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Two patients with chronic valvular heart disease and myocardial infarction were assisted at our hospital. Both of them were febrile and only one had petechiae associated with signs of valvular involvement led to suspicion of infective endocarditis. Although blood cultures were negative, echocardiographic, surgical and anatomopathologic findings were compatible with infective endocarditis. They required cardiac surgery during the acute phase of the infection because they presented progressive hemodynamic deterioration and no satisfactory response to antimicrobial regimen too. One patient died at late follow-up (two weeks after the hospital discharge) and the other survived, but with signs of cardiac failure (class II of NYHA) one year after the procedure.

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A 55-year-old woman with chronic spinal subdural hematoma, diagnosed by magnetic resonance (MR) is presented. There was no coagulation defect, anticoagulant therapy, or trauma.

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Ventriculoperitoneal or cyst-peritoneal shunts are the usual treatment for children with Dandy-Walker syndrome. A combined ventricular and cyst shunt is often necessary and, in some cases, multiple revisions have to be done. Two patients with this syndrome were treated with posterior fossa exploration and cyst fenestration after several shunt revisions. The procedure was well tolerated with good results in both cases. The patients' data and preliminary results are presented here.

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A direct fistula between cerebral cortical arteries and venous channels may result in an impressive aneurysm-like, saccular dilation of the venous portion. We had the opportunity to treat two children with this rare arteriovenous malformation, with excellent results. The controversy on the classification and treatment of this pathology is discussed briefly.

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An 88-year-old man was found at laminectomy to have an encapsulated spinal epidural hematoma. The surgical result was gratifying and reinforced a recent statement that spinal surgical procedures in the very elderly should not be withheld on the basis of age alone. Moreover, the rarity of this pathology in this age group and the clear identification of the lesion on the computed tomography scan of this case are to be noted.

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O tratamento das malformacoes arteriovenonosas tem progredido nos ultimos anos, as custas da evolucao das tecnicas neurocirurgicas e neurorradiologicas. O tratamento ideal continua a ser a remocao cirurgica total, que nem sempre e possivel e as vezes acarreta riscos importantes. As diversas tecnicas de embolizacao tem permitido tratar com sucesso certo numero de pacientes, mas persistem restritas a poucos centros, sendo uteis em apenas alguns casos. No presente trabalho sao feitas consideracoes baseadas em revisao da literatura e na experiencia adquirida no tratamento de 116 pacientes, 76 dos quais foram operados e 8 submetidos a embolizacao

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Os osteoblastomas sao tumores osseos benignos raros. Os autores descrevem os aspectos clinicos, o quadro radiologico, angiografico e cintilografico e a tomografia por computacao de 1 doente portador de osteoblastoma de coluna cervical. A remocao cirurgica seguida de artrodese de coluna resultou em alivio da sintomatologia apresentada pelo doente

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Computed Tomography (CT) has been very useful in the follow-up of patients with brain tumors. Soon after the craniotomy, CT would show any residual tumor if an incomplete excision was done. CT has been essential when one needs to evaluate any deterioration in the patient's neurological status post operatively. In such instances, CT may detect brain edema, hematoma, hydrocephalus and the presence of air. CT findings are more accurate than those obtained from conventional neuroradiology or from intracranial pressure monitoring, being also more innocuous than those methods. Later in the post operative follow-up, CT allows, besides precocious diagnosis of tumor recurrences, a good evaluation of the results obtained by chemiotherapy or radiotherapy. When hydrocephalus is accompanying the primary pathology, ventricular size can be rapidly evaluated by CT. Difficulties may arise when one wishes to differentiate CT images of radionecrosis from tumor recurrences at least in the initial stages.

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A tomografia computadorizada tem grande valor no controle dos pacientes com tumores cerebrais.Imediatamente apos o ato cirurgico pode ser util para avaliar a retirada do processo expansivo ou para comprovar a area atingida.Nos primeiros dias apos a intervencao tem sido indicada principalmente quando ha piora do quadro neurologico. Nestas condicoes, o exame permite verificar a existencia de ar, edema, hematoma, desvios ventriculares e hidrocefalo Os dados fornecidos sao mais precisos que os obtidos com outros exames neuroradiologicos ou com a medida continua da pressao intracraniana, metodos menos inocuos. A longo prazo a tomografia permite o diagnostico precoce de recidivas, a avaliacao da eficacia de tratamentos radio ou quimioterapicos e o controle do hidrocefalo. Ainda nao e possivel fazer o diagnostico diferencial entre radionecrose e recidiva tumoral

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Solitary granulomatous lesions due to cysticercosis in the brain were found by computed tomography in six patients. The CT images were in all cases very similar to those from brain neoplasms. The cerebrospinal fluid complement fixation test for cysticercosis was negative in all of the cases. The definite etiological diagnosis could only be made by craniotomy in this series.

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The differential diagnosis between brain atrophy versus subdural effusion in children has shown some difficulties in a few cases, mainly when the frontal subarachnoid space is very large on computed tomography. We think that a simple procedure, that is, CT scans in the lateral and prone position following the standard examination, may be worth to clarify those cases of doubtful diagnosis.

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A case of calcified choroid plexus papilloma in a 7 years old child is reported. The radiologic findings are discussed.

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