Forty-seven hospitalized patients with a diagnosis of presenile or senile dementia and without focal neurological disease of major systemic illness were given complete neurological, neuroradiological, and neuropsychological examinations. Mortality at one year after hospitalization was determined, 12 patients being lost to follow-up. Of the remaining 35 patients, 19 were alive and 1l had died. These groups did not differ in age, education, length of dementia history, sex, race, or degree of cerebral atrophy (by computerized tomography). Significant differences were found in degree of electroencephalographic abnormality and in 8 of 14 cognitive measures, the the largest single difference being on a test of expressive language. Discriminant function analysis made with the cognitive measures as dependent variables yielded a correct prediction (classification analysis) of mortality in all but 1 case (97% accuracy). These results suggest that (1) degree of functional brain impairment rather than degree of cerebral atrophy may be the more important influence on mortality in dementia patients without focal lesions, (2) short-term survival may be accurately predicted in such patients by tests of cognitive functioning, and (3) expressive language deficit in such patients may indicate a particularly poor prognosis for survival.

Computerized tomography was used to measure cerebral ventricular size in hospitalized alcoholic patients, all of whom had evidence of liver disease. Twelve alcoholic patients with neurologic symptoms such as withdrawal seizures, neuropathy, and drug overdose were included. All these patients had normal results from the mental status examinations by the time of discharge. Alcoholic patients had a much higher mean ventricular size compared to 60 control patients. One third of the alcoholics had markedly enlarged ventricles as opposed to only one of the 60 controls.

Sixteen patients with suspected cerebral metastases were studied with magnetic resonance (MR) imaging before and after the intravenous administration of 0.1 mmol/kg of gadolinium diethylenetriaminepenta-acetic acid. The images were interpreted blindly by two neuroradiologists; all clinical, radiologic (computed tomographic and MR imaging), and pathologic data were reviewed to arrive at a final "best diagnosis," which was then compared with the prior blinded interpretations. Of seven patients found to have multiple metastases, six (86%) had at least one tumor nodule depicted by postinfusion MR imaging that was missed by one or both observers on review of preinfusion images alone. Lesions missed on preinfusion studies were usually small nodules hidden by or not detected next to regions of high-signal edema thought to be related to the adjacent tumor nodule. The authors believe that contrast enhancement improves detection of metastatic foci with MR imaging and that the findings indicate broader implications for the detection of multiple lesions from other causes.

We analyzed the distribution of nasal erectile tissue by reviewing five sets of magnetic resonance imaging scans that were obtainedpre-andpost-decongestion. We found that cavernous tissues were located at three sites: the inferior turbinate, the middle turbinate, and the nasal septum. This study reaffirms the findings of previous studies that were performed with other modalities such as computed tomography scanning and cadaver dissections.