[Computed tomography in methanol intoxication]. / Tomografia computadorizada na intoxicação por metanol. Relato de caso.

We had the opportunity to follow a methanol intoxication case with CT scans, at the 1st and 6th day after admission. Symmetrical putaminal and white matter lesions were seen on the last CT examination, and occurred with the worsening of neurological manifestations, despite the appropriated treatment. The CT demonstration of brains lesions disclosed the toxic effect of the methanol and could be a guideline to the neurological prognosis.

[Orbital phlebography evaluation in 8 cases of Tolosa-Hunt syndrome]. / Avaliação da flebografia orbitária em oito casos de síndrome de Tolosa-Hunt.

Tolosa-Hunt syndrome (THS), or painful ophthalmoplegia is associated to a non-specific granulomatosis of unknown etiology, that involves the superior orbital fissure and its nervous and vascular structures. The clinical picture that responds to steroid therapy, is variable and is always associated with pain. Inflammatory conditions, tumors and aneurysms can produce similar symptoms. Computed tomography, cerebral angiography and orbital phlebography are the imaging methods of choice for making the diagnosis. We revised the results of these radiological examinations of eight patients seen at the Hospital São Paulo from 1989 to 1991, with the diagnosis of THS according to Hunt and Hannerz criteria. The analysis of orbital phlebographic changes based upon Hannerz et al. systematization showed non-specific features, but those were able to help the diagnosis.

Endovascular treatment of intracavernous carotid aneurysm with hyperprolactinaemia.

SUMMARY: A 42-year-old woman presented with headache, galactorrhoea, marked hyperprolactinemia and normal neurologic examination. CT, MR and MR-angiography showed an intracavernous carotid artery aneurysm with minimal displacement of the pituitary stalk. Treatment by embolisation using GDC coils allowed exclusion of the aneurysm. Galactorrhoea resolved and serum prolactin levels fell to normal after eight months. Followup MR showed absence of the aneurysm, although the discrete mass effect persisted, suggesting that hyperprolactinaemia was due to pulsatility.

Pathogenesis of uncus deformation and vertebral artery compression: histologic investigations of the uncus and dynamic angiography of the vertebral artery in the cadaveric cervical spine.

Twenty-one cervical spines were collected from fresh cadavers (12 male, nine female), their ages ranging from 10 to 90 years (mean 49.47). After removing muscle debris from the spines, they were mounted and tested on a device to passively reproduce the main movements of the spine. The degree of motion in flexion-extension and lateral bending significantly decreased from group A (ages 10-49 years) to group B (51-90 years) (p < 0.005) and was directly correlated with the amount of cervical spine degenerative alterations. The incidence of these alterations, classified according to Lysell (1969), was highest at C5-6. On the testing machine, dynamic angiography of the vertebral artery showed an impingement with extrinsic compression of the vessels in four of 28 successful injections. The histologic serial sections of the uncus showed a characteristic pattern of ossification-deformation: a newly formed cartilaginous tissue tipping the apex of the uncus, forming a double protruding contour of the apex, rapidly ossifying, and appearing to deform outward together with the disk degeneration and consequently decreasing in height.

Tomografia computadorizada na intoxicaçäo por metanol: relato de caso / Computed tomography in methanol intoxication

Tivemos a oportunidade de acompanhar com exames de TC caso de intoxicaçäo por metanol. O paciente foi submetido ao exame no momento da internaçäo e após seis dias, pela persistência de quadro neurológico grave. Observou-se nesta última a presença de lesöes putaminais simétricas e da substância branca subcortical, apesar do tratamento adequado. A comprovaçäo tomográfica de lesöes cerebrais evidenciou efeito tóxico do metanol e pode orientar o prognóstico neurológico

Avaliaçäo da flebografia orbitária em oito casos de síndrome de Tolosa-Hunt / Orbital phlebography evaluation in 8 cases of Tolosa-Hunt syndrome

A Síndrome de Tolosa-Hunt (STH) ou oftalmoplegia dolorosa é associada a granulomatose inespecifica de etiologia desconhecida que acomete a fissura orbitária superior. Compromete estruturas nervosas e vasculares causando quadro clínico variável que sempre se associa a dor e apresenta resposta favorável à corticoterapia. Processos inflamatório, tumores e anmeurismas dessa regiäo podem causar sintomas semelhantes. A tomografia computadorizada, a angiografia cerebral e a flebografia orbitária säo métodos de imagem indicados para orientar o diagnóstico. Revisamos os resultados destes exames radiológicos de oito pacientes atendidos no Hospital Säo Paulo no período 1989 a 1991, com diagnóstico de STH segundo os critérios de Hunt e Hannerz. A análise das alteraçöes da flebografia orbitária, de acordo com a sistematizaçäo feita por Hannerz e col. Mostrou ser este exame inespecífico, porém capaz de orientar melhor mo diagnóstico