metrizamide and Neurilemmoma

Topics: Ependymoma; Humans; Meningeal Neoplasms; Metrizamide; Myelography; Neurilemmoma; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Topics: Adolescent; Adult; Female; Glioma; Humans; Male; Metrizamide; Middle Aged; Neurilemmoma; Spinal Cord Neoplasms; Tomography, X-Ray Computed

The usefulness of intravenous contrast-enhanced CT in delineating intraspinal cord tumors has not been well documented. To determine if intradural spinal tumors enhance, if the location and type of tumor can be determined, and if a double dose of contrast material provides more information than a single dose, a retrospective study of 23 patients with proven intradural extramedullary or intramedullary tumors was performed. All the tumors studied with CT after intravenous contrast enhancement showed that most lesions (18/23) enhanced, contrary to published reports. Contrast-enhanced studies delineated the extent of the tumor, helping to separate solid and cystic components. The enhancement pattern of ependymomas and astrocytomas was similar, while schwannomas had a characteristic appearance. A double dose of intravenous contrast material had no apparent advantage over a single dose.

Topics: Adolescent; Adult; Aged; Astrocytoma; Child; Child, Preschool; Ependymoma; Female; Humans; Infant; Iothalamate Meglumine; Male; Metrizamide; Middle Aged; Myelography; Neurilemmoma; Retrospective Studies; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Intramedullary schwannoma without evidence of von Recklinghausen's disease is extremely rare. Only 23 cases have been reported in the literature. A 42-years-old woman with transverse type myelopathy at the level of Th 6, was referred to our department. Myelography showed diffuse swelling of the thoracic cord. Delayed myelo CT scan revealed the existence of syrinx at C 6 and Th 10 spinal cord level. On NMR spin echo image, high intensity signal with an ovoid shape was visualized in Th 7-8 spinal cord parenchyma and the syrinx was verified below the level of C 5. Based on these findings, she was diagnosed as having Th 7-8 intramedullary spinal cord tumor. Th 6 to Th 9 laminectomy followed by the complete removal of well encapsulated tumor was performed. The rostral and caudal pole of the tumor was found to be located intramedullary. The tumor at the level of Th 7-8, extended not only to the extramedullary space but also to the extradural space. Histopathological examination revealed that the specimen was Antoni A type neurinoma. She showed good recovery. Following hypotheses have been postulated on the cytogenesis of intramedullary schwannoma in the literature: Central displacement of Schwann cells during embryonic development. Schwann cells ensheathing aberrant intramedullary nerve fibers. Schwann cells along the intramedullary perivascular nerve plexus. A critical area where posterior root loose their sheath on entering the pia mater. Transformation of pial cells of neuroectodermal origin into Schwann cells. The cytogenesis of these reported cases may not be identical.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Female; Humans; Magnetic Resonance Spectroscopy; Metrizamide; Myelography; Neurilemmoma; Spinal Cord Neoplasms; Tomography, X-Ray Computed

In case of the advanced extension into the thoracic cavity, it has been difficult to remove a large thoracic spinal hourglass tumor by conventional laminectomy, even adding costotransversectomy, due to high risk of injuring diverse important vessels and other organs by blind manipulation. A case of a large thoracic spinal hourglass neurinoma with advanced extension into the mediastinum is presented. A 49-year-old female was admitted for the further examination of the left mediastinal tumor, incidentally detected on routine chest roentgenogram, which was suspected as the part of spinal hourglass tumor. Her neurological examination was normal except hyperreflexia of bilateral lower extremities. Plain chest roentgenogram showed a left mediastinal mass behind the aortic arch and the descending aorta, which slightly enlarged in size, compared with its previous size in the chest film taken 3 years ago. Thoracic spine tomogram showed the destruction of the left pedicle of T4, the absorption of posterior aspect of the T4 vertebral body and the dilatation of the left intervertebral foramen between T4-T5. Myelogram showed the complete block of dye column at T4. Metrizamide CT scan revealed the large extradural hourglass tumor, which compressed the dural theca anterolaterally and extended through the dilated left T4-T5 intervertebral foramen into the left mediastinum and attached to the descending aorta. Two stage operation, the first for the removal of the left mediastinal tumor by transthoracic approach and the second for intraspinal canal tumor by posterior approach, was performed with success for this large thoracic spinal hourglass tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Female; Humans; Laminectomy; Mass Chest X-Ray; Mediastinal Neoplasms; Methods; Metrizamide; Middle Aged; Myelography; Neurilemmoma; Spinal Neoplasms; Thoracic Vertebrae; Tomography, X-Ray Computed

Topics: Cervical Vertebrae; Foramen Magnum; Humans; Male; Meningeal Neoplasms; Metrizamide; Middle Aged; Myelography; Neurilemmoma; Spinal Neoplasms

Fourteen patients with acoustic neurinomas varying in size from 7 to 30 mm were treated by stereotactic radiosurgery and then were followed for 4 years. The tumors of eight patients decreased 1 to 10 mm in diameter, no change was found in two, and the tumor increased slightly in three patients. Loss of the ability to enhance with contrast administration on computed tomographic scan was a common effect of the treatment. One patient in poor general condition died from intercurrent disease 6 months after radiosurgery. At postmortem examination, a large central necrosis was found. Among five patients with hearing before treatment, full preservation was demonstrated in one; in the other four, the mean impairment of speech discrimination score was 43%. One patient with total unilateral deafness regained hearing and achieved a discrimination score of 60% at 1 year after treatment. There was transient facial weakness in five patients, which was detectable only by electromyography in one. Facial hypesthesia appeared in two patients and was transitory in one of them. Thirteen of the patients are in good or excellent general condition. Stereotactic radiosurgery offers the only therapeutic alternative to open operation in the management of acoustic neurinomas. It is worth considering for every patient, but especially for poor risk patients and those with bilateral tumors.

Topics: Adult; Aged; Cranial Nerve Neoplasms; Female; Humans; Male; Metrizamide; Middle Aged; Neurilemmoma; Preoperative Care; Stereotaxic Techniques; Tomography, X-Ray Computed; Vestibulocochlear Nerve Diseases

Computed tomographic myelography (CTM) is the procedure of choice in patients exhibiting spinal manifestations of neurofibromatosis. Due to the lack of specificity of several of the more important plain spine radiographic findings in this disease, CTM may be necessary to distinguish between surgical and nonsurgical entities. CTM will determine the size, shape, and intraspinal extension of posterior mediastinal neural tumors and separate them from the more common thoracic meningoceles. CTM will likewise elucidate the causes of posterior vertebral body scalloping, distinguishing between dural ectasia and neural tumor. CTM will also frequently demonstrate additional asymptomatic lesions at other levels.

Topics: Adult; Child; Diagnosis, Differential; Female; Humans; Male; Mediastinal Neoplasms; Meningocele; Metrizamide; Myelography; Neurilemmoma; Neurofibromatosis 1; Spinal Cord; Spinal Cord Neoplasms; Spinal Neoplasms; Tomography, X-Ray Computed

Topics: Brain Neoplasms; Foramen Magnum; Humans; Male; Metrizamide; Middle Aged; Neurilemmoma; Tomography, X-Ray Computed

Twenty-two spinal neurinomas, admitted to the Department of Neurosurgery, Kyoto University Medical School during the past 40 years, were retrospectively analysed under the circumstances that most of lower spinal and or spinal cord tumors had usually been handled by orthopedic surgeons in Japan. Of the total of 22 cases, there were 14 cervical, 6 thoracic and 2 lumbar neurinomas. Age distribution was from 16 to 70 years of age with the average 38. Von Recklinghausen's disease accompanied spinal neurinoma in 4 cases. Of 3 cases under the age of 20, two were associated with von Recklinghausen's disease. Motor deficits were the prominent clinical symptoms on admission in 63% of the cases, while pains were the initial symptoms in 77% of the cases. Twenty-nine percent of cervical neurinomas were of dumbbell type, extending both in the intraspinal and extraspinal spaces. In addition to the conventional neuroradiologic investigations, CT metrizamide myelography was extremely advantageous in detecting the localization and relation of spinal neurinomas to the spine and spinal cord as well as bony changes. Laser surgery was utilized in the recent two cases of spinal neurinomas of dumbbell type. It was found useful in that it enabled intraspinal decompression by a non-touch technique prior to laminectomy.

Topics: Adolescent; Adult; Aged; Female; Humans; Laser Therapy; Male; Metrizamide; Middle Aged; Myelography; Neoplasms, Multiple Primary; Neurilemmoma; Neurofibromatosis 1; Neuroma, Acoustic; Spinal Cord Neoplasms; Spinal Neoplasms

Topics: Adolescent; Adult; Arachnoiditis; Child, Preschool; Female; Humans; Lymphoma; Male; Metrizamide; Middle Aged; Myelography; Neurilemmoma; Solubility; Spinal Cord Neoplasms; Water

Either EMT Head Scanner, CT 1010 (slice thickness 10mm) or EMI Body Scanner, CT 5005 (slice thickness 13mm) was used. The concentration of metrizamide was 170-250 mgI/microliter and the amount was 7-10 microliters. Either lumbar puncture or lateral C puncture was made.. 26 cases were included in this study. 1) disc disease: 11 cases, 2) spinal cord tumor: 6 cases, 3) Arnold-Chiari malformation: 3 cases, 4) atlantoaxial dislocation: 3 cases, 5) ossification of the posterior longitudinal ligament (associated with ossification of the ligamentum flavum): 2 cases (1 case), 6) spinal foreign body (acupuncture needle): 1 case.. 1) CT metrizamide myelography visualizes the subarachnoid space and makes it possible to know the lesion in the spinal canal in relation to the spinal cord in transverse plane. 2) It is difficult to determine the exact level of the lesion in axial plane. 3) The present technique does not allow to visualize the root sleeves. 4) It is difficult to delineate a compression of the subarachnoid space by small localized lesions (esp., disc diseases) due to overlapping the patent adjacent subarachnoid space within a slice 10 mm to 13 mm thick.

Topics: Astrocytoma; Humans; Meningeal Neoplasms; Meningioma; Metrizamide; Myelography; Neurilemmoma; Spinal Cord Neoplasms; Spinal Diseases; Tomography, X-Ray Computed

Amipaque (Metrizamide) when injected intrathecally, acts as a drug which may cause side effects and even complications. The adverse effects depend on the amount and concentration of the medium which reach the surface of the brain. The examination of the cervical area carries a risk that undiluted contrast material escapes into the cranial cavity. Knowledge of physical, physiological and pathophysiological properties of the medium is mandatory for proper management of the examination. Careful evaluation of the patient and the diagnostic problem and correct technique of cervical myelography gives perfect diagnostic information, minimal side-effects and no risk of serious complications.

Topics: Contrast Media; Humans; Intervertebral Disc Displacement; Metrizamide; Myelography; Neurilemmoma; Osteoarthritis; Retrospective Studies; Spinal Cord Neoplasms; Spinal Diseases; Syringomyelia

Topics: Astrocytoma; Humans; Lipoma; Meningeal Neoplasms; Meningioma; Metrizamide; Myelography; Neurilemmoma; Radiographic Image Enhancement; Spinal Cord Neoplasms; Tomography, X-Ray Computed

Metrizamide (Amipaque) computerized tomography cisternography (CTC) provides a rapid, simple, and accurate radiographic modality of intrathecal enhancement for detecting and morphologically characterizing cerebellopontine (CP) angle masses. The technique is of especial value in masses greater than 1.5 cm that are not detected on intravenously enhanced computerized tomography. Metrizamide CTC was used in six patients with no CP angle mass and in four patients with acoustic neurilemomas.

Topics: Cerebellar Neoplasms; Cerebellopontine Angle; Humans; Metrizamide; Neurilemmoma; Neuroma, Acoustic; Pneumoencephalography; Tomography, X-Ray Computed

Our experience with the water-soluble contrast medium metrizamide (Amipaque) for ventriculography is described. No significant side effects were observed in our 27 patients, of whom 12 were children. A mild increase in CSF cell count disappeared after a few days. In 24 of the 27 patients, very good or adequate, and in any case diagnostic, information was obtained regarding the third and fourth ventricles, aqueduct, as well as sometimes the basal cisterns and outline of the cerebellum.

Topics: Adolescent; Adult; Cerebral Ventricle Neoplasms; Cerebral Ventriculography; Child; Child, Preschool; Craniopharyngioma; Female; Hemangioma, Cavernous; Humans; Hydrocephalus; Infant; Male; Medulloblastoma; Metrizamide; Middle Aged; Neurilemmoma

A survey is made of the development of water-soluble contrast media and of the experimental and preliminary clinical investigations of the new water-soluble contrast medium metrizamide. The experiences with the medium indicate that its use in the subarachnoid space is safe and reliable.

Topics: Animals; Contrast Media; Humans; Intervertebral Disc Displacement; Metrizamide; Myelography; Neoplasm Metastasis; Neurilemmoma; Spinal Cord Neoplasms; Spinal Neoplasms

Metrizamide seems to be a suitable contrast medium for ventriculography and myelography. This contrast medium is less toxic and far less epileptogenic and spasmogenic than the other water-soluble contrast media in current use. No serious complications were noted in the present series. Transient changes in EEG were recorded, mainly with cervical myelographies. However, it is too early to evaluate the long-term side effects.

Topics: Adolescent; Adult; Aged; Cerebral Aqueduct; Cerebral Ventricle Neoplasms; Cerebral Ventriculography; Child; Child, Preschool; Contrast Media; Humans; Infant; Infant, Newborn; Intervertebral Disc Displacement; Metrizamide; Middle Aged; Myelography; Neoplasm Metastasis; Neurilemmoma; Pineal Gland; Spinal Cord Neoplasms; Teratoma