Transient encephalopathy and asterixis following metrizamide myelography

✓ A case is presented in which cervicolumbar myelography with metrizamide was followed by transient encephalopathy and asterixis. Metabolic etiology was excluded. A large degree of intracranial penetration of metrizamide was demonstrated by computerized tomography. Residual symptoms persisted for 10 days.</jats:p

Reactive Gliosis Simulating Butterfly Glioma: A Neuroradiological Case Study

Abstract Reactive gliosis was found in a 40-year-old man who presented with intractable seizures thought to be due to a malignant neoplasm. Although two separate lesions located bilaterally in the frontal lobes were evident on the computed tomographic scan, a connection between these lesions along the fibers of the corpus callosum was clearly demonstrated on T2-weighted magnetic resonance images. The unusual radiological appearance of this gliosis, which simulated a malignant butterfly glioma on magnetic resonance imaging (MRI), is reported. Because MRI is still a new modality, its images should be interpreted with judicious caution.</jats:p

Spinal Subarachnoid Hematoma Complicating Lumbar Puncture: Diagnosis and Management

Abstract Two patients with altered hemostatic mechanisms developed spinal subarachnoid hemorrhage after difficult lumbar punctures. One patient had received anticoagulation therapy soon after lumbar puncture and the other had a low platelet count (63,000/mm3) at the time of lumbar puncture. In both patients a hematoma evolved, producing blockage of cerebrospinal fluid flow. Clinical manifestations consisted of severe back and radicular pain with sphincteric disturbances followed by rapidly developing severe paraparesis. Of the methods of radiographic evaluation that were used, including computed tomography (CT) without contrast enhancement, myelography, CT with intrathecally administered contrast medium, and magnetic resonance imaging, we found the best study to be myelography via lateral cervical puncture followed by CT. Unfortunately, diagnosis was delayed, and surgical evacuation of the hematomas did not substantially improve the patients' conditions. The salient clinical and radiographic features of this disorder and its pathophysiology are reviewed. Prompt recognition of these lesions is necessary so that surgical intervention may maximize chances of recovery.</jats:p

Primary Intraspinal Fibrosarcoma

Abstract Fibrosarcomas of dura mater are very rare tumors representing only 0.5% of all central nervous system sarcomas. A higher incidence of dural fibrosarcomas has been reported in patients with neurofibromatosis. We present a case of spinal dura mater fibrosarcoma in a patient without neurofibromatosis. The diagnostic and therapeutic strategy in the clinical management is discussed.</jats:p

Intracranial Adenocystic Carcinoma Presenting as a Primary Brain Tumor

Abstract We present a case of an intracranial adenocystic carcinoma that clinically and radiographically mimicked a primary intracranial tumor. The radiological work-up of this tumor is presented in detail. We suggest that perineural intracranial invasion by the tumor along the trigeminal nerve resulted in its presentation as a primary intracranial tumor.</jats:p