Four patients with leptomeningeal metastases documented by neuroradiological examinations are reported. All had central nervous system or systemic neoplasms and showed clinical signs of carcinomatous meningitis. Gadolinium-enhanced MRI (Gd-MRI) disclosed for each patient pathological foci, allowing delineation of the extent of meningeal disease. Although non-specific, these findings, combined with the clinical context and CSF analysis, may lead to a rapid diagnosis and treatment of carcinomatous meningitis, even when malignant cells are not detected in the cerebrospinal fluid.

MRI with surface coils is currently the preferred method for evaluating degenerative cervical spine disease. The differentiation between soft disc herniation and osteophytic spurs is not always obvious, however, on a 05 Tesla unit. The procedure of choice for soft disc herniation, MRI on a 0'5 T superconducting system associated with plain radiography of the cervical spine, in selecting patients for anterior cervical discectomy without interbody fusion (ACD), was evaluated. This prospective study comprised 100 patients with cervical radicular symptoms, not subsiding after conservative treatment. Plain radiographs were obtained for al patients. Patients without spinal instability, spondylosis, or major osteophytes on plain radiographs and without clinical findings of myelopathy underwent MRI (n = 59) on a 05 Tesla superconducting system. The other 41 patients underwent CT myelography. On MRI, herniation of a cervical soft disc was seen in 55 patients and the localisation corresponded well with the clinical symptoms. CT myelography showed a foraminal herniation in one of four selected patients with negative MRI. Fifty of 55 patients underwent ACD. All herniations were confirmed at operation, but in two patients there were important foraminal spurs not seen on MRI. It is concluded that 0-5 T MRI combined with plain radiographs offers an accurate, non-invasive test in the assessment of selected patients with cervical radiculopathy.

Intracranial hemorrhage is an uncommon complication of dural puncture. In most instances, hematomas are subdural: they may be unilateral or bilateral. Rarely are intraparenchymal cerebral hemorrhages related to dural puncture. This report describes a delayed occurrence of bilateral intraparenchymal hemorrhages in a 38-year-old woman 7 days after lumbar myelography with iohexol. A review of the literature is presented.

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