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This paper is the outcome of an extensive retrospective study of the clinical and radiological manifestations of a large number of craniopharyngiomas from five leading neuroscience centres in the U.K. The literature about this tumour has been reviewed with particular reference to its origin and radiological manifestations.

We report MRI findings in 6 patients with Behçet's disease and CNS involvement. There were 3 different stages of imaging appearance: (1) During the acute illness, there were scattered areas of high signal intensity on T2-weighted images with predilection to the central structures of the cerebrum, the cerebral peduncles, and basis pontis. (2) During the recovery phase, most of these findings improved, but some white matter high signal areas persisted in the upper brainstem and peripheral subcortical white matter. Occasionally, findings were suggestive of microhematoma. (3) During the chronic phase, atrophy of posterior fossa structures became evident with decreased signal intensity suggestive of hemosiderin deposits.

Five female patients with primary hypothyroidism and radiological evidence of a pituitary enlargement were studied before and after a mean of 30 months (range 12–83 months) treatment with thyroxine (T₄). Before treatment, serum thyroid-stimulating hormone (TSH) levels were elevated in every patient (mean 392 mU/l, range 240–475) and prolactin levels in 4 (mean 79 µg/l, range 48–143 µg/l). CT scanning confirmed the presence of pituitary enlargement in the 4 patients studied, which was suprasellar in 3. The remaining patient had an enlarged fossa on a lateral skull radiograph. During treatment with T₄, TSH and prolactin levels were normal in all. Complete disappearance of the enlargement was seen on follow-up scans in all patients and 1 developed an empty sella. The induction of a pituitary enlargement by primary hypothyroidism results from reversible hyperplasia of both the TSH and prolactin-secreting cells in most instances. Occasionally, however, hyperplasia of the thyrotrophs can occur in isolation and an empty sella can occur after successful treatment with T₄. Thyroid function tests should be obtained in all hyperprolactinemic patients.

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HE most common site for metastatic deposits from a cerebellar medulloblastoma is the spinal subarachnoid space; distant spread of this malignant tumor usually takes place via the cerebrospinal fluid pathways. Extracranial metastases may occur after surgery, but metastases outside the central nervous system are extremely rare. There are a number of reports of confirmed extracranial metastases of medulloblastoma.l,~,4-m3,14,aG,rg,~0,~z,23,-~7 Weiss ~4 formulated four criteria to aid in the establishment of a definite relationship between the primary growth and the secondary deposits: 1. The proven presence of a single histologically characteristic tumor of the central nervous system, 2. A clinical history which demonstrated that this tumor accounted for the initial symptoms, 3. A complete necropsy to exclude the presence of another primary site, 4. Identical morphology of primary lesion and metastases with due allowances for difference of anaplasia. We are describing two additional cases of skeletal metastases that meet these criteria. The two patients have received cytotoxic drug therapy and are still living. Lassman et al., 9-~2 have noted that many of the malignant intracranial gliomas of childhood may improve and the patients live longer when treated with vincristine sulphate (Oncovin*). These two cases of medulloblastoma became radio-resistant, developed bony metastases, and then responded to treatment with this drug.