Tumours of the quadrigeminal plate and adjacent structures

The history of Swedish neuroradiology

The history of Swedish neuroradiology is reviewed.

Posterior lateral choroidal artery in antero-posterior angiographic projection

Opacification of the lateral posterior choroidal artery in antero-posterior projections was analysed in 282 left-sided brachial angiograms. In 40.5% of cases the artery was sufficiently opacified to evaluate its course. The authors report the time intervals for filling of the artery in normal angiograms. The pattern described may serve as a basis for the evaluation of the displacement of the lateral posterior choroidal artery by midline tumours.

Microsurgical anatomy of the choroidal arteries: lateral and third ventricles

✓ The microsurgical anatomy of the arteries supplying the choroid plexus of the lateral and third ventricles was examined in 50 formalin-fixed cerebral hemispheres using × 3 to × 20 magnification. There was marked variation in the area of choroid plexus supplied by the choroidal arteries; however, the most common pattern was for the anterior choroidal artery (AChA) to supply a portion of the choroid plexus in the inferior horn and part of the atrium; the lateral posterior choroidal artery (LPChA) to supply a portion of the choroid plexus in the atrium and posterior part of the temporal horn and body; and the medial posterior choroidal artery (MPChA) to supply the choroid plexus in the roof of the third ventricle and a portion of that in the body of the lateral ventricle. The LPChA's and MPChA's occasionally sent branches to the choroid plexus on the contralateral side. The most frequent neural branches of the three choroidal arteries were as follows: AChA branches to the optic tract, cerebral peduncle, temporal lobe, and lateral geniculate body; LPChA branches to the thalamus, geniculate bodies, fornix, and cerebral peduncles; and MPChA branches to the thalamus, pineal body, cerebral peduncle, and tegmentum of the midbrain. Each of the choroidal arteries was divided into a cisternal and plexal segment. The cisternal segments were the most common site of origin of neural branches, but they also gave rise to some plexal branches. The plexal segments occasionally gave rise to neural branches.

Cisternal abnormalities produced by clinical tumours in the posterior cranial fossa. III. Tumours of the brain stem and pontine angle

The pneumographic appearances of the subarachnoid cisterns have been analysed in detail in a clinical series of 17 patients with brain stem tumours and in 40 with pontine angle tumours. The cisternal distortions may be used to distinguish tumours in the pons from tumours in the medulla oblongata and also to distinguish tumours of the pontine angle with different modes of growth, e.g. tumours mainly indenting the cerebellar hemisphere from those mainly indenting the brain stem. The results should be applicable also for an analysis of cisternal pathology by other methods such as computer tomography and cisternography with positive contrast media.

Clinical and morphological studies of pituitary and diencephalic space-occupying lesions before and after operation, with special reference to temperature regulation

In this study investigations are reported which analyze the clinical and morphological results in the treatment of diencephalic tumours. Depending on their location, these tumours are classified according to the extent of hypothalamic compression. The following parameters were studied: body temperature, blood pressure, pulse rate, serum electrolytes, water balance, and serum glucose. Hormonal tests were carried out to detect disturbances of pituitary and diencephalic function. The clinical findings were verified by morphological study of the hypothalamus in serial sections. The study covers 193 patients with sellar and diencephalic tumours. This analysis led to the following conclusions: 1. The postoperative temperature course is a reliable parameter for the diagnosis of diencephalic damage. 2. Diabetes insipidus is evidence of a diencephalic lesion. 3. Disturbances in the regulation of the serum glucose, electrolytes, blood pressure, and pulse rate are signs of a diffuse diencephalic lesion. 4. Endocrinological disturbances in the late phase indicate permanent diencephalic damage. This study indicates that the clinical findings in the acute postoperative period permit evaluation of the extent of the hypothalamic damage. These findings are consistent with Rothballer's observations on the pre-operative evaluation of these tumours.

Clinical and morphological studies of pineal tumours

This is a report of clinical, morphological, diagnostic, endocrinological and therapeutical experiences with 18 patients with tumours in the pineal region. The histological diagnosis was verified in four cases by autopsy, in seven cases by biopsy, and in one case by microscopical verification of tumour cells in the CSF. In all biopsy cases we are dealing with typical germinomas. In the other clinical cases diagnosis was made by neuroradiological and endocrinological methods. The localization was possible by encephalotomography or CT scan, according to Kageyama, Particular attention was given to the endocrinological dysfunctions which originate in the hypothalamus. Also the hypothalamic dysfunctions after irradiation were discussed. Since the results of primary surgical approach and biopsy have been unsatisfactory, we preferred a non-operative schedule for treatment of pineal tumours.

Treatment of tumours of the posterior part of the third ventricle and the pineal region: a long term follow-up

This paper represents a further investigation into the origninal series, with additional cases from N.I.N.U. This follow-up has been immeasureably enhanced by the availability of the EMI Scanner. It seems clear that there continues to be adequate evidence that the use of shunting procedures, followed by radiotherapy, is a rational approach to tumours of the pineal and posterior third ventricular region. Short of more extensive evidence to the contrary, we feel that it remains the method of choice in the initial treatment of these difficult lesions.

Results of irradiation of tumors in the region of the pineal body

The clinical findings and results of radiation treatment in 14 patients with tumors in the region of the pineal body are presented. The neurologic signs and symptoms improved significantly in 11 patients (79 per cent). The survival rate for five years or more was 50 per cent. Radiation therapy as the primary method of treatment is discussed.