-
The radiodiagnostic signs of congenital basal encephalocele are well known. The case history described here shows that a long existing, acquired, traumatic transethmoidal encephalocele can cause the same roentgen appearance. The differences between the congenital and recent posttraumatic forms are indicated.
-
Extensive calcification in the intracranial portion of a glomus jugulare tumor is reported. This finding has not been reported previously in the literature. The patient probably was afflicted with this process for many years and presented with a subarachnoid hemorrhage. The combination of this tumor with subarachnoid hemorrhage is rare.