A case of neurocutaneous melanosis developing a leptomeningeal melanoma is described in a ten year old girl in whom an intraspinal lipoma had been resected seven years earlier. Standard and CT myelographic findings are described and the complementary role of Gadolinium-enhanced MRI is discussed. The literature is reviewed and the association of a lipoma and neurocutaneous melanosis has not been encountered.

The authors report on five cases of septic sinus thrombosis occurring as early complications and/or long-term complications of infections in the head and neck region. The necessity for early diagnosis of this condition by high-resolution CT scanning is emphasized, as it provides a reliable diagnostic tool to evaluate this serious intracranial disease at a relatively early stage, provided an intravenous contrast medium is used. Although MRI represents an interesting new technique in the assessment of intracranial pathology, it cannot be routinely carried out during the acute phase of this condition due to metal life-support systems near the patient.

A 19-year-old male was referred because of a grease-gun injury of the left orbit, resulting in a 25 mm proptosis and marked decrease in vision. The clinical diagnosis of penetration of the retrobulbar fat space by the grease and the subsequent accurate drainage of the grease was made possible on the basis of high resolution computed tomography (CT) and magnetic resonance imaging (MRI). As a result, lateral orbitotomy could be avoided. Eight months after the injury the visual acuity was fully recovered and the proptosis reduced to 2 mm. The visual field was relatively undisturbed. The specific value of CT and MRI for the management of this unusual trauma is briefly discussed.

This report concerns a clinical trial with gadolinium-DTPA (Gd-DTPA) as an intravenous contrast medium for magnetic resonance imaging (MRI) in patients with disorders of the central nervous system. Fifty patients, 30 females and 20 males, were examined without and with Gd-DTPA. The contrast medium was well tolerated by all patients. The results of MRI scanning without and with Gd-DTPA and those obtained with computed tomography (CT) using intravenous contrast enhancement were compared. This investigation comprised mainly patients with intracranial tumors, multiple sclerosis, and nasopharyngeal tumors. The results may be summarized as follows: I) MRI with Gd-DTPA (MRI +) gave better results than MRI without Gd as regards delineation of the lesion, blood vessels and edema in cerebral tumors, pituitary adenomas and acute forms of multiple sclerosis (MS). 2) MRI+ was better than CT in 32 of the 50 cases examined; with intracerebral tumors it was better in 15 out of 18 cases. 3) MRI + was always better than CT in patients with MS. In 3 out of 7 cases MRI demonstrated the acute MS lesions. 4) MRI + seemed to have advantages also in nasopharyngeal tumors as ascertained from this limited experience.