Complex fractures of the clivus: diagnosis with CT and clinical outcome in 11 patients

During a 20-month period, fractures of the clivus occurring after craniocerebral trauma were diagnosed with computed tomography (CT) in 11 patients. Five patients had longitudinally oriented fractures; these were fatal in four patients due to either vertebral-basilar artery occlusion, brain stem trauma, or both. Six other patients had transversely oriented fractures that extended through the carotid canal and petrous temporal bone. While less frequently contributing directly to mortality, transverse fractures were also associated with cerebrospinal fluid leaks (two patients) and a cavernous sinus-carotid fistula (one patient). They were not as frequently associated with Horner syndrome or cranial nerve deficits as suggested in the current literature. This retrospective evaluation reveals two distinct injury patterns that demonstrate a difference in related morbidity and mortality.     

Distal esophageal ballooning following Heller myotomy

Eccentric ballooning of the distal esophagus was observed radiographically in 11 of 23 patients (48%) who underwent Heller myotomy for achalasia. While, to the authors' knowledge, ballooning at the site of myotomy incision has not been described previously in the radiologic literature, it should be recognized as a normal and frequent postoperative finding. Radiologists should be aware of this finding so that it is not mistaken for postoperative abnormalities following esophagomyotomy or an epiphrenic diverticulum.     

高位腰椎间盘突出症

目的：通过147例高位腰椎间盘突出症的回顾性研究,旨在提高对本症的认识,减少漏诊,误诊,方法：回顾性分析报告147例高位腰椎间盘突出,结果：治疗腰1,210例,腰2。3 32例,腰3,4 105例,其中双间隙突出34例,跳跃性突出27例,伴椎管狭窄31例。瘫痪3例,非手术治疗34例,手术113例,优47例,良8例,差92例,重点讨论了高位腰椎及椎间盘和神经根的解剖特点和临床三大特征及诊断治疗,提出对不同程度的病人用不同治疗方式以及手术中需要注意的六个问题。