Cerebral Infarction in a Child after Moderate Brain Trauma: A Case Report

2017 ◽  
Vol 14 (02/03) ◽  
pp. 098-100
Author(s):  
Dhaval Gohil ◽  
Bhagavatula Devi ◽  
Dhananjaya Bhat ◽  
Dhaval Shukla
Keyword(s):  
Head Injury ◽  
Cerebral Infarction ◽  
Ct Scan ◽  
Cerebral Artery ◽  
Vital Role ◽  
Traumatic Head Injury ◽  
Rehabilitation Care ◽  
Computed Tomographic ◽  
Orbital Roof ◽  
Suprasellar Region

AbstractIntracranial hematomas and contusions are common entity after traumatic brain injury in children and young population. However, cerebral infarction after traumatic head injury is a rare entity with frequency ranging from 1.9 to 10.4%. We herein report a case of cerebral infarction in right anterior cerebral artery (ACA) and parts of middle cerebral artery (MCA) territory after moderate head injury in a 14-year-old boy, in whom computed tomographic (CT) scan of the brain was performed 3.5 hours after injury, which showed specks of pneumocephalus in sellar suprasellar region, and 12 hours after injury showed right ACA territory infarct and evolving infarct in right MCA territory. Bony injury included right orbital roof and right sphenoid wing linear undisplaced fractures. Possible mechanism for development of infarction is right internal carotid artery (ICA) dissection by fractured bone fragments and/or thrombosis. The patient developed hemiplegia on second day after trauma. Intracranial pressure (ICP) monitoring was done, which was suggestive of raised ICP. The patient underwent right fronto-temporo-parieto craniotomy and decompression (tissue sent for histopathologic analysis) and augmentative duraplasty with bone flap replacement on fifth day after trauma. Histopathology was suggestive of cerebral infarct with hemorrhage. The patient was improved at follow-up, 10 months after trauma after rehabilitation, and physiotherapy to modified Rankin scale (mRS) score 3. Hence delayed CT scan plays a vital role in detecting developing posttraumatic infarcts, and rigorous rehabilitation care is necessary for clinical improvement.

Coincidental Pituitary Adenoma and Parasellar Meningioma: Case Report

Neurosurgery ◽  
1986 ◽  
Vol 19 (2) ◽  
pp. 267-270 ◽  
Author(s):  
Kenji Yamada ◽  
Takashi Hatayama ◽  
Masahiro Ohta ◽  
Katsuaki Sakoda ◽  
Tohru Uozumi
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Head Injury ◽  
Ct Scan ◽  
The Other ◽  
Histopathological Findings ◽  
Computed Tomographic ◽  
First Case ◽  
History Of

Abstract We report a patient who had pituitary adenoma and parasellar meningioma coincidentally, with neither irradiation nor a history of head injury. Preoperative computed tomographic (CT) scan had shown a large intrasellar mass with ringlike enhancement; in contact with this mass, another well-enhanced mass had been shown. Histopathologically, the intrasellar mass was diagnosed as chromophobic pituitary adenoma and the other mass as meningotheliomatous meningioma. We present clinical, radiological, and histopathological findings and discuss previously reported cases of coincidental pituitary adenoma and meningioma without irradiation. This is the first case report since the advent of CT that pituitary adenoma and parasellar meningioma in contact with each other could be clearly demonstrated by CT.

Craniopharyngioma

Neurosurgery ◽  
1981 ◽  
Vol 9 (1) ◽  
pp. 76-78 ◽  
Author(s):  
Maurice H. Lipper ◽  
Pulla R. S. Kishore ◽  
John D. Ward
Keyword(s):  
Ct Scan ◽  
Clinical Analysis ◽  
High Density ◽  
Computed Tomographic ◽  
Ct Findings ◽  
Suprasellar Region

abstract Craniopharyngioma usually presents on a computed tomographic (CT) scan as a hypodense or isodense lesion, with calcification, in the suprasellar region. A case with atypical CT findings of a huge, homogeneous, high density, apparently solid, lobulated suprasellar mass is presented. An explanation for the appearance of the tumor is discussed based upon clinical analysis of the tumor contents.

scholarly journals Application of PECARN rules would significantly decrease CT rates in a Dutch cohort of children with minor traumatic head injuries

2020 ◽  
Vol 179 (10) ◽  
pp. 1597-1602
Author(s):  
Nicky Niele ◽  
Marlies van Houten ◽  
Ellen Tromp ◽  
J.B. van Goudoever ◽  
Frans B. Plötz
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Clinical Decision ◽  
Research Network ◽  
Ct Scans ◽  
Lower Percentage ◽  
National Guidelines ◽  
Traumatic Head Injury ◽  
Traumatic Head ◽  
Dutch Cohort

Abstract The aim of this study was to determine the potential impact of the Pediatric Emergency Care Applied Research Network (PECARN) rules on the CT rate in a large paediatric minor traumatic head injury (MTHI) cohort and compare this with current national Dutch guidelines. This was a planned sub-study of a prospective multicentre observational study that enrolled 1006 children younger than 18 years with MTHI. We calculated the number of recommended CT scans and described trauma-related CT scan abnormalities. The PECARN rules recommended a significantly lower percentage of CT scans in all age categories, namely 101/357 (28.3%) versus 164/357 (45.9%) (p < 0.001) in patients under 2 years of age and 148/623 (23.8%) versus 394/623 (63.2%) (p < 0,001) versus in patients 2 years and older. Conclusion: The projected CT rate can significantly be reduced if the PECARN rules are applied. We therefore advocate that the PECARN guidelines are also implemented in The Netherlands. What is Known:• To guide clinicians whether to perform a CT scan in children with a minor traumatic head injury (MTHI) clinical decision rules has been developed.• The overall CT scan rate in adherence with the Dutch MTHI guidelines is 44%. What is New:• The projected CT rate can significantly be reduced in a Dutch cohort of MTHI if the PECARN rules are applied.• The Dutch national guidelines for MTHI can safely be replaced by the PECARN rules.

Posttraumatic Dissecting Aneurysm of the Anterior Cerebral Artery: Case Report

Neurosurgery ◽  
1988 ◽  
Vol 23 (2) ◽  
pp. 221-225 ◽  
Author(s):  
Masaharu Amagasa ◽  
So Sato ◽  
Kazunori Otabe
Keyword(s):  
Case Report ◽  
Head Injury ◽  
Corpus Callosum ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Mechanical Damage ◽  
Dissecting Aneurysm ◽  
Mechanical Injury ◽  
A Minor

ABSTRACT A case of cerebral infarction in the territory of the anterior cerebral artery after a minor head injury is reported. It is possible that direct or mechanical damage by the edge of the falx or stretching and shearing of the anterior cerebral artery after an acute shift of the corpus callosum caused the localized lesion of the left anterior cerebral artery. We think that this mechanical injury caused a dissecting aneurysm or a cerebral arterial dissection, which was diagnosed by sequential angiographic changes.

scholarly journals Role of sequel CT scan head after twenty four hours of traumatic head injury

2015 ◽  
Vol 2 (2) ◽  
pp. 195 ◽  
Author(s):  
Pradeep Balmiki ◽  
Anjeev Chourasia ◽  
Ishwar Chourasia
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Traumatic Head Injury ◽  
Traumatic Head

Computed Tomographic Diagnosis of Ruptured Giant Posterior Cerebral Artery Aneurysms

Neurosurgery ◽  
1988 ◽  
Vol 22 (3) ◽  
pp. 553-558 ◽  
Author(s):  
LCDR Brett A. Scott ◽  
Zelig Weinstein ◽  
CDR Morris W. Pulliam
Keyword(s):  
Ct Scan ◽  
Temporal Lobe ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Filling Defect ◽  
Intracerebral Hematoma ◽  
Intravenous Contrast ◽  
Diagnostic Features ◽  
Computed Tomographic ◽  
Diagnostic Ct

Abstract Ruptured giant posterior cerebral artery (PCA) aneurysms are encountered rarely. Although computed tomographic (CT) scan features of giant intracranial aneurysms have been described. CT scan features of acutely ruptured giant saccular PCA aneurysms have not been reported. A case of an acutely ruptured giant saccular PCA aneurysm with diagnostic CT scan features and autopsy confirmation is presented. Two additional cases of apoplexy with identical clinical courses and CT scan appearances, both attributed to giant saccular PCA aneurysms, are described. Diagnostic CT scan features included evidence of intraparenchymal temporal lobe and intraventricular hemorrhage, the presence of a filling defect in the temporal lobe hematoma that enhanced after intravenous contrast administration, and evidence of proximal PCA entrance into the contrast-enhanced filling defect in the intracerebral hematoma. The incidence of PCA aneurysms and the anatomy of the PCA as it relates to these giant aneurysms, their clinical presentation, and diagnostic features of the CT scan are discussed. (Neurosurgery 22:553-558, 1988)

Civilian Occult Orbitocranial Penetrating Injury Presenting with Cerebral Abscess in Elderly Patient

2017 ◽  
Vol 14 (02/03) ◽  
pp. 145-148
Author(s):  
Mazhar Mulla ◽  
Bhagyashri Bhende ◽  
Swapnil Patil ◽  
Aditya Patil ◽  
Batuk Diyora
Keyword(s):  
Ct Scan ◽  
Mass Effect ◽  
Interesting Case ◽  
Penetrating Injury ◽  
Case Review ◽  
Computed Tomographic ◽  
Orbital Roof ◽  
Orbital Wall ◽  
The Right ◽  
The Brain

AbstractOrbital penetrating injuries are uncommon and occur following accidental entry of objects through orbit. The authors report an interesting case of right frontal abscess resulting from orbitocranial penetrating injury due to accidental penetration of wooden stick into the right eye, which remained undiagnosed. A 70-year-man presented with complaints of headache and vomiting for few days. His computed tomographic (CT) scan of the brain revealed peripheral rim-enhancing cystic lesion in the right frontal lobe with perilesional edema, mass effect, and midline shift. Orbital CT scan revealed hyperdense lesion just lateral to medial orbital wall. Magnetic resonance imaging of the brain showed cystic peripheral rim-enhancing lesion that was homogenous hypointense on T1-weighted images and homogenous hyperintense on T2-weighted images. The patient underwent right frontal craniotomy. Pus was drained out, and abscess wall was excised. Foreign bodies protruding through fractured orbital roof were found and removed. He made good clinical recovery. He has received intravenous antibiotics for 2 weeks followed by 4 weeks of oral antibiotics. He had no visual symptoms. The authors report the case, review the literature, and highlight need for imaging in every case of orbital penetrating injury to prevent the life-threatening cerebral parenchymal complications.

scholarly journals A COMPARISON OF GLASGOW COMA SCORE WITH COMPUTED TOMOGRAPHIC FINDINGS IN CASES OF TRAUMATIC BRAIN INJURY AT TERIATRY CARE HOSPITAL BIKANER

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Kapil Pareek ◽  
Dinesh Sodhi
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Trauma Center ◽  
Head Injuries ◽  
Care Hospital ◽  
Medical College ◽  
Reduce Radiation Exposure ◽  
Computed Tomographic ◽  
Gcs Score ◽  
Larger Sample

Background: Our present study aimed at correlation of GCS score with computed tomographic findings in cases of head injury and to evaluate that GCS scoring can be used as an alternate tool in clinical management of head injuries in settings where CT scans are not available or contraindicated. Methods: The present study was conducted in Department of Neurosurgery, Trauma center of S. P. Medical College and A.G. of Hospitals, Bikaner. The study group consisted of a total of 100 head injury patients presenting to the Trauma center and admitted in neurosurgery ward. Results: Contusion was the most frequent finding in cases with positive CT scan findings. All (100%) subjects with severe head injury had positive CT scan findings. Conclusions: Careful clinical selection based on GCS score before ordering CT scan can help reduce radiation exposure patients and pressure on limited resources. Studies with larger sample size would be warranted Keywords: CT scan, head injury, Glasgow Coma Scale Score

scholarly journals A STUDY ON CORRELATION OF DEGREE OF MIDLINE SHIFT ON CT SCAN AND GLASGOW COMA SCALE IN PATIENTS OF ACUTE TRAUMATIC HEAD INJURY

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Sandeep Kumar ◽  
Narendra Kumar Kardam ◽  
Kushal babu Gahlot ◽  
Manphhol Singh Maharia
Keyword(s):  
Head Injury ◽  
Glasgow Coma Scale ◽  
Ct Scan ◽  
Subdural Hematoma ◽  
Midline Shift ◽  
Extradural Hematoma ◽  
Traumatic Head Injury ◽  
Coma Scale ◽  
Depressed Fracture ◽  
Traumatic Head

Background: The larger the amount of the midline shift on CT scan the poorer will be the outcome of traumatic head injury. Other variables such as Glasgow coma scale have been subsequently introduced to build more complex and accurate prognostic model. Methods: A study was conducted on patients with acute traumatic head injury. Most common and important complication of traumatic head injury is the development of an increased intracranial pressure resulting in midline shift. The larger the amount of the midline shift on CT scan the poorer will be the outcome of traumatic head injury. Results: External injury of scalpel is seen in 92% of cases, blackening of eye in 50% & vomiting in 50%. Cerebral contusion (50%) was the most common CT scan finding followed by depressed fracture (32%), subdural hematoma (22%) than extradural hematoma (6%). Hemorrhagic contusion was the most common CT scan finding irrespective of GCS score. In patients with GCS 3-5 other outcome findings are extradural hematoma, subdural hematoma, & depressed fracture. In patients with GCS 6-8 other common findings are extradural hematoma, depressed fracture & hemorrhagic contusion. In patients with GCS 9-12 other common findings were hemorrhagic contusion, depressed fracture & intra cerebral hematoma. In patients with GCS 13-15 other common findings were depressed fracture, hemorrhagic contusion. Conclusions: The increased degree of midline shift in patients with head injuries by CT scan was related to the severity of head injury (GCS= 3-12) and was significantly related to poor final clinical outcome. Keywords: CT scan, Glasgow coma scale, acute traumatic head injury.

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