Persistent primitive trigeminal artery in monochorial twins. A case report.

The trigeminal artery is one of the arterial structures that constitute anastomosis between the carotid and the posterior circulation during fetal life and usually regress. However these arterial structures may persist in adult life and the trigeminal artery is the one that most frequently show such behaviour. We describe the case of two monochorial female twins with a persistent primitive trigeminal artery revealed by magnetic resonance angiography.

Osteogenic Sarcomatous Degeneration of the Temporal Bone Squama in Paget's Disease. A Case Report.

Paget's bone disease is a common disorder affecting approximately 3-4% of the population over 40 and up to 10-11% of the population older than 80 years. It is characterized by excessive and abnormal bone remodelling. The disease predominates in bones containing red marrow, with a clinical course characterized by active and quiescent periods; pelvis, sacrum, spine and skull are the most affected parts. We report the case of a 79-year-old woman with polyostotic Paget's disease who had a focal sarcomatous degeneration diagnosed by CT and MR.

Optic chiasm involvement secondary to herpetic encephalitis. A case report.

Herpes simplex (HSV) encephalitis is one of the most common central nervous system (CNS) viral infections in adults. Early diagnosis is essential for treatment. We describe the case of a 70-year-old man who reported sudden bilateral reduction of visus. Four days after admission the patient showed high fever, followed the next day by a generalised convulsive crisis and coma. A first magnetic resonance imaging (MRI) showed no alterations, whereas the second showed the usual patterns of HSV encephalitis. With a clinical suspicion of herpetic encephalitis an intravenous therapy with acyclovir was established. The diagnosis of herpetic encephalitis was confirmed by cerebrospinal fluid (CSF) detection of herpes simplex DNA sequences. A further ten days later we performed a third MRI, demonstrating the typical pattern of HSV encephalitis and an increase in size and signal of the optic chiasm.

Dural arteriovenous fistula at the craniocervical junction with perimedullary venous drainage.

MR imaging showed swelling and diffuse signal changes in the spinal cord in two patients with progressive myelopathy. MR angiography revealed slow-flow perimedullary vessels extending to the skull base, which are consistent with drainage vessels of a dural arteriovenous fistula at the craniocervical junction. This fistula was subsequently seen in both patients on selective arteriograms of the ascending pharyngeal and vertebral arteries.

Balloon occlusion of the carotid artery in the treatment of cavernous giant aneurysms: two cases.

Over recent years, endovascular occlusion of the carotid artery has become a valid alternative to its more traditional surgical ligation in the treatment of cavernous giant aneurysms. The authors report two cases treated with balloon occlusion in two patients with clinical signs of cavernous sinus syndrome. The procedure consisted of occluding the aneurysm and the carotid by means of detachable balloons. This was preceded by a 30-minute clinically monitored occlusion test aimed at evaluating the functioning of Willis' circle. The treatment was carried out under neuroleptoanalgesia, so optimal control of the neurological condition of the patient was possible. Partial symptom regression was obtained in both cases.

Percutaneous discectomy using Onik's method: 3 years' experience.

A total of 234 patients treated by percutaneous discectomy at 237 levels and followed-up between 11 months and 3 years 4 months showed an overall success rate of about 75%. In a subgroup of 112 of these patients rechecked for a second time, the clinical results remain consistently good even 24 months after surgery. In a special group of 28 patients who complained only of low back pain, percutaneous discectomy achieved a success rate of 85.7%. Complications consisted of one disc infection which cleared without clinical or radiological sequelae (0.26%).

[Venous angioma associated with cavernous angioma. Presentation of three cases]. / Associazione di angioma venoso ed angioma cavernoso. Presentazione di tre casi.

Cavernous angiomas and venous angiomas may be discovered as associated lesions in the same patient. Most Authors report that Venous angiomas are not true vascular malformation; they should be considered as variant of normal venous drainage, consisting of tortuous medullary veins converging into a dilated draining one. By rule, they are quite asymptomatic, and very rarely bleed. On the other side, cavernous angiomas are true vascular malformations, usually angiographically occult. Their association is relatively rare, but it is important because of the possibility of bleeding, which should be related to the presence of the cavernous malformation. We report the cases of three patients studied by Computed Tomography, Magnetic Resonance and Digital Angiography in our Neuroradiologic Department.

Unusual radiological presentation of a primary CNS lymphoma.

The Authors report a case of primary cerebral lymphoma occurred in a 62 years old lady, who came to observation for headache and mood alterations. An enhanced CT showed a lesion recalling a meningeal sarcoma. Points of interest in this case are the unusual radiological appearance and the infrequent localization. Main anatomical and clinical characteristics of primary CNS non-Hodgkin lymphomas are recalled, even with regard to modern immunohistochemical techniques.

CT in low back and sciatic pain due to lumbar canal osseous changes.

In a consecutive series of 600 patients scanned by CT for various spinal diseases, those with low back and sciatic pain without disc herniation were selected for study. The causes proved to be joint facet degeneration (32 cases), stenosis of the neural foramina (13 cases), stenosis of the spinal canal (13 cases), lateral recess stenosis (6 cases) and spondylolisthesis (6 cases). The predominance of joint facet pathology as the underlying cause of low back and sciatic pain in the absence of disc herniation is confirmed. CT scanning of the soft tissues as well as of the skeletal structures is crucial to the aetiological diagnosis of the condition under study and hence to the proper planning of treatment.