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  • Author or Editor: Stanley L. Barnwell x
  • By Author: Edwards, Michael S. B. x
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Stanley L. Barnwell and Michael S. B. Edwards

✓ The case of an 11-year-old boy is reported in whom two intramedullary lesions developed at the thoracic-cervical and thoracic-lumbar junctions 2½ years after resection and irradiation of a medulloblastoma in the posterior fossa. There was no evidence of subarachnoid spread of the tumor. Magnetic resonance imaging was used to localize these lesions, and provided much better diagnostic information than either computerized tomography scans or myelograms.

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Stanley L. Barnwell, Christopher F. Dowd, Richard L. Davis, Michael S. B. Edwards, Philip H. Gutin and Charles B. Wilson

✓ The cases of seven patients with intramedullary, cryptic vascular malformations of the spinal cord are reported. In all patients, the clinical course was progressive; a Brown-Séquard syndrome was the most common presenting symptom complex. Magnetic resonance (MR) imaging was performed in all patients. The pattern seen most often was a focus of high signal (on both T1- and T2-weighted MR images) surrounded by a larger zone of low signal (best seen on T2-weighted images), and was remarkably similar for all patients. Six patients underwent surgical exploration; removal of the lesions halted the progression of symptoms in five patients, and one patient had worsened sensory function after surgery. Motor function did not decrease postoperatively in any patient. The one patient who refused surgery has continued to decline neurologically. Histopathological examination of surgical specimens showed a cavernous malformation in one patient, a venous malformation in one, venous varices in two, and organizing hematomas in two; these findings are markedly different from those in previously reported cases of cryptic vascular malformations.