Superficial hemosiderosis of the central nervous system. A case report.

A case of idiopathic superficial hemosiderosis (SH) of the central nervous system and a review of the literature are presented. The patient suffered from progressive cerebellar ataxia, hearing loss, anosmia, spastic paraparesis, but no mental deterioration. The diagnosis was made with brain and spinal MRI, that showed in T2 weighted images superficial hypointensity of spinal cord, medulla oblungata, pons, mesencephalon, cerebellum and cerebral hemispheres, images that are considered pathognomonic of SH. Repeated spinal fluid examinations were negative, suggesting that evidence of overt subarachnoidal bleeding is not essential in the diagnosis. In patients with SH of unknown etiology no valid therapy is yet available.

Age-related changes of methionine-enkephalin and beta-endorphin/beta-lipotropin immunoreactivity in human CSF.

Methionine-enkephalin (ME-IR) and beta-endorphin (BE-IR) immunoreactive material CSF concentrations have been measured in subjects of different ages affected by lumbar or cervical disk hernia. The two peptides exhibited different age-related trends. ME-IR levels rose significantly with age while no changes were observed in the case of BE-IR.

[Computerized tomography in diffuse post-traumatic brain damage]. / La tomografia computerizzata nel danno cerebrale diffuso post-traumatico.

Among 851 patients admitted following a head injury at the Neuroradiological Service and Neurosurgical Department of the University Hospital of Padua from January 1979 to June 1981, 51 presented a diffuse damage of the white matter of the brain. The CT scan, the only neuroradiological method able to show such a lesion, does never reveal large lesions but only minimal alterations of the cerebral parenchyma, opposite to the severity of clinical picture. We discuss the etiopathogenetic, anatomopathologic and neuroradiologic aspect of diffuse brain damage, emphasizing, the technical difficulties in the demonstration, on CT scan, of some lesions, particularly at the level of the brainstem.

[The diagnostic value of the CT scan in subarachnoid haemorrhage from intracranial aneurysms (author's transl)]. / Die diagnostische Bedeutung der CT bei subarachnoidaler Blutung aus Hirnarterienaneurysmen.

Fifty cases of subarachnoid haemorrhage from aneurysms are reported. Computer tomography gave direct evidence of aneurysm in 13 cases and indirect signs in 25 cases. In the remaining 12 cases the aneurysm could not be located. Apart from this we were able to demonstrate 16 intraventricular haemorrhages, 16 intracerebral haemorrhages, six cases of oedema of the brain, nine subarachnoid haemorrhages and, finally on 31 occasions enlargement of the ventricles. The role of the CT scan has been investigated in terms of its value in the planning and execution of surgical treatment.

[The CT-scan and hypocycloidal cysternography with water soluble non ionic contrast media (metrizamide and iopamidol) in sellar and parasellar lesions (author's transl)]. / La cisternografia opaca computerizzata ed ipocicloidale con mezzi di contrasto non ionici (metrizamide e iopamidolo) nelle lesioni sellari e parasellari.

A group of 30 patients with sellar or parasellar lesions were investigated by CT-scan and hypocycloidal tomography after lumbar injection of water-soluble non ionic contrast media. The combination of the 2 techniques (CT-scan and tomography) allowed very satisfactory diagnostic results and the excellent tolerance of non-ionic contrast was confirmed in this patient series.

Posttraumatic intraventricular haemorrhages.

Of a series of 350 patients studied for blunt head trauma by CT scan 10 were found to have an intraventricular haemorrhage (IVH); in 8 cases we could find concomitant CT abnormalities as well as intracerebral contusion or haemorrhage, and in two cases no other CT abnormality was noted. CT scan represents the first reliable and non-surgical tool for identifying this process. Two possible mechanisms that govern the formation of an IVH are postulated: a) an erosion of the ventricular wall by an intracerebral haemorrhage; b) the rupture of subependymal veins deformed by the negative pressure following dilatation of the ventricular wall. The prognosis in our cases is severe.

Primary brain stem haematomas. Diagnosis and treatment.

Case histories are reported of 18 patients in whom the diagnosis of primary brain stem haematoma and brain stem haemorrhage was made by computed tomography (CT). The possibility of an early diagnosis of brain stem haematoma, and the differential diagnosis of brain stem haemorrhage by a combination of clinical and tomodensitometric criteria is emphasized. It is concluded that CT is a highly reliable method for the diagnosis, location, and management of brain stem haematoma.