CT of primary and secondary craniocerebral neuroblastoma

Eleven children with craniocerebral neuroblastoma (three primary and eight metastatic) were examined by computed tomography (CT). The findings in both primary and secondary neuroblastoma correlate well with the known neuropathologic findings. Primary cerebral neuroblastoma originates in the brain parenchyma of the supratentorial space, and may extend into the cerebrospinal fluid pathways. Secondary neuroblastoma is confined to the osseous structures of the calvarium and orbit, and adjacent subperiosteal spaces (epidural and epicranial). In both forms of neuroblastoma, intratumoral hemorrhage is frequent. Separation of the cranial sutures often relates to epidural deposits of tumor extending to the sutural margins. In this form of sutural diastasis, intracranial pressure is not elevated. When elevated intracranial pressure accompanies sutural diastatis, CT findings reveal epidural deposits compressing the major dural venous sinuses in the region of their confluence.