Imaging and clinical findings of intracranial lipomas

Intracranial lipomas (ICLs) are rare congenital malformations associated with some central nervous system anomalies and clinical findings. The aims of this study were to assess the locations, associated malformations, and imaging and clinical findings of patients with ICLs. Based on published reports, the neuroradiologic features, clinical symptoms and signs, differential diagnosis, and surgical indications are discussed. Seventeen cases of ICL were reviewed, on which the results of neurologic and radiologic examinations were based, including computed tomography (CT) and magnetic resonance imaging (MRI) findings. A total of 20 lipomas were observed in 17 patients. The locations of the lipomas were interhemispheric fissure and/or callosal (45%), choroid plexus and/or intraventricular (15%), pericallosal (10%), the quadrigeminal plate and/or superior cerebellar cistern (10%), the prepontine cistern (10%), hypothalamic and/or suprasellar (5%), and the Sylvian fissure (5%), respectively. Associated midline anomalies were observed in 3 patients with callosal and/or pericallosal lipoma and in 1 patient with a Sylvian fissure lipoma. Two patients had epilepsia. One patient had a lipoma of the quadrigeminal plate cistern causing obstructive hydrocephalus by compression and partial obstruction of the aqueduct. Presenting complaints and results of the neurologic examinations were not associated with lipomas in the other 14 patients. CT and MRI easily showed the fatty content of the ICLs and associated anomalies in all patients. ICLs are mostly located midline and discovered incidentally. Sometimes, there are associated midline anomalies and vascular variants; the most common associated neurologic symptom is epilepsy. They rarely require surgical intervention. Copyright © 2005 by Lippincott Williams & Wilkins

Bare stent-graft technique: A new method of endoluminal vascular reconstruction for the treatment of giant and fusiform aneurysms

We present our initial experience with a newly developed endovascular stent graft technique in the treatment of two patients with giant aneurysms. In both of these patients, surgery and conventional endovascular techniques were likely to fail. The technique resulted in the successful management of the aneurysms in both cases. Our technique is described, and related experiences in the literature are discussed

Spinal dural involvement in Erdheim-Chester disease: MRI findings

There are very few reported cases of Erdheim-Chester disease that document involvement of dura at the level of the spinal cord. Among these reports, we know of no publication that includes detailed MRI findings. To the best of our knowledge, the case presented here is the first published report of this specific manifestation of Erdheim-Chester disease that includes detailed MRI findings in addition to the related history. Spinal manifestations of Erdheim-Chester disease in our patient were at the dorsal and lumbar levels (T1-T6 and T12-T11 respectively). Both epidural and subdural linear large masses were present, causing spinal cord compression at the dorsal level and epidural thickening at the lumbar level