The magnetic resonance (MR) findings of three cases with vertebro-basilar dissecting aneurysms (DA) were compared with those of two cases with vertebro-basilar fusiform aneurysms (FA). No abnormal findings, excepting a dilatation of a signal-void area corresponding to the arterial blood flow, were shown on the MR images in the patients with a FA. In contrast to the FA cases, various abnormalities were detected by the MR studies in all three DA cases. An intimal flap and a double lumen were demonstrated in one case. An intra-mural hematoma was shown in one case. A hematoma neighboring the parent artery was demonstrated in two cases. MR imaging was thought to be useful for detecting intracranial vascular lesions, such as a DA, and for discriminating between a DA and a FA.

Secondary tethered cord syndrome following initial repair for spinal dysraphism is an important area of interest. In this study, 32 cases with spinal dysraphism in the lumbosacral region were enrolled, in whom radical repair with autologous material had been carried out in the early stage soon after birth. During the follow-up period of up to 19 years 10 months, surgery was considered to be indicated in 2 of the 8 lipomeningocele cases and in 6 of the 24 meningocele and meningomyelocele cases, because of the presence of tethered cord syndrome 4-19 years after the primary operation. In all 8 of these cases, MR imaging demonstrated tethered spinal cord in the form of low conus medullaris. In 6 of the 8 operated cases surgery was followed by improvement of the spinal neurological deterioration. According to our experience, early untethering for secondary tethered cord syndrome is essential. In addition, since the complications of Silastic duraplasty at untethering were all minor and the operative outcome was satisfactory, the use of silicone rubber sheeting as a dural substitute might be recommended to prevent adhesion of the spinal cord.

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