Skull x rays, CT scans, and making a decision in head injury

Abstract The first part of this work, published in 1988, included 25 patients who had computed tomographic (CT) scans without contrast enhancement and plain x-rays of the lumbar spine before, 1 week after, and 6 to 7 weeks after a successful operation for lumbar disc herniation. The present study extends the follow-up period to 3 years in 19 of the 25 original patients. Clinical examinations, lateral plain x-rays, and CT scans without contrast enhancement of the operated disc were repeated. The results indicate a decrease or even a disappearance of the hyperdense extradural material thought to represent fibrosis. An image suggestive of persistent disc herniation was still present in 5 of 8 patients with this finding on early postoperative CT scans. Persistent intradiscal gas was seen in nearly half of the patients. Total normalization of the posterior extraspinal structures was the rule. There was no correlation between CT appearance and residual complaints of the patients. CT scans without contrast enhancement may be sufficient to guide the surgeon in postoperative patients with massive signs and symptoms of recurrent root compression in whom a second operation is indicated on clinical grounds. In all other cases, myelography followed by CT scans is considered appropriate to investigate failed back surgery syndrome. (Neurosurgery 29:1-7, 1991)

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Head, Examined: Clarence Darrow's X-Ray Vision of Criminal Responsibility

The Journal of Psychiatry & Law ◽

10.1177/009318531103900406 ◽

2011 ◽

Vol 39 (4) ◽

pp. 627-661 ◽

Cited By ~ 1

Author(s):

Kenneth J. Weiss

Keyword(s):

19Th Century ◽

Criminal Responsibility ◽

Scientific Evidence ◽

Ct Scans ◽

X Rays ◽

Pathological Anatomy ◽

X Ray ◽

Murder Trial ◽

Scientific Arguments ◽

Penalty Phase

Shortly after Roentgen's discovery of X-rays and their application to human imaging, the legal profession began to use the technology in litigation. Though the use of brain imaging did not find its way into formal arguments about criminal responsibility early in its evolution, such an analysis has been sought. 19th Century attempts to connect “pathological anatomy” to behavior were mostly disappointing. In 1924, the celebrated murder trial of Leopold and Loeb in Chicago became an early example of the use of scientific testimony that included radiographic exhibits. The penalty-phase decision to spare the defendants' lives was not based on scientific arguments. Sixty years later, the trial of John Hinckley included admission of CT scans to aid psychiatric testimony. Using excerpts from the expert reports and testimony, this article examines the nature and purpose of scientific evidence pertaining to blameworthiness. The author concludes that improvements in neuroimaging will continue to force a dialog between science and the law.

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Truncated Inception Net: COVID-19 Outbreak Screening using Chest X-rays

10.21203/rs.3.rs-20795/v1 ◽

2020 ◽

Cited By ~ 4

Author(s):

Dipayan Das ◽

KC Santosh ◽

Umapada Pal

Keyword(s):

Neural Network ◽

World Wide ◽

Imaging Techniques ◽

Imaging Systems ◽

Ct Scans ◽

X Rays ◽

X Ray ◽

X Ray Imaging ◽

Proposed Model ◽

Different Types

Abstract Since December 2019, the Coronavirus Disease (COVID-19) pandemic has caused world-wide turmoil in less than a couple of months, and the infection, caused by SARS-CoV-2, is spreading at an unprecedented rate. AI-driven tools are used to identify Coronavirus outbreaks as well as forecast their nature of spread, where imaging techniques are widely used, such as CT scans and chest X-rays (CXRs). In this paper, motivated by the fact that X-ray imaging systems are more prevalent and cheaper than CT scan systems, a deep learning-based Convolutional Neural Network (CNN) model, which we call Truncated Inception Net, is proposed to screen COVID-19 positive CXRs from other non-COVID and/or healthy cases. To validate our proposal, six different types of datasets were employed by taking the following CXRs: COVID-19 positive, Pneumonia positive, Tuberculosis positive, and healthy cases into account. The proposed model achieved an accuracy of 99.96% (AUC of 1.0) in classifying COVID- 19 positive cases from combined Pneumonia and healthy cases. Similarly, it achieved an accuracy of 99.92% (AUC of 0.99) in classifying COVID-19 positive cases from combined Pneumonia, Tuberculosis and healthy CXRs. To the best of our knowledge, as of now, the achieved results outperform the existing AI-driven tools for screening COVID-19 using CXRs.

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AI INFLUENCE IN COVID-19 DETECTION

Journal of University of Shanghai for Science and Technology ◽

10.51201/jusst/21/07235 ◽

2021 ◽

Vol 23 (07) ◽

pp. 1116-1120

Author(s):

Cijil Benny ◽

Keyword(s):

Neural Network ◽

Statistical Analysis ◽

Convolutional Neural Network ◽

Case Reports ◽

Ct Scans ◽

Data Sets ◽

X Rays ◽

Medical Field ◽

Primary Key ◽

Made In

This paper is on analyzing the feasibility of AI studies and the involvement of AI in COVID interrelated treatments. In all, several procedures were reviewed and studied. It was on point. The best-analyzing methods on the studies were Susceptible Infected Recovered and Susceptible Exposed Infected Removed respectively. Whereas the implementation of AI is mostly done in X-rays and CT- Scans with the help of a Convolutional Neural Network. To accomplish the paper several data sets are used. They include medical and case reports, medical strategies, and persons respectively. Approaches are being done through shared statistical analysis based on these reports. Considerably the acceptance COVID is being shared and it is also reachable. Furthermore, much regulation is needed for handling this pandemic since it is a threat to global society. And many more discoveries shall be made in the medical field that uses AI as a primary key source.

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Association of post-traumatic communication of endocranium and nasal cavity with recurrent meningoencephalitis without rhinorrhea

Vojnosanitetski pregled ◽

10.2298/vsp1011945d ◽

2010 ◽

Vol 67 (11) ◽

pp. 945-948 ◽

Cited By ~ 1

Author(s):

Djula Djilvesi ◽

Petar Vulekovic ◽

Tomislav Cigic ◽

Zeljko Kojadinovic ◽

Vladimir Papic ◽

...

Keyword(s):

Case Report ◽

Head Injury ◽

High Resolution ◽

Ct Scans ◽

Direct Impact ◽

Skull Base Fracture ◽

Therapeutic Procedures ◽

History Of ◽

Post Traumatic ◽

Transnasal Endoscopic Surgery

Introduction. A gunshot head injury, characterized by a huge intensity of mechanical force, in addition to the direct tissue damage at the location of direct impact, may cause a skull and skull base fracture, distant from the the point of direct impact, which could be further complicated by creating a communication between endocranium and nasal/paranasal cavities. Such cases pose a great diagnostic and therapeutic challenge for every clinician. Case report. The patient is presented with the history of a perforating gunshot head injury six years ago, with recurrent attacks of meningoencephalitis subsequently, without rhinorrhea. By using high resolution CT scans, previous traumatic skull injury was verified and a fissure in the frontoethmoidal region, far from the point of direct impact, was detected. The patient underwent transnasal endoscopic surgery, in order to seal the communication on skull basis. The patient did not suffer from meningoencephalitis during the next two years. Conclusion. In the cases with late occurrence of posttraumatic meningoencephalitis with no signs of rhinorrhea, a possibility of an existing communication between intracranial and nasal cavities should be considered, as well. By applying modern diagnostic and therapeutic procedures such communication should be precisely located and sealed.

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Diagnostic and Clinical Management of Skull Fractures in Children

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.194261 ◽

2016 ◽

Vol 6 ◽

pp. 47

Author(s):

Christoph Arneitz ◽

Maria Sinzig ◽

Günter Fasching

Keyword(s):

Hospital Stay ◽

Head Trauma ◽

Clinical Management ◽

Skull Fracture ◽

Neurological Symptoms ◽

Ct Scans ◽

Skull Fractures ◽

X Rays ◽

Minor Head Trauma ◽

The Mean

Objective: The indications of routine skull X-rays after mild head trauma are still in discussion, and the clinical management of a child with a skull fracture remains controversial. The aim of our retrospective study was to evaluate our diagnostic and clinical management of children with skull fractures following minor head trauma. Methods: We worked up the medical history of all consecutive patients with a skull fracture treated in our hospital from January 2009 to October 2014 and investigated all skull X-rays in our hospital during this period. Results: In 5217 skull radiographies, 66 skull fractures (1.3%) were detected. The mean age of all our patients was 5.9 years (median age: 4.0 years); the mean age of patients with a diagnosed skull fracture was 2.3 years (median age: 0.8 years). A total of 1658 children (32%) were <2 years old. A typical boggy swelling was present in 61% of all skull fractures. The majority of injuries were caused by falls (77%). Nine patients (14%) required a computed tomography (CT) scan during their hospital stay due to neurological symptoms, and four patients had a brain magnetic resonance imaging. Nine patients (14%) showed an intracranial hemorrhage (ICH; mean age: 7.3 years); one patient had a neurosurgery because of a depressed skull fracture. Nine patients (14%) were observed at our pediatric intensive care unit for a mean time of 2.9 days. The mean hospital stay was 4.2 days. Conclusions: Our findings support previous evidence against the routine use of skull X-rays for evaluation of children with minor head injury. The rate of diagnosed skull fractures in radiographs following minor head trauma is low, and additional CT scans are not indicated in asymptomatic patient with a linear skull fracture. All detected ICHs could be treated conservatively. Children under the age of 2 years have the highest risk of skull fractures after minor head trauma, but do not have a higher incidence of intracranial bleeding. Neuroobservation without initial CT scans is safe in infants and children following minor head trauma and CT scans should be reserved for patients with neurological symptoms.

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Review of postoperative CT and ultrasound for endovascular aneurysm repair using Talent stent graft: Can we simplify the surveillance protocol and reduce the number of CT scans?

Acta Radiologica ◽

10.1258/ar.2012.110291 ◽

2013 ◽

Vol 54 (1) ◽

pp. 54-58 ◽

Cited By ~ 11

Author(s):

Thomas Nyheim ◽

Lars Erik Staxrud ◽

L Rosen ◽

Carl Erik Slagsvold ◽

Gunnar Sandbæk ◽

...

Keyword(s):

Stent Graft ◽

Mixed Model ◽

Endovascular Aneurysm Repair ◽

Plain Film ◽

Ct Scans ◽

X Rays ◽

Time Sensitivity ◽

Surveillance Protocol ◽

Aneurysm Repair

Background Simplifying a postoperative surveillance protocol for endovascular aneurysm repair (EVAR) requires quality control comparing computerized tomography (CT) and ultrasound (US) results of abdominal aortic aneurysm (AAA) diameter measurements and endoleaks. Purpose To test if US is comparable to CT, then assess a simplified follow-up with our conventional surveillance to assess patient safety. Material and Methods During 2001-2006, data on 56 patients treated with Talent stent graft were prospectively registered. Median follow-up was 41.5 months (range, 2-94 months), with CT, US, and plain film abdomen X-rays (PFA) at 1, 6, and 12 months, then yearly. Bland-Altman plot was used to assess the agreement between CT and US measuring the AAA diameters and mixed model by the time effect to assess the difference in diameter over time. Sensitivity and specificity for detection of endoleaks by US, with CT as ‘gold standard’ were calculated. A simplified surveillance protocol with US/PFA at 6 and 8 weeks, CT/US/PFA at 1 year, and yearly US/PFA thereafter, was evaluated. CT was carried out when poor visibility, endoleak detected, AAA diameter increase (≥5 mm) on US or migration (≥10 mm) on PFA. This regime was compared with our conventional follow-up protocol. Results Diameter measurements on US appear comparable to CT with 91% specificity and 85% sensitivity for endoleaks detected by US. Using the simplified surveillance protocol no endoleaks, migrations, or endotension requiring treatment were overlooked. The simplified protocol generated 53 selective CT scans, avoiding approximately 144 CT scans. If further simplified by omitting the 1-year CT scan, one type II endoleak would be missed with a 1-year delay, eliminating a further 45 CT scans. Conclusion US appears comparable to CT in the follow-up of Talent stent grafts in our institution. The proposed simplified surveillance protocol seems safe and can lead to a significant reduction in the number of CT scans.

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