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Pathological Variations and Positive and Negative Images

Bernard Messert, MD; Allan B. Levin, MD

Arch Neurol. 1972;26(1):49-59.

Abstract
The use of iodinated serum albumin cerebrospinal fluid flow studies in the evaluation of a multiplicity of central nervous system abnormalities is described and correlated with contrast studies and surgical and pathological findings. The concept of negative-positive images is presented. The negative images correspond to localized areas of decreased or absent radoiactivity and are due to localized obstructions in the subarachnoid spaces. The focal nature of these "holes" in the scans can be diagnostic features in entities such as subdural hematoma, hemispheric tumors, and processes filling or infiltrating the subarachnoid spaces. The positive images or "puddles" of increased or retained activity in the scans correspond to destructive focal cortical lesions and correlate with posttraumatic areas of encephalomalacia, areas of vascular degeneration, and atrophies of the cortex seen in degenerative and developmental disorders.

Author Affiliations
Madison, Wis

From the departments of neurology (Dr. Messert) and neurosurgery (Dr. Levin), University of Wisconsin, and the Veterans Administration Hospital (Dr. Messert), Madison, Wis.

Footnotes
Accepted for publication May 21, 1971.

Reprint requests to Veterans Administration Hospital, 2500 Overlook Terrace, Madison, Wis 53705 (Dr. Messert).

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