By Holger Pettersson MD, PhD, Derek C. F. Harwood-Nash MB, ChB, FRCP(C) (auth.)
To examine the phenomenon of ailment with out books is to sail an uncharted sea. whereas to check books with no sufferers isn't to visit sea in any respect. Sir William Osler Over a interval of 5 years, the impression of computed tomography (CT) on pediatric neuroradiology on the health facility for in poor health little ones, Toronto, has been, as anticipated, within the evaluation of the mind and its abnormalities. Concurrent with this program was once the creation of Metrizamide (Amipaque, Nyegaard & Co. AS, Oslo, Norway), a water-soluble CSF distinction medium, used essentially as a myelog raphic agent. the following software of the wide-aperture CT scanner to imaging of the backbone in little ones supplied striking advances within the scientific administration of spinal disorder due to the fact that CT is much extra actual than regular neuroradiologic approaches. The com bination of CT and Metrizamide additional one other measurement to the imaging of the backbone and of the spinal twine and nerve roots. Such spinal CT and CT Metrizamide myelography in childrens now occupies an important a part of daily pediatric neuroradiologic perform. they've got dramatically superior our figuring out of the traditional anatomy and pathologic entities of the backbone and its contents in young children; have altered and more advantageous the surgical administration of such ailments; and feature considerably greater the medical deal with ment of such illnesses within the specialties of neurosurgery, orthopedic surgical procedure, and genito-urinary surgical procedure . .
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Extra resources for CT and Myelography of the Spine and Cord: Techniques, Anatomy and Pathology in Children
1 gives the size of the cord at different levels in different ages. These values were obtained from 45 patients in whom both MM and CTMM were performed, and each examination was considered normal. 0 mm. 5 mm. As the size of the cord was measured at all the recorded levels in each of only a few patients, the number of measurements at each level and in each age group does not allow any extensive statistical analysis. 1 it is clear that the cord increases in size most rapidly during the first months of life, while after about the age of 6 months the rate of increase of the size is much slower.
The tip of the odontoid ossifies from one or two separate centers. The relationship between the occipital condyles and the C1, as well as between the C1 and C2 vertebrae, is often best seen in the coronal view (Fig. 2). The lower cervical vertebrae in infancy ossify from a small composite center in the vertebral body, and from two C-shaped ossification centers in the pediclelamina complexes; with very small transverse processes. During the first years of life the pedicles become thicker and the transverse processes and the foramina transversaria are completely formed at approximately 3 years of age (Fig.
The syringohydromyeliac cavity is opacified. no unexpected discomfort at the examination, and there was no new neurologic disturbance during or after the procedure. Syringohydromyelia is often accompanied by a Chiari malformation (see Fig. 18) and examination of the occipitocervical junction should always be performed in cases of syringohydromyelia using CTMM; wherein the low tonsils are readily demonstrated. Syringobulbia within a large brain stem is very rare. Diastematomyelia Diastematomyelia denotes a longitudinal split of the spinal cord extending over one or several vertebral levels, or rarely over multiple discrete levels, usually in the 48 CT and Myelography of the Spine and Cord lower thoracic or upper lumbar area, although higher levels or the filum terminale might also be involved.
CT and Myelography of the Spine and Cord: Techniques, Anatomy and Pathology in Children by Holger Pettersson MD, PhD, Derek C. F. Harwood-Nash MB, ChB, FRCP(C) (auth.)