Spontaneous regression of a dural arteriovenous malformation.

The case of a 50-year-old man with a supratentorial dural arteriovenous malformation (AVM) associated with intracerebral hemorrhage is reported. Angiographically confirmed spontaneous regression of the AVM occurred without any form of surgical intervention. A possible mechanism of spontaneous closure of the AVM is offered.

Mycotic aneurysm complicating staphylococcal endocarditis.

OBJECTIVE: To emphasize the role of noninvasive diagnostic investigative methods and their importance in early detection of mycotic aneurysm related to staphylococcal endocarditis, and of monitoring therapy or identifying complications. PATIENTS AND METHODS: Two patients with mycotic aneurysm that developed as complications of staphylococcal endocarditis are presented. The first patient had mesenteric artery mycotic aneurysm and presented with sudden rupture one month after initial diagnosis of mitral valve infective endocarditis and completion of a full course of antimicrobial therapy. The second patient had multiple cerebral mycotic microaneurysms and presented with hemorrhagic cerebral embolization from aortic valve infective endocarditis. RESULTS: The first patient died because of ischemic cerebral edema 48 h after rupture of the mesenteric artery mycotic aneurysm and massive hemoperitoneum, which was treated surgically with distal ileal resection and ileostomy. The second patient was alive two years after prolonged antimicrobial therapy and aortic replacement to treat moderate aortic regurgitation and progressive left ventricular enlargement. CONCLUSIONS: Mycotic aneurysm is a rare complication of infective endocarditis but has a high mortality rate because of its early or late potential catastrophic rupture. Diagnosis by noninvasive diagnostic imaging techniques of mycotic aneurysm before rupture would be beneficial for its treatment.

Tumor blush with intracranial extensions of carcinoma of the paranasal sinuses.

Two malignant intracranial tumors that originated in the paranasal sinuses are described. The patients in both cases were investigated for neurological disorders and had no relevant history of sinus disease. Cerebral angiography demonstrated tumor vascularity identical to meningioma.

Diagnostic accuracy of cerebral angiography and computerized transaxial tomography.

Computer tomography (CT) of the brain has become widely accepted as an accurate method of studying a variety of intracranial diseases. In a prospective controlled study one group of radiologists interpreted cerebral angiograms and another interpreted CT studies undertaken in the same patients. The overall rates of diagnostic accuracy were similar (81 and 84% for angiography and CT, respectively), albeit less than reported in the literature, and thus support the contention that CT scanning should be available as the initial neuroradiologic examination whenever possible.

Computer tomography of the brain in Hamilton.

Computer tomography, a new noninvasive, rapid and easily tolerated technique of brain examination, has been evaluated by analysis of 1000 examinations. It is much more sensitive than conventional radiographic techniques and can resolve soft-tissue structures that differ only slightly in density. It also provides direct visualization of the ventricular system. The range of clinical applications is wide; it is especially useful in differentiating intracerebral hemorrhage from infarction, and in demonstrating many brain tumours, particularly supratentorial, though enhancement with a water-soluble contrast medium injected intravenously is often necessary.