Fifty patients who sustained mild to moderate closed head injury (CHI) underwent a CT scan, MRI, and neurobehavioural testing. At baseline 40 patients had intracranial hyperintensities detected by MRI which predominated in the frontal and temporal regions, whereas 10 patients had lesions detected by CT. Neurobehavioural data obtained during the first admission to hospital disclosed no distinctive pattern in subgroups of patients characterised by lesions confined to the frontal, temporal, or frontotemporal regions, whereas all three groups exhibited pervasive deficits in relation to normal control subjects. The size of extraparenchymal lesion was significantly related to the initial Glasgow Coma Scale score, whereas this relation was not present in parenchymal lesions. One and three month follow up MRI findings showed substantial resolution of lesion while neuropsychological data reflected impressive recovery. The follow up data disclosed a trend from pervasive deficits to more specific impairments which were inconsistently related to the site ofbrain lesion. These results corroborate and extend previous findings, indicating that intracranial lesions detected by MRI are present in most patients hospitalised after mild to moderate CHI.Individual differences in the relation between site of lesion and the pattern of nueropsychological findings, which persist over one to three months after mild to moderate CHI, remain unexplained.Since the application of MRI to neurosurgical patients several reports`7 and our quantitative study of 20 patients8 have shown that this technique is more sensitive than CT scanning in detecting intracranial abnormalities after closed head injury (CHI). In view of our preliminary description8 of individual patients with mild to moderate CHI exhibiting distinctive neurobehavioural sequelae associated with frontal v temporal lobe hyperintensities, we extended this study to 50 cases. We evaluated the neuroanatomical distribution of abnormalities visualised by MRI in patients sustaining mild to moderate CHI; resolution of these apparent lesions over one to three months; and the relation between cerebral site of lesion and neurobehavioural sequelae.

There was no correlation between pain severity and disease severity by sinus CT scan as graded by the Lund-McKay, Harvard, or Kennedy staging system. Facial pain and headache, although frequent complaints of patients with rhinosinusitis, are not useful predictors of sinus disease severity. There appears to be a difference in pain perception between the two North American populations.

Magnetic resonance (MR) imaging was performed in 94 patients who sustained closed head injury of varying severity. Results of MR studies obtained after the intensive care phase of treatment disclosed that intracranial lesions were present in about 88% of the patients. Consistent with the centripetal model of progressive brain injury proposed in 1974 by Ommaya and Gennarelli, the depth of brain lesion was positively related to the degree and duration of impaired consciousness. Further analysis indicated that the relationship between depth of brain lesion and impaired consciousness could not be attributed to secondary effects of raised intracranial pressure or to the size of intracranial lesion(s).

tlons are diseasespecific and when recognized on radiographs, make correct diagnosis possible. I I Figure 1 Schematic drawing depicting the development of normal and abnormal vertebral bodies. The vertebral body: Acquired and congenital disorders Kumar et al.

Three cases of documented sarcoid meningoencephalitis were reviewed. Computed tomography (CT) showed enhancing, perivascular, linear, and nodular areas along the subarachnoid space, extending deep into the white matter. In one case the perivascular granulomatous infiltration, which caused small vessel periangiitis, gave rise to a CT pattern closely resembling that of arteriovenous malformation or infarction with gyral enhancement. This infiltrative pattern might be seen in other chronic meningeal processes. The pathophysiology responsible for the unusual CT appearance and the differential diagnosis are discussed.