Biomedical subjects
Publications and source records attributed to M L Paige.
Asymptomatic vertebral hemangiomas occur frequently in adults but the discovery of a similar lesion in the pediatric are group is uncommon. A case which involves all the neural arch components with resultant spinal cord compression is rare and is reported with a review of pertinent literature.
A case malignant pleural mesothelioma is presented. The initial CT scan of the chest showed a left paraspinal pleural mass at T6-T7 level. Subsequently the mass was partially resected by a left thoracotomy. The patient later developed spinal cord findings, and a followup CT scan showed partial destruction of the twelfth dorsal vertebra and intraspinal tumor at T11-T12 level. This is only the second case reporting spinal cord compression by mesothelioma and the first documented by computed tomography.
Low back pain and/or pain radiating to one or both lower limbs can result from causes other than intervertebral disc disease. Recently three patients presented with low back pain radiating down the legs. When CT examination of the lumbar spine proved unrewarding, magnetic resonance imaging (MRI) was performed. Avascular necrosis (AVN) of the femoral head was diagnosed and subsequently treated before femoral head collapse occurred. In patients with unexplained low back pain, AVN of the hip should be considered and ruled out by MRI, even if conventional plain films, polytomes, and radionuclide scans are negative. The early diagnosis of AVN of the femoral head may be critical in determining whether a surgical revascularization procedure might be successful in treatment, or replacement with an endoprosthesis will be necessary, if femoral head collapse has already occurred.
Among 1500 MR studies of the brain, performed during 1 year, there were six cases of physiologic calcifications (four in the falx cerebri, two in the deep gray matter) that revealed high signal intensity on T1- and variable signal on T2-weighted images. This phenomenon should be recognized and not confused with entities of clinical significance especially hemorrhage.
Over 3 1/2 years, 401 magnetic resonance studies were performed for suspected sellar-parasellar masses. Twenty-nine pituitary macroadenomas and 12 meningiomas were detected. Among the meningiomas there were three whose MR appearance simulated that of a pituitary tumor. In none of these cases was the diaphragma sellae visualized. Furthermore, in one case the prolactin level was elevated. A preoperative diagnosis of pituitary tumor resulted in an inappropriate surgical approach being used initially for its removal (transsphenoidal). Thus, nonvisualization of the diaphragma sellae and elevated prolactin levels do not exclude a nonpituitary origin of a sellar-parasellar tumor. Other methods for preoperative differentiation are discussed.
The clinical and radiologic manifestation of neurocysticercosis are varied. Since the introduction of anticysticercal drugs, surgery is only rarely needed in treatment. During the last 2 years, we have encountered two patients with minimal symptomatology whose cerebral CT and magnetic resonance studies demonstrated single lesions consisting of an enhancing nodule surrounded by edema. There was ring enhancement of the nodule in one case and homogeneous enhancement in the other. Surgery was performed in both cases, because the primary consideration was brain tumor.