Background -Acute spontaneous spinal cord syndromes often remain etiologically ambiguous despite extensive diagnostic efforts. In the previous literature five cases are described with acute spinal cord syndromes interpreted as spinal cord ischemic strokes because of association with vertebral body infarctions on MRI. Case Descriptions-Three cases are presented, and the literature is reviewed. In addition to an extensive diagnostic battery including an initial MRI without pathological signs, follow-up MRI at different time intervals from the onset of symptoms showed T2 hyperintense signals in vertebral bodies. Patient 1, who had plaques in the abdominal aorta, had suffered a thoracolumbar spinal infarction; this and a concomitant infarction of the left portion of T-12 could be demonstrated on follow-up MRI on day 12. Patient 2, who had incomplete transverse spinal artery syndrome below T-3, had an abnormal signal at the T-2 level of the spinal cord on follow-up MRI on day 5; this was one segment above infarction of the dorsal area of T-3, corresponding to the ascending course of the medullary artery. The spinal cord of patient 3, who had a posterior spinal artery syndrome below T-11, was unremarkable on follow-up MRI on day 14, but a T2 hyperintense signal was noted in the dorsal area of T-10. Conclusions-Vertebral body infarction represents the only confirmatory sign for the otherwise exclusionary diagnostic procedure for spinal cord ischemic stroke and must be searched for on follow-up MRI as a key to correct diagnosis.(Stroke. 1998;29:239-243.)

Computerized tomographic (CT) scans of 271 patients with histologically proven bronchial carcinoma accomplished for initial tumor staging were retrospectively evaluated for signs of cerebral metastasis. The results for the histologic subtypes were quite different. In 13.8% of patients with small cell carcinoma and limited disease the authors found signs of brain metastasis. However, routine cerebral staging in these patients did not seem to be useful because of lack of therapeutic consequences. On the other hand, no patient with non-small cell carcinoma (N-SCC) and tumor Stage I or I1 had brain metastases. All patients with brain metastasis from N-SCC had been classified as tumor Stage 111 before cerebral imaging. Among these patients, however, the authors found brain metastasis in 17.5% of those without known distant metastatic disease (III/MO), especially in large cell carcinoma and in adenocarcinoma. Stage III/MO patients should undergo routine cerebral imaging if their tumor is surgically resectable and thoracotomy is planned. Cancer 66:2007-2011,1990. RANIAL COMPUTED TOMOGRAPHY (CT) camed Out C as part of routine initial staging procedures in patients with bronchial carcinoma is not unanimously accepted ,'-' particularly when patients do not show neu-rologic symptoms. Varying tendencies toward cerebral metastasis have been found for the different histologic subtypes of lung However, most studies published so far either do not differentiate for tumor histologic type,',3,4,6 or consider only small cell carcinomas (SCC).5,7 The question whether routine cerebral imaging can change the overall assessment of tumor stage usually remains un-discussed. This study was intended to depict results of routine cerebral imaging in patients with bronchogenic carcinoma From the Department for Neuroradiology and Computerized To-mography, Evangelische Krankenanstalten, Duisburg-Nord, Federal

The authors describe the MRI findings in a case of megadolicho-basilar artery, seen over a period of 3 years. The value of MRI in monitoring the course of the megadolicho-basilar artery is discussed.

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