Lipomata of the central nervous system

The radiological features and some clinical aspects of lipomata of the central nervous system are discussed, with examples of the different sites of involvement.

Trauma of the arterial supply to the brain visualised by angiography

The radiographic appearances of some of the many changes that occur within the arterial supply to the brain after trauma are discussed.

Teaching medical students how to care for the dying

An experimental course for medical students is described in which the main focus in on the development of a continuing relationship between a medical student and a terminally ill patient. The goals of the course, its format, its evaluation by both patient and student participants, the problems encountered and the implications for instruction on death and dying are discussed.

Schwannomas of the central nervous system

Isolated schwannomas may occur in many different situations within the central nervous system. Most neurilemmomas are benign, and enucleation after longitudinal dissection of the nerve will usually affect a cure. It is for this reason that the roentgenological appearances should be appreciated and this diagnosis considered so as to attempt total surgical removal.

The use of a written summary in group psychotherapy supervision

Clinical supervision is an important feature of the education of the group therapist. The authors describe the application of a summary written by trainee cotherapists in their supervision. They found that the summary, which is supplied to the patients as well as to the supervisor, serves several functions that contribute to improved quality of clinical supervision and training of group therapists.

The angiographic evaluation of the internal carotid artery

The importance of adequate evaluation of the internal carotid artery is stressed since pathology within it may mimic many intracranial diseases. Some of the many appearances seen on carotid angiography are described.

The widened cervical intervertebral foramen

Widening of an intervertebral foramen in the cervical spine is a striking radiogical finding and generally denotes a patient with a dumbbell spinal tumor. Other, rare causes can also produce widening, such as expansion, tortuosity or elongation of the vertebral arteries, and congenital absence of a pedicle.

The written summary as a group psychotherapy technique

During the past 18 months, we have been preparing detailed written summaries of the events of group therapy meetings, which have then been mailed to the group members. This technique was introduced initially as a device to provide structure in a very anxious group. We soon realized that the summary had a great potential for enhancing therapist effectiveness and it came to assume a number of other functions. In this report, we describe our experience with this technique, emphasizing its importance as a tool to improve the cognitive integration of the group therapy experience for both patient and therapist.

The value of the external carotid circulation in the assessment of intracranial disease

The external carotid circulation often contributes a vascular supply in intracranial disease. Adequate radiological evaluation of this circulation is important and may alter the surgical management in these patients.

Intracranial aneurysms presenting as mass lesions

Giant aneurysms within the carotico-basilar system usually differ in their symptomatology from the more common forms of intracranial aneurysms. By virtue of their size they may act as space occupying lesions and compress neighbouring structures. Diagnosis of these aneurysms as well as determination of position and size cnanot be carried out by clinical examination alone. Radiology with its special procedures is essential in confirming this diagnosis.

The radiology of arachnoid pouches

The radiographic appearances in 14 cases with arachnoid pouches are reviewed. Their clinical summaries, operative findings and anatomical distribution are tabulated.

Angiographic appearances in Paget's disease of the calvarium

A case is presented to demonstrate the angiographic findings in Paget's disease of the calvarium. These angiographic changes suggest that the blood supply to the calvarium is mainly through its inner aspect via the distal branches of the external carotid artery.

Congenital absence of a pedicle in a cervical vertebra

The importance of agenesis of a pedicle lies in its resemblance to a destructive lesion of the pedicle or to an expanding lesion in an intervertebral foramen. The correct diagnosis can be made roentgenologically by demonstrating a widened intervertebral foramen at the level of an absent pedicle with posterior displacement of the maldeveloped lateral mass. Two cases of agenesis of a pedicle in a cervical vertebra are presented.

Tapeworm cyst infestations of the brain

Tapeworm cyst infestations of the brain often present as diagnostic problems. The radiological appearances in proven cases are discussed with a brief review of the life cycle and clinical presentations.

Brain-stem abscess in childhood. Case report

✓ A rare case is reported of a solitary abscess of the brain-stem which was suspected clinically, confirmed surgically, and successfully removed. The few reports of similar cases in the literature are reviewed.

Hypothyroidism in patients treated with lithium: a review and two case reports

Two different types of hypothyroidism can occur during lithium administration, one with evidence of underlying thyroiditis, the other without. Two cases are reported, one of type 1, the other of type 2, and 17 other cases of lithium-induced hypothyroidism in the literature are reviewed. The literature on the occurrence of goitre during lithium treatment, and that on the alteration of thyroid function tests are also reviewed. Possible mechanisms for the disturbance of thyroid function are discussed and recommendations for managing this complication of lithium therapy are made.