Computed tomography and myelography of the postoperative lumbar spine.

Postoperative myelographic changes in the thecal sac, epidural tissues, and bony canal, as well as nerve roots, may be difficult to interpret. A series of 32 postoperative patients, all of whom had a metrizamide myelogram and subsequent lumbar computed tomogram, was reviewed to examine the ability of computed tomography to recognize abnormalities when the myelogram is equivocal or uninterpretable. Criteria to distinguish recurrent herniated disk from postoperative changes are presented, including the demonstration of mass densities similar to and in continuity with the intervertebral disk. In 12 reoperated cases, five recurrent herniated disks and two new herniated disks were diagnosed and confirmed. In 20 nonreoperated cases, no recurrent herniated disks were identified, although two new herniated disks were found at levels not believed clinically significant. Computed tomography after metrizamide myelography appears to be a reliable technique for distinguishing abnormalities in the postoperative spine.

High-resolution metrizamide CT cisternography in sellar and suprasellar abnormalities.

Metrizamide computerized tomographic cisternography was performed with a small dose and low concentration of intrathecal metrizamide using a newer generation of computerized tomography scanner for the evaluation of sellar and suprasellar abnormalities. The examination was performed with thin sections in axial, direct coronal, and (when feasible) direct sagittal projections in a high-resolution technique. The relationship of the lesions with carotid arteries, optic chiasms, and hypothalamic structures was accurately defined.

CT in trauma of the base of the skull and its complications.

Diagnosis and accurate delineation of fractures involving the base of the skull can easily be done with newer generation computed tomography (CT) scanner. CT also demonstrates associated complications, such as hemorrhage, brain injury, and leakage of cerebrospinal fluid (CSF), not seen in plain skull radiography or tomography.

Ct in spinal trauma.

The radiological evaluation of patients with acute spinal trauma has always been a challenging problem. Multiple radiological procedures are often necessary for complete evaluation of the extent of spinal injury. CT provides an ideal modality whereby accurate assessment of displacement of bony fragments as well as associated spinal cord and nerve root injury can easily be performed, eliminating the need for difficult radiological procedures.

Metrizamide CT cisternography in the diagnosis and localization of cerebrospinal fluid rhinorrhea.

Metrizamide computed tomography cisternography was performed for the diagnosis and accurate localization of cerebrospinal fluid (CSF) rhinorrhea in six patients (five posttraumatic and one spontaneous). The examination not only delineated the fracture or bony defect through the base of the skull, but it also demonstrated the leakage of CSF mixed with metrizamide.

CT detection of intracranial aneurysms in subarachnoid hemorrhage.

Contrast enhanced computed tomography (CT) scans of 59 patients with subarachnoid hemorrhage were evaluated for intracranial aneurysms. After prospective study, the CT results were compared with angiography. Depending on the location, the CT detection rate varied from a low of 36% for the internal carotid artery complex to a high of 76% for anterior and middle cerebral artery aneurysms. It was concluded that angiography may be deferred if the causative aneurysm is demonstrated by CT.

Spontaneous rupture of a pineal teratoma.

A case of a spontaneously ruptured pineal teratoma is presented. This was diagnosed by computed tomography (CT) and was confirmed later at operation.

Spontaneous thymic hemorrhage in an adult.

Acute hemorrhage in a normal thymus in neonates and infants has been reported in the literature. These patients were known to have an antecedent cause or defects in coagulation. The case of an adult who developed acute hemorrhage in a normal thymus and who was known not to have any defects in coagulation, hypertension, or other underlying cause is reported.