199SUMMARY A series of 38 patients with angiographically proven cerebral venous thrombosis (CVT) affecting dural sinuses is reported. This study shows that CVT is not rare, that the clinical diagnosis is extremely difficult because of the variable modes of onset and groupings of symptoms, that most CT findings are non specific and that angiography remains the best diagnostic tool. Only 4 patients died, which suggests a more benign outcome than classically described. None of the 23 heparin treated patients died, which indicates that anticoagulants were not harmful in this series.
Spontaneous dissecting aneurysm of the vertebral artery is an infrequent cause of vertebro basilar ischemic strokes. Previously reported cases concern essentially occlusion of the basilar artery. Only 14 cases of spontaneous dissecting aneurysm concern the extracranial vertebral artery among these eight were angiographically documented. In this study based upon 15 patients (20 dissecting aneurysms), the authors discuss etiological factors, such as hypertension or fibromuscular dysplasia: on clinical findings they insist upon the diagnostic value of preliminary symptoms, cervical pain or posterior headaches; the most frequent angiographic appearance was a long and irregular stenosis of one or two segments of the vertebral artery. The prognosis of these aneurysms most often appears favourable in this group.
SUMMARY Using positron tomography, a study of regional cerebral glucose utilisation was performed prospectively in a highly selected group of six neurologically unaffected primary chronic alcoholics. In this group, neuropsychological, behavioural and CT scan anomalies were comparable with those previously reported in more extensive studies. With respect to age-matched control values, cerebral metabolic rate was not significantly modified in the selected cortical, subcortical and cerebellar regions of interest. However, the metabolic regional distribution index, which reflects the distribution pattern of glucose utilisation, was selectively and significantly decreased in the mediofrontal area, pointing to a limbic metabolic dysfunction apparently linked to chronic alcoholism. Using the '8F-fluoro-2-deoxy-D-Glucose ('8FDG) method26 PET studies were carried out on an ECAT II, between the end of the first week and the end of the first month of the hospital admission with apparent abstinence. Three adjacent brain levels were scanned consecutively (respectively 15, 35, 55 mm above and parallel to the orbitomeatal line) on subjects at rest, eyes closed, ears unplugged and free from any medication for at least 24 hours, according to our usual protocol.25 Briefly, all images were corrected for attenuation using Ge68-Ga68 transmission scans; 18FDG radioactivity blood curve was obtained from crosscalibrated plasma counting of serial arterial blood samples, 1165
The authors report their experience based upon 56 cases of CT in cerebral thrombophlebitis. Direct signs of occlusion of the veins are infrequent and interest lies in the abnormalities due to brain edema or venous infarct. It is fundamental to recognize these infarcts as their evolution is favorable under treatment. Angiography is necessary to confirm the diagnosis of thrombophlebitis which can be only suspected on CT findings.
Extracranial vertebral arteriovenous fistulae of non traumatic origin are extremely rare. The authors report two cases of spontaneous vertebro-vertebral arteriovenous fistulae associated with fibromuscular dysplasia. They discuss the relation-ship between arteriovenous fistulae and fibro-muscular dysplasia, and the specific problems of treatment in these two cases.
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