Effects of general anaesthesia on size of cerebrospinal fluid spaces during and after pneumoencephalography.
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The mode of anaesthesia used during pneumoencephalography has a significant effect on the size of the cerebral ventricles 24 hours after the procedure. Post-encephalographic ventricular enlargement is less marked in patients examined under nitrous oxide anaesthesia. This appears to be related to passage of the gas into the ventricles during the encephalogram, and subsequent diffusion outwards. Variations in arterial carbon dioxide tension during the anaesthesia do not contribute significantly to changes in ventricular size. However, both hyperventilation and inhalation of nitrous oxide may cause apparent increase in size of the cerebral sulci. (+info)
Intraspinal arachnoiditis and hydrocephalus after lumbar myelography using methylglucamine iocarmate.
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A 35 year old woman developed a severe meningeal reaction after lumbar myelography using the water-soluble contrast medium methylglucamine iocarmate. Three months after myelography the findings were a transverse spinal cord syndrome corresponding to the middle thoracic segments resulting from well developed leptomeningeal adhesions. This was combined with a noncommunicating hydrocephalus, probably the result of leptomeningeal fibrosis in the posterior fossa. After treatment with a ventriculoatrial shunt the patient is almost free of symptoms. A possible pathogenetic relationship between the contrast medium, the chronic leptomeningeal changes, and the symptoms of our patient is discussed on the basis of the literature. (+info)
Contrast-enhanced lesions on computerised tomography in multiple sclerosis.
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Two patients are described in whom computerised tomography revealed contrast-enhanced lesions in the early stages of multiple sclerosis. Such lesions may be differentiated from tumours by their transient nature, lack of space-occupying effect, and localisation in the white matter. Contrast enhancement in demyelinating disease is probably related to local breakdown of the blood-brain barrier. (+info)
Adult idiopathic communicating hydrocephalus with and without shunting.
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The outcome in 37 adult patients with idiopathic communicating hydrocephalus treated by ventriculoatrial shunting is presented. Only 33% showed definite improvement, and no diagnostic procedures accurately predicted the outcome of surgery. These were compared with a "control" group of 12 patients who were not shunted; 50% of these were stable for up to 36 months. These findings, and the high frequency of serious complications (35%), suggest caution in recommending a shunt procedure. (+info)
Accuracy of ventricular volume estimation.
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Sources of error in the estimation of ventricular volume from CAT scans are discussed and the accuracy of the measurement assessed. Two methods of calculating ventricular volume from an intraventricular injection of radioisotope are described and compared. Finally, the CAT scan and isotope methods are compared and contrasted. The error associated with a single measurement of volume by any of these techniques is between 20% and 30%. In patients with no ventricular catheter there is no choice other than to use CAT scanning, but if intraventricular injection is possible this method offers a potentially more accurate volume determination because of his higher signal-to-noise ratio. (+info)
Normal children with large heads--benign familial megalencephaly.
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Fifteen normal children with large heads (circumference greater than 0.5 cm above the 98th centile) were studied. CAT scans were pefrormed to exclude hydrocephalus, and ventricular size was compared with that of hydrocephalic children. In 11 of the 13 families in which the parents' heads were measured, one parent (10 fathers and one mother) was found to have a large head, as had 6 of 17 siblings. Head circumference at birth was large in 7 of 10 babies and rate of head growth was excessive in 8 of 13. Skull x-ray showed suture diastasis in 7 infants. These families have a benign familial megalencephaly. It is important to recognise this so as to avoid unnecessary investigation and anxiety about normal children with large heads. (+info)
The fragile X syndrome in a large family. I. Cytogenetic and clinical investigations.
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Cytogenetic and clinical investigations were performed in 85 members of a large family, in which 18 males and seven females were mentally retarded. In the male patients the fragile site Xq27 was found in 6 to 44% (mean 22.5%) of peripheral blood lymphocytes. One non-retarded male expressed the cytogenetic abnormality in 6% of his cells. In 21 females the fra(X) was found in 3 to 28% (mean 8.7%) of their cells. Two obligate carriers did not express the fragile site. A significant difference in expression between the seven retarded (mean 16.7%) and seven non-retarded female carriers of corresponding age (mean 6.3%) was found (alpha = 0.01). No significant correlation between expression and age could be established, either in males or in females. The cytogenetic results appeared to be consistent. To avoid false positives, a cut-off point was chosen: males were considered to be fra(X) negative if no more than one in 100 cells showed the abnormality; for females the cut-off point was two in 100 cells. Segregation analysis did not detect significant deviations from the expected ratios. The putative presence of a transmitting male is discussed. The results of recombinant DNA analysis will be published elsewhere. Clinical investigations confirmed the findings of others. CT scans showed an enlargement of the ventricular system that exceeded the expected age changes. (+info)
Selective indications for the use of praziquantel in the treatment of brain cysticercosis.
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The selective use of praziquantel for the treatment of brain cysticercosis in human beings is described, based upon the results of clinical tests conducted during a 2 year period. Forty patients with clinical diagnosis of cysticercosis, confirmed and documented by CT, were treated. They are divided into four groups, representative of the various forms of the disease. The results assessed by clinical evaluation and sequential CT, give a ten point criterion of the indications for praziquantel. (+info)