Biomedical subjects
Publications and source records attributed to H W Pribram.
The information obtained by computed tomography (CT) and cerebral angiography is compared in eight cases of cerebral venous malformation. Angiography was found to be more reliable for detecting the presence and specific nature of these malformations. Pathological and radiographic differential features between the various forms of cerebral vascular malformations are discussed.
Two patients with xanthogranuloma of the 3rd ventricle are described. In each instance the tumor obstructed the interventricular foramina and caused dilatation of the lateral ventricles and signs of increased intracranial pressure; computerized tomography demonstrated the dense, nonenhancing lesion in the anterior 3rd ventricle. The pathogenesis of these rare tumors is discussed. These cases affirm the need to consider xanthogranuloma in the differential diagnosis of anterior 3rd ventricle tumors in adults.
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A unique case of a patient with an undiagnosed convexity meningioma is presented. Hemorrhage into the tumor, following the administration of anticoagulant drugs for the treatment of thrombophlebitis, resulted in severe neurological defects and the eventual demise of the patient.
Two patients with cryptococcal infection of the central nervous system are described. The first presented with signs of an intracranial mass and was subsequently shown to have two lesions within the brain which were later identified as cryptococcal granulomata. Antifungal therapy did not eradicate the lesions; following their excision and continued therapy, the CSF became sterile however. The other patient had signs of a fulminant meningoencephalitis which initially were thought to represent the pathophysiological expression of an expanding brain tumor. These reports are used as a basis to review the various aspects of central nervous system cryptococcosis, particularly as they may relate to the neurosurgeon and the therapy of the disease.
Hereditary hemorrhagic telangiectasia is an autosomal inherited defect. Associated neurological abnormalities may occur. A case is reported with cutaneous and visceral lesions associated with calvarial, dural and orbital vascular malformations. Striking radiological abnormalities were present.
Epidural venography is a simple and effective technic in the diagnosis of herniated intervertebral discs. The procedure may be performed in the outpatient department using percutaneous transfemoral catheterization. Our experience in 87 cases suggests that epidural venography is superior to Pantopaque myelography at the L5-S1 level, comparable to, and in some cases superior, at the L4-L5 level. The epidural venogram was abnormal in 33 cases. The findings were confirmed at operation in 25 of these. The remaining eight patients are being followed or are awaiting surgical treatment. Twenty of the 25 cases had had normal Pantopaque myelograms. Fifty-four of the 87 cases were considered to be normal.
Two patients developed necrosis of the brain 12-32 months subsequent to irradiation of extracerebral tumors. The pathology and probably pathogenesis are discussed. Craniotomy with excision of necrotic brain may be lifesaving.
An unusual case of an adult with a craniopharyngioma within the third ventricle is reported. The patient complained of headaches, had a history suggestive of diabetes insipidus, and presented with a severe dementia. A brain scan revealed the suprasellar midline lesion, and a pneumoencephalogram confirmed its location within the third ventricle. Therapy included partial surgical excision, followed by a ventriculoatrial shunt and radiation.
Eleven cases of known metastatic disease to the sella turcica are reported. The clinical, plain film roentgenographic and angiographic presentations are discussed with reference to the differential diagnosis and possible distinguishing characteristics of metastatic disease.
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