TABLE 11-9. SKULL X-RAYS IN THE DIAGNOSIS OF INTRACRANIAL DISEASE

  1. Calcified pineal or habenular commissure: this is often shifted with lateralized intracranial masses. Remember, however, that bilateral cerebral masses or masses that are far frontal or occipital may not shift the pineal appreciably.
  2. Abnormal calcifications (tumors, aneurysms, arteriovenous malformations, etc.)
  3. Increased vascular markings in the skull, when tumors (such as meningiomas) are fed from the external carotid circulation.
  4. Sclerosis or erosion from underlying tumors (such as meningiomas).
  5. Erosion of the drosum sellae as a sign of increased intracranial pressure.
  6. Enlargement of the sella turcica from an intrasellar mass.
  7. Enlargement of the optic foramen or of the internal auditory meatus or canal from tumors of the second or eighth cranial nerves. Erosion of other foramina may also be detected with special views (foramen rotundum, ovale, jugular foramen, etc.).
  8. In children, spreading sutures, indicative of increased pressure.
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