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Conventional catheter-based angiography, magnetic resonance imaging/angiography, and computed tomographic angiography are all techniques routinely practiced for the diagnosis of aneurysms. With regard to the evaluation of treated aneurysms, each of these imaging modalities has inherent advantages and disadvantages. This review was aimed to provide a better understanding of the optimal application and interpretation of the available imaging modalities for the assessment of treated cerebral aneurysms.

Objective: To evaluate the magnetic resonance imaging results (MRI) of patients with electronystagmography (ENG) suggestive of central vestibular dysfunction and to determine if MRI abnormalities correlate with ENG findings., Study Design: Retrospective blinded case review., Setting: A regional neurotology center., Patients: Patients with ENG suggesting central vestibular dysfunction were identified (n = 30). An age-matched group of patients with normal ENG results were used as controls (n = 28)., Main Outcome Measures: MRI abnormalities in cerebellum, brain stem, cerebellar peduncles, and central ENG findings., Results: Twenty-one patients with abnormal MRI results of the vestibular pathway were found, 15 with abnormal and 6 with normal ENG results. MRI correlation with ENG findings has a better predictive value in older patients than in younger patients. Sixteen patients had MRI evidence of vascular compression, seven of whom had abnormal and nine of whom had normal ENG results., Conclusions: This study suggests that a detailed review of MRI images of the vestibular pathway is warranted, and, in patients with central ENG abnormalities, MRI may support the diagnosis of central vestibular dysfunction. MRI cannot support central vestibular dysfunction caused by vascular compression.

The role of thrombolysis in brain ischemia in patients with atrial myxoma is unknown. A patient with acute brain ischemia and previously undiagnosed atrial myxoma recanalized an occluded middle cerebral artery with intra-arterial thrombolysis. Arterial occlusion from presumed myxoma may be amenable to fibrinolysis. Angiography before treatment in patients with atrial myxoma excludes a myxomatous pseudoaneurysm and permits site-specific thrombolytic instillment.

Prenatal diagnoses of the genetic disorders alpha, beta thalassemia, HbS, Hb Lepore, hemophilia and cystic fibrosis were sought in 88 cases. Six unsuccessful attempts at diagnosis resulted from DNA polymorphisms which were only 50% informative (four cases) and prenatal diagnoses which had been undertaken before it was known whether DNA polymorphisms in family studies were informative (two cases). The most frequent indications for prenatal diagnosis were the hemoglobinopathies although requests for exclusion of cystic fibrosis formed the majority during 1989. Strong linkage disequilibrium between the cystic fibrosis defect and its associated DNA polymorphisms facilitated detection of this disorder. Late presentations among patients with beta thalassemia and hemophilia and the necessity for more specialised genetic counselling were the commonest problems encountered.