Annotated Bibliography Nolan Altman, James A. Brunberg, Allen D. Elster, Ajax E. George, David B. Hackney, Robert B. Lufkin, JeffreyS. Ross, Joel D. Swartz, Jane L. Weissman, and Samuel M. Wolpert Brain Tumors and Cysts Aylward EH, Brandt J, Codori AM, Mangus RS, Barta PE, Harris GJ. Reduced basal ganglia volume associated with Peterson DL, Sheridan PJ, Brown WE Jr. Animal models the gene for Huntington's disease in asymptomatic at­ for brain tumors: historical perspectives and future direc­ risk persons. Neurology 1994;44:823-828. tions. J Neurosurg 1994;80:865-876. Volumes of the basal ganglia structures were signifi­ An excellent review of animal models available for those cantly reduced in asymptomatic at-risk siblings of Hun­ involved in brain tumor research. Included are spontane­ tington patients with marker-positive genes, but not in ous tumors, carcinogen-induced tumors, virus-induced siblings with marker-negative genes.O SMW tumors, models based on cell or tissue transplantation, and transgenic models. This paper is not for the general SchneiderS, Feifel E, Ott D, Schumacher M, Luking CH, reader, but will be of great interest to academicians and Deuschl G. Prolonged MRI T2 times of the lentiform nu­ researchers.O ADE cleus in idiopathic spasmodic torticollis. Neurology 1994; 44:846-850. Magnetic resonance (MR) findings in 22 patients with spasmodic torticollis were compared with those of 28 age­ Degenerative and Metabolic Disease and matched control subjects. T2 values in the putamen and Aging pallidum on both sides were significantly higher in the patients than in the controls. The authors speculate that Bensimon G, Lacomblez L, Meininger V, and the ALS/ the findings could represent focal gliosis.OSMW Riluzole Study Group. A controlled trial of riluzole in amyotrophic lateral sclerosis. N Eng/ J Med 1994;330: Rouanet F, Tison F, Dousset V, Corand V, Orgogozo JM. 585-591. Clinical/scientific notes: early T2 hypointense signal ab­ One hypothesis about the origin of amyotrophic lateral normality preceding clinical manifestations of central sclerosis implicates abnormal accumulation of glutamate pontine myelinolysis. Neurology 1994;44:979-980. (the primary excitatory central nervous system neuro­ In this interesting case report, the authors describe a transmitter) at synapses. Experimentally, riluzole inhibits patient with central pontine myelinolysis in whom an MR the presynaptic release and postsynaptic actions of gluta­ study revealed hypointense signal on T2-weighted se­ mate. This double-blind, placebo-controlled, prospective quences in the basis pontis 1 week before the onset of study was carefully performed and analyzed. Survival in clinical signs of the disease while the patient was still the riluzole group was statistically greater than survival in markedly hyponatremic. On a second MR image obtained the placebo group; the effect was greatest in patients with 1 week later, the typical appearances of central pontine bulbar-onset amyotrophic lateral sclerosis, with only a myelinolysis, hypointense areas on T1-weighted and hy­ "trend" in patients with limb-onset disease. Riluzole also perintense on T2-weighted images, were seen.OSMW slowed the deterioration of muscle strength. So far, ther­ apy for amyotrophic lateral sclerosis has been inadequate. Graham SH , Meyerhoff DJ, Nat R, et al. Magnetic reso­ These results might constitute a breakthrough.OJLW nance spectroscopy of N-acetylaspartate in hypoxic­ ischemic encephalopathy. Ann Neuro/1994;35:490-494. Lipton SA, Rosenberg PA. Mechanisms of disease: exci­ Water-suppressed proton MR spectroscopic imaging tatory amino acids as a final common pathway for neu­ measurements of N-acetylaspartate may be a sensitive rologic disorders. N Eng/ J Med 1994;330:613-620. way to measure selective neuronal loss of patients with This review article clarifies some mechanisms briefly hypoxic-ischemic encephalopathy as shown in this single alluded to in the preceding article. Glutamate, the principal case report.ONA excitatory CNS neurotransmitter, is involved in cognition, memory, movement, sensation. Overstimulation of gluta­ mate receptors may cause "excitotoxicity" and cell death in acute injury (stroke, trauma, hypoglycemia, epilepsy) and chronic injury (amyotrophic lateral sclerosis). The article goes into exquisite technical detail, but it is impor­ tant and worth skimming.OJLW From Miami Children's Hospital (N.A.); University Hospital, Ann Arbor, Mich (J.A.B.); Bowman Gray School of Medicine, Winston-Salem, NC (A.D.E.); NYU Medical Center, New York (A.E.G .); Hospital of the University of Pennsylvania, Philadelphia (D.B.H.); UCLA School of Medicine, Los Angeles (R.B.L.); The Cleveland Clinic Foundation (J.S.R.); The Germantown Hospital and Medical Center, Ph iladelphia (J.D.S.); University of Pittsburgh School of Medicine (J.L.W. ); and New England Medical Center Hospital, Boston (S.M.W.). AJNR 15:1596-1600, Sep 1994 0195-61 08/ 94/1508-1596 © American Society of Neuroradiology 1596 AJNR: 15, September 1994 ANNOTATED BIBLIOGRAPHY 1597 Hematologic Disorders Kuppersmith RB, Disher MJ, Deveikis JP, Frey K, Shulkin BL, Clevens RA, Wolf GT. Management of an osteogenic Case records of the Massachusetts General Hospital. sarcoma of the maxilla. Ann Otol Rhino/ Laryngol 1994; Weekly clinicopathological exercises: N Eng/ J Med 1994; 103:408-412. 330:920-927. Radionuclide bone scan, coronal CT, coronal pre- and Bilateral epistaxis, retinal hemorrhages, and bilateral postcontrast T1-weighted MR, anteroposterior angiogram, central-retinal-vein occlusions were among the clinical and a positron emission tomography scan are used to manifestations of "hyperviscosity syndrome." Plain films illustrate this lesion. Approximately 10% of all osteosarco­ of skull and hip showed lytic foci. "A diagnostic procedure mas are found in the head and neck region, most often in was performed": monoclonal protein identified in blood the mandible or maxilla. All maxillary osteosarcomas are and urine clinched the diagnosis of (did you guess?) mul­ believed to arise in the alveolar ridge. This case occurred tiple myeloma.DJLW in a 35-year-old man with a 115-pack per year smoking history who had undergone local excision of a smaller tumor 2 years before.D JDS Inflammatory Disease Drobyski WR, Knox KK, Majewski D , Carrigan DR. Brief Neck and Nasopharynx report: fatal encephalitis due to variant B human herpes­ Kerner MM, Bates ES, Hernandez F, Mickel RA. Carcino­ virus-6 infection in a bone marrow-transplant recipient. ma-in-situ occurring in a Zenker's diverticulum. Am J N Eng/ J Med 1994;330:1356-1360. Otolary ngol 1994; 15 ( 3): 223-226. This is the first documentation of central nervous system Zenker Pharyngoesophageal Diverticulum results from infection by human herpesvirus-6. Autopsy revealed dam­ an outpouching in the inferior constrictor muscle known as age to astrocytes and myelin in frontal white matter, and to Killian Dehiscence. The authors present the sixth reported neurons in hippocampus gray matter. Other herpesvirus case of carcinoma-in-situ occurring within a Zenker diver­ infections have a propensity for the limbic system. Unfor­ ticulum. They emphasize that cigarette smoking, hemop­ tunately, no imaging studies are included.D JLW tysis, previous upper-aerodigestive-tract malignancy, and a prolonged history of the diverticulum have been identi­ Gilden DH. Herpes zoster with postherpetic neuralgia­ fied as risk factors.D JDS persisting pain and frustration. N Eng/ J Med 1994;330: 932-933. Stack MC, Ridley MB. Spontaneous cervical emphysema Postherpetic neuralgia is pain in one to three der­ in a child. Otolaryngol Head Neck Surg 1994;110:318- matomes after resolution of cutaneous herpes zoster in the 323. This is a long, mistitled case report of a child who (pre­ same distribution. Ongoing ganglion inflammation (zoster sumably) performed repeated Valsalva maneuvers, caus­ sine herpete) may cause postherpetic neuralgia. Current ing alveolar rupture. The authors state that all "spontane­ doses of oral acyclovir are not effective, but higher oral ous" cervical emphysema has a cause " if closely studied." doses, or intravenous therapy, may attenuate or eliminate Their bias is apparent: this is really an article on various the pain. Good news for sufferers.DJLW causes of cervical emphysema. Captions for the two plain films (neck, chest) and lung-window CT images (neck, chest) describe arrows pointing to the emphysema, but the arrows are nowhere to be seen.D JLW Mandible and Maxilla Mori H, Nishimura Y, Satomi F, Mohri D, Kumoi T. Recon­ Eisele DW, Richtsmeier WJ, Graybeard JC, Koch WM, sideration on the hyoid syndrome. Otolaryngol Head Neck Zinreich SJ. Three-dimensional models for head and neck Surg 1994;110:324-329. tumor treatment planning. Laryngoscope 1994; 104:433- The authors present four cases, illustrated with three CT 439. images and one xeroradiograph. Each case (and figure) Plastic mandibular models generated by three-dimen­ purports to show an abnormally prominent greater cornu sional computed tomography (CT) reconstruction and of the hyoid. All patients had the offending greater cornu dental impression type models of the maxilla were each removed, with relief of symptoms. Nonetheless, "hyoid evaluated for usefulness for the head and neck surgeon. greater cornu" syndrome, caused by irritation of the sym­ The first type was expensive and technologically intensive pathetic plexus around carotid artery or sinus branch of and the second type was simple but limited. Both models glossopharyngeal