Forty seven cases of central nervous system cavernous angioma (21 males and 26 females) are described. The main clinical signs were epilepsy and brainstem syndromes. Digital subtraction intraarterial angiography, when used, failed to reveal cavernoma. CT detected many of the lesions, but the most successful supplementary diagnostic procedure was MRI which produces highly characteristic images of cavernous angioma. The diagnosis of cavernous angioma was confirmed in the 18 cases in which the tumour was removed surgically. ities." CT and MRI, however, have both proved to be valuable diagnostic aids, the latter especially27 28 (the number of cavernomas diagnosed may be expected to increase rapidly in the near future). CT shows cavernomas as hyperdense or heterogeneous lesions (more rarely as hypodense ones), and a variable degree of enhancement after intravenous contrast injection is quite common, as is calcification.2"'0 Triple-dose injection with delayed detection has b'een used to improve sensitivity."l 32In this article we describe and discuss the clinical, angiographic, CT and MRI signs of 47 patients with CNS cavernomas. Patients and methodsWe studied retrospectively 47 patients in a three year period (December 1986-November 1989

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Soft tissue calcification that involves primarily the medial portion of the arterial vasculature is a widely recognized and common complication of chronic kidney disease Vascular calcification (VC) causes increased arterial stiffness and contributes to the high cardiovascular mortality and morbidity in dialysis patients. The pathogenesis of VC is complex and includes factors that promote calcification and others that inhibit calcification. Studies in dialysis patients have shown a correlation between VC and a number of uremia-related factors. Overall, abnormalities in calcium and phosphate metabolism, such as hyperphosphatemia and a raised serum calcium-phosphorus product traditionally have been thought of as important determinants in patients with chronic renal failure. Common therapeutic interventions in secondary hyperparathyroidism have come under scrutiny for associations with the development of VC. Calcimimetics provide a means of controlling serum levels of parathyroid hormone in secondary hyperparathyroidism without increasing the calcium-phosphorus product and, more important, may lower the risk for VC in these patients.

Immunohistochemistry could not predict residual or recurrent disease. Only incomplete excision and histological high risk did so. The factors independently associated were histological high-risk lesion and incomplete resection.