Focused encephalography.

Focused encephalography is a diagnostic procedure performed after computed tomography (CT) that can be specifically focused on diagnostic problems not solved by CT. The authors have used the procedure in 20 cases, and it has proved to be quick, risk-free, and without serious side effects. It provides useful supplementary diagnostic information, and can be especially helpful when CT is not available or when the CT scanner is an early-generation model.

Neuroradiological detection of small and intracanalicular acoustic tumors: an emphasis on CO2 contrast-enhanced computed tomographic cisternography.

Seventy patients suspected clinically of having an acoustic tumor were evaluated using the computed tomographic (CT) scan as the initial neuroradiological procedure, followed by CO2 contrast CT cisternography in cases where the intravenous contrast-enhanced scan did not reveal any lesion. Forty-eight gas CT cisternograms revealed 10 small acoustic tumors, 2 of which were totally intracanalicular. The authors present a review of the basic CT anatomy of the temporal bone as it relates to acoustic tumors. Based upon the ease of performance of the procedure, the low postexamination morbidity, and the excellent diagnostic results, CO2 CT cisternography is recommended as the procedure of choice in the diagnosis of small and intracanalicular acoustic tumors.

Virtues and vagaries of high-resolution CT air cisternography in the diagnosis of acoustic neuromas.

A series of 125 consecutive, bilateral, high-resolution, computerized tomographic (CT) air cisternograms was prospectively reviewed and analyzed. Emphasis was placed on identifying problems encountered in performing the study and potential sources of error in interpretation. In two patients there was difficulty in transporting the air bolus because spinal cord tumors coexisted with bilateral acoustic neuromas. Potential false-positive results were avoided in four patients by persistent efforts to fill the internal auditory canal. Later reexaminations were recommended for four patients whose examinations were suspicious or suggestive of tiny acoustic neuromas. Unilateral Mondini malformation was incidentally diagnosed in one patient. Six patients required therapy for persistent headache after lumbar puncture. High-resolution CT air cisternography is believed to be the method of choice for investigating the nonenhancing or small acoustic neuroma. However, this method is not without potential problems, some of which are discussed.

Ethical aspects of research on brain morphology in psychiatric patients.

Morphometric and functional brain research is now an integral part of the most concentrated effort in a century to understand some of the most distressing illnesses to which man can fall victim. It will undoubtedly expand. The only ones with anything to fear from this work are those who, for ideological reasons, cannot accept its basic premises. The ethical issues it raises are not in general insurmountable, though the questions posed by the concept of informed consent remain.

[Pituitary apoplexy after pneumoencefalogram]. / Apoplexia hipofisaria apos pneumencefalograma

A case of pituitary apoplexy following the performance of a pneumoencephalogram is reported. No such a case has been published in the literature, to the author's knowledge. The etiopathogenetic mechanism is discussed and a recomendation is made that surgery should be performed straight after completion of the pneumoencephalogram, should it show a significant supraselar extension of a pituitary adenoma, even in the absence of increased intracranial pressure.

[Dynamics and pathogenesis of alterations in the bioelectrical activity of the brain following pneumoencephalography]. / K dinamike i patogenezu izmenenii bióelektricheskoi aktivnosti golovnogo mozga posle pnevmoéntsefalografii.

In 40 patients with remote sequalae of closed brain injury the authors studied the brain bioelectric activity before and following pneumoencephalography in dynamics. Changes in the EEG after PEG were seen in all cases in the form of decreased alpha-activity and a significant increase in the index of slow theta and delta waves. The dynamics in the EEG changes did not depend upon the clinical syndrome and were the same in patients with epileptical seizures, as well as in patients with posttraumatic syndrome. The EEG changes following PEG were transitory and were usually combined with distinct disturbances of metabolic-vegetative functions. This permits to allocate a certain place in the pathogenesis of detected EEG changes to the action of the air and x-ray on the brain membranes, as well as on the reticular structure, hypothalamic centers of metabolic-vegetative functions.

[Pneumoencephalography in the diagnosis and complex treatment of traumatic epilepsy]. / Pnevmoéntsefalografiia v diagnostike i kompleksnom lechenii travmaticheskoi épilepsii.

Pneumoencephalographic examinations (after endolumbar injection of 60 ml of air) were carried out in 84 patients who developed epileptic seizures after closed brain injuries. In all the patients diffuse cysto-adhesive arachnoiditis, open inner hydrocephalus, and delayed resorption of air from the cerebral ventricles were revealed roentgenologically. A therapeutic effect that manifested itself in a subjective improvement, abatement of the organic signs, cessation, diminution on the frequency, or transformation of the seizures into milder ones was noted in 77% of the patients. Data on vegetative reactions and changes of the brain bioelectrical activity under the influence of the pneumoencephalography are presented. Possible role of those changes in the mechanisms of the pneumoencephalography therapeutic action is discussed.