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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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Spread of blood in cerebrospinal fluid following craniotomy simulates spinal metastases

S Cronqvist1, D Greitz, P Maeder

  • 1Department of Neuroradiology, University Hospital, Lund, Sweden.

Neuroradiology
|January 1, 1993
PubMed

Insights

Postoperative myelography in children with posterior fossa tumors revealed subarachnoid changes. Differentiating tumor spread from adhesions is crucial to prevent unnecessary spinal cord radiotherapy.

Area of Science:

  • Pediatric Neuroradiology
  • Neuro-oncology
  • Spinal Imaging

Background:

  • Posterior cranial fossa tumors are common in children.
  • Postoperative complications can mimic tumor spread on imaging.
  • Accurate diagnosis is essential for appropriate treatment planning.

Purpose of the Study:

  • To evaluate myelographic findings in children with posterior fossa tumors.
  • To differentiate between subarachnoid changes due to tumor spread and postoperative adhesions.
  • To guide treatment decisions and avoid unnecessary radiotherapy.

Main Methods:

  • Postoperative myelography using water-soluble contrast media.
  • Study included 36 children diagnosed with posterior cranial fossa tumors.
  • Analysis of myelographic findings, including normal studies, intramedullary tumors, and subarachnoid changes.

Main Results:

  • 15 myelograms were normal.
  • 5 patients had intramedullary tumors, with 3 showing subarachnoid changes indicating tumor spread.
  • 16 patients exhibited subarachnoid changes attributed to postoperative adhesions, distinct from tumor spread.

Conclusions:

  • Subarachnoid changes on postoperative myelography can result from tumor spread or adhesions.
  • Adhesions are likely caused by blood distributed via cerebrospinal fluid pulsations.
  • Distinguishing between tumor-related and adhesion-related changes is vital to prevent erroneous radiotherapy to the spinal cord.

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