Summary
Sixty children aged between one month and fifteen years were submitted to RIHSA cisternography and/or ventriculography for a variety of lesions affecting the CSF pathways. These included cases of hydrocephalus and other congenital malformations of the central nervous system, posttraumatic and post meningitic sequelae. The investigation has been found to be valuable not only in differentiating between arrested and progressive hydrocephalus but also in unmasking associated anomalies of CSF flow and pathways in cases of meningomyelocele and encephalocele. It is excellent for delineating a CSF fistula and can also be utilised to demonstrate the size and extent of a subdural hematoma or hygroma. Pathological concentration and delayed clearance of the isotope in the region underlying the skull defect was a consistent finding in all cases of growing fracture (craniocerebral erosion). Single or multiple sites of blocks were observed in cases of postmeningitic (tuberculous) sequelae.
Résumé
Les auteurs ont étudié 60 cas de cisternographies à la RISA avec/ou ventriculographies chez des enfants âgés de un mois à 15 ans, atteints de différents troubles de la circulation du LCR. Cette étude comprenait des cas d'hydrocéphalie et d'autres malformations congénitales du système nerveux central ainsi que des séquelles post-traumatiques et post-méningitiques. L'examen se révéla fiable, non seulement dans la différenciation entre hydrocéphalie compensée ou progressive mais également dans la détection d'anomalies associées de la circulation de LCR en cas de méningo-myélocèles d'encéphalocèles. Cette technique est excellente pour la localisation d'une fistule de LCR; elle peut également visualiser la taille et l'extension d'un hématome sous-dural ou d'un hydrome. La concentration pathologique et l'élimination tardive du radio-élément dans la région sous-jacente à la lacune crânienne étaient constantes dans tous les cas de lacunes post-traumatiques. Des blocages uniques ou multiples furent observés dans des cas de séquelles postméningitiques (tuberculose).
Zusammenfassung
Bei 60 Kindern im Alter swischen 1 Monat und 15 Jahren wurde die RIHSA-Cisternographie und/oder Ventrikulographie durchgeführt. Es sollten damit unterschiedliche Hydrocephalus-Formen und andere angeborene Mißbildungen des Zentralnervensystems, auch posttraumatische und postmeningitische Veränderungen nachgewiesen werden. Diese Untersuchungsmethode zeigt sich besonders wertvoll zur Differenzierung der einzelnen Hydrocephalus-Arten zum Nachweis von Anomalien der Liquorzirkulation, besonders bei Meningomyelozelen und Encephalozelen. Auch können Liquorfisteln und subdurale Hämatome oder Hygrome damit exakt festgestellt werden. Pathologische Veränderungen finden sich auch bei allen Patienten mit wachsenden Frakturen. Bei postmeningitischen (tuberkulösen) Verklebungen konnte der Stopp lokalisiert werden.
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Tandon, P.N., Rao, M.A.P., Basu, A.K. et al. 131I-RIHSA CSF scanning in pediatric neurosurgical practice. Neuroradiology 8, 119–123 (1974). https://doi.org/10.1007/BF00345044
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DOI: https://doi.org/10.1007/BF00345044