Radiological diagnosis of inorganic lead poisoning

A 43-year-old woman had abdominal pain and anemia due to inorganic lead poisoning. Plain abdominal x-ray films showed metallic densities within the lumen of the large bowel. The patient admitted that she used to chew the sheets of metallic lead enclosing wine bottle necks regularly. We report the case because of both the unusual radiographic findings and the exceptional source of lead intoxication.

Anti-K1 of the IgA class associated with Morganella morganii infection

An anti-K1 alloantibody developed in a patient infected with Morganella morganii. The serologic behavior and response to dithiothreitol initially suggested that the alloantibody was an IgM. However, flow cytometry and the separation of immunoglobulin classes by serum chromatography revealed that the anti-K1 was constituted solely of IgA. These data suggest that bacteria-induced red cell antibodies might be of the IgA class.

[Chronic myelomonocytic leukemia and solid neoplasms: is it a causal or a fortuitous association?]

Out of a series of 36 patients with chronic myelomonocytic leukaemia (CMML), five cases are reported with the association of this hemopathy to solid neoplasms. In two patients this last was a cutaneous tumour, while the remainders had, respectively, papilloma of the bladder, carcinoma of the sigma, and cutaneous T-cell lymphoma. These neoplasms were diagnosed in all cases prior to the discovery of CMML. When applying the "patient/year" method, significantly higher frequency of solid tumours was found for CMML patients, which would support the hypothesis that this myelodysplasia could be regarded as a paraneoplastic condition.

[Computerized tomography findings in annular pancreas in an adult]

We present a case of annular pancreas in an adult female studied by computerized tomography. CT demonstrated an enlarged pancreatic head in the center of which was visualized the contrast-filled duodenal lumen. We consider these findings to be sufficiently characteristic of annular pancreas to permit differential diagnosis with neoplastic processes of the pancreatic head without having to resort to more invasive diagnostic methods like endoscopic retrograde cholangiography.

Arachnoid cysts with intracystic and subdural haematoma

Two cases of arachnoid cysts with acute intracystic and subdural haematomas are described. CT examination was performed in both cases, and showed a hyperdense expansion with thinning of the inner table of the skull. The different ways in which subdural haematomas associated with arachnoid cysts may be seen on CT are discussed.

Post-radiation cranial malignant fibrous histiocytoma studied by CT

A 37-year-old woman presented with a proven case of malignant fibrous histiocytoma of the skull. This is thought to be a rare complication of post-radiation to a chromophobe adenoma which was treated by radiotherapy nine years previously. The radiation dose given to the sella region after the removal of the chromophobe adenoma was 4500 cGy.

Gliomatosis cerebri with formation of a glioblastoma multiform. Study and follow-up by magnetic resonance and computed tomography

A case of gliomatosis cerebri studied by computed tomography (CT) and magnetic resonance imaging (MRI) is reported. Follow-up by serial CT revealed a right parieto-occipital glioblastoma. Gliomatosis cerebri and multiform glioblastoma were demonstrated by histologic study. Anatomic and CT data were correlated. The role of CT and MRI in the diagnosis of this disease was evaluated and case studies of CT published in the literature were reviewed.

MRI and CT of ankylosing spondylitis with vertebral scalloping

Three cases of cauda equina syndrome in long-standing ankylosing spondylitis are reported. In all, vertebral scalloping and dural ectasia were confirmed by magnetic resonance imaging and computed tomography. MRI showed widening of the dural sac with signal intensity corresponding to cerebrospinal fluid. CT demonstrated asymmetrical lesions of the posterior elements of the lumbar spine. Myelography was not felt necessary to confirm the findings.

Vertebral arch tuberculosis in two human immunodeficiency virus-seropositive heroin addicts

We studied two cases of disseminated tuberculosis with vertebral arch involvement in drug addicts seropositive for human immunodeficiency virus. The first patient developed a paraplegia while he was recovering from a meningeal tuberculosis. On the abdominal plain roentgenogram, the right transverse process of L-2 was absent, and a computed tomographic scan revealed destruction of the right vertebral arch together with a collection in the paravertebral area. The second patient had miliary tuberculosis and complained of lumbar pain. The radiologic findings were similar to those in the first case, but at the L-4 level.

Aneurysms of the posterior cerebral artery in children

Two cases of aneurysms of the posterior cerebral artery, diagnosed by CT and confirmed angiographically, are reported. In the first case, the aneurysm was discovered fortuitously. The second began with intracerebral haemorrhage. A review of the literature is reported.

Computed tomography in supratentorial hemangioblastoma

Supratentorial hemangioblastomas are rare. A 28-yr-old man with a solid tumor in the left temporal region is described. There was neither meningeal connection nor associated polycythemia or Von Hippel-Lindau disease. Contrast enhanced computerized tomography showed a hyperdense, homogeneous lesion and cerebral angiography demonstrated a nodular tumor blush. The microscopic appearance of the lesion is described with a review of previously reported cases.

Cerebral computed tomography in maple syrup urine disease

Maple syrup urine disease (MSUD) is an inherited metabolic disorder due to decreased decarboxylation of branched chain keto acids triggering an accumulation of leucine, isoleucine, and valine. We describe two infants with biochemically confirmed MSUD in whom computed tomography (CT) revealed cerebral edema. In one of these cases repeat CT 40 days after institution of appropriate therapy revealed that the edema had disappeared and the ventricles had enlarged.

Prolapsed lumbar disk: value of CT in diagnosis

A group of 40 patients with symptoms of prolapsed lumbar disk, seven of which were recurrent after surgery, was studied by computed tomography. In all cases, the diagnosis was confirmed by myelography and posterior surgery. Computed tomography was performed after the disappearance of myelographic contrast medium. Positive herniated disk was shown by computed tomography in 88%. In postoperative cases, computed tomography after intravenous contrast enhancement favored the recognition of postoperative scar, rather than recurrent herniation. Computed tomography also facilitated the diagnosis of spondylotic lesions, which may accompany herniated disks. Computed tomography should reduce the need for myelography, which is reserved for cases with doubtful computed tomographic findings.

Study of tuberculous meningitis by CT

Computed tomography is a very valuable method by which the pathogenic evolution of tuberculous meningitis may be followed, thereby facilitating its differential diagnosis and controlling the efficiency of therapy. The initial miliary tuberculosis in the brain, very often unaccompanied by neurological symptoms, may offer very evident CT images. CT may also demonstrate the fibrogelatinous exudate which fills the basal cisterns and surrounds the arterial vessels which cross this region. Because of this, secondary arteritis is frequent and may be indirectly detected by CT in the form of foci of ischemic infarcts. Tuberculomas may be multiple, and are found equally in the cerebral and the cerebellar parenchyma. These tuberculomas present different images on CT, depending on the evolution of the disease at that moment. Hydrocephalus is a common complication of TM and is caused by a lack of reabsorption of the cerebrospinal fluid, or by an obstructive lesion in the ventricular drainage pathways due to a tuberculoma. This complication is usually easily identified by CT, which, moreover, permits the control of its evolution.

Morphological and cytochemical study of a hypothalamochiasmatic perivascular neuronal system

The topographical localization and some cytochemical characteristics of groups of perivascular neurons in the hypothalamus and in the optic chiasma have been studied. In the anterior hypothalamic area there are neuronal groups located around the blood vessels which penetrate the optic chiasma still associated with neurons. These perivascular neurons show some characteristics similar to those observed in neurosecretory hypothalamic neurons, but differ from them in that they show a greater intensity of thiaminopyrophosphatase and nucleoside-diphosphataseactivities. It is suggested that these neuronal groups may constitute a special hypothalamochiasmatic-perviscular-neurosecretory system (H. Ch. P. N. S.).

Contribution to the study of the arterial nutrition of the cervical spinal cord

The feeding of the anterior spinal artery of the cervical cord is very poor. Angiographic studies have shown that only two to three radiculomedullar arteries assure the feeding of this arterial axis. Since it is possible that smaller feeding arteries exist, which are not visible on a conventional X-ray study, we have reviewed cases with arteriovenous aneurysms or vascularized tumors in the cervical region, and obstructions of the vertebral arteries. In these cases, the feeding arteries may be hypertrophic. In spite of being hypertrophic, their number is not increased, and the statistical proportion is the same as in the studies carried out in normal cases.

Etiology of moya moya disease acquired or congenital

Nine cases of Moya Moya disease collected since 1968 are presented. The absence of inflammatory signs and the high percentage of congenital malformations is emphasized. However, despite the post-mortem findings in one of the cases, no etiologic factor has been conclusively demonstrated.

Some aspects of the spinal cord circulation in cervical myelopathy

Under usual technical conditions, it is possible, in a great percentage of cases, to visualize angiographically the afferent radiculospinal artery feeding the anterior cervical spinal axis, coming from the vertebral arteries. The level of its emergence is varied, predominating at C5--C6. This radiculospinal artery can be directly affected by a spondylotic lesion at the foraminal level and is one of the causes of the ischemic syndrome observed in the cerival myelopathies resulting from this process.