Angiography in Senile Cerebral Atrophy

An avascular zone between the surface of the brain and the calotte at angiography in adults is considered an indication of extracerebral haematoma. The different types of extracerebral haematomas, i. e. acute and chronic subdural haematomas and epidural haematomas, may also generally be distinguished angiographically (NORMAN 1956, CRONQVIST & KOHLER 1963). There are however conditions, such as senile cerebral atrophy, in which the angiographic appearances so much resemble those of an acute subdural haematoma as to make the differential diagnosis difficult or impossible. A fluid-filled space between the brain surface and the calvaria in advanced cerebral atrophy results from a volumetric reduction of the brain and at angiography produces an avascular zone. This diagnostic alternative to subdural haematoma has not been given much attention in the literature. CLONING & KLAUSBERGER (1956) mentioned that in advanced cerebral atrophy an avascular zone appeared under the calotte, and that this zone is evenly distributed over the whole cerebral surface while in subdural haematoma it is limited to a part of the hemisphere. The pericallosal artery may be situated in the midline in both conditions. BILLET (1959) also described an avascular