Cerebral contrast staining mimicking parenchymal haemorrhage in a stroke patient

2020 ◽  
Vol 13 (12) ◽  
pp. e236400
Author(s):  
Elvin Yuan Ting Lim ◽  
Saravana Kumar Swaminathan
Keyword(s):  
Ct Scan ◽  
Middle Cerebral Artery ◽  
Signs And Symptoms ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Iodinated Contrast ◽  
Acute Infarct ◽  
The Right ◽  
The Brain

A 75-year-old female patient presented with signs and symptoms of a right hemispheric syndrome. A CT scan of the brain with angiogram showed an acute infarct in the right middle cerebral artery (MCA) territory secondary to thromb-occlusion of the M1 segment of the right MCA. A follow-up CT scan 2 weeks later showed a large hyperdense region in the infarcted area. With the aid of a dual-energy CT scan, this was eventually shown to be due to contrast staining from an earlier administration of iodinated contrast on the same day, rather than frank haemorrhagic conversion of the recent right MCA infarct.

scholarly journals RONC-26. A CASE OF RADIATION NECROSIS OF THE CEREBELLUM 16 YEARS AFTER CHEMORADIOTHERAPY FOR MEDULLOBLASTOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii460-iii460
Author(s):  
Mayuko Miyata ◽  
Masahiro Nonaka ◽  
Akio Asai
Keyword(s):  
Radiation Necrosis ◽  
Tumor Resection ◽  
Pathological Examination ◽  
Secondary Cancer ◽  
Brain Necrosis ◽  
Cerebellar Medulloblastoma ◽  
Cerebellar Peduncle ◽  
The Right ◽  
The Brain

Abstract BACKGROUND If new lesions are observed during follow-up of the malignant tumor after treatment, it is difficult to distinguish whether the tumor is a recurrent lesion, secondary cancer, or radiation necrosis of the brain. We have encountered a patient with symptomatic radiation necrosis of the cerebellum 16 years after treatment of medulloblastoma. CASE PRESENTATION: A 24-year-old man who had received a tumor resection and chemoradiotherapy for cerebellar medulloblastoma at the age of 8 presented with dizziness. For the past 16 years, there was no recurrence of the tumor. He subsequently underwent MRI scan, and T1-Gd image showed enhanced lesion in the right cerebellar peduncle. Cerebrospinal fluid cytology analysis was negative for tumor. We suspected tumor reccurence or secondary cancer, and performed lesion biopsy. The result of the pathological examination was radiation necrosis of the cerebellum. DISCUSSION: The interval of radiation necrosis of the brain and radiotherapy can vary from months to more than 10 years. So, whenever a new lesion is identified, radiation brain necrosis must be envisioned. According to guidelines in Japan, there is no absolute examination for discriminating tumor recurrence from radiation brain necrosis and diagnosis by biopsy may be required. CONCLUSION We experienced a case of symptomatic radiation necrosis of the cerebellum 16 years after treatment. In patients showing new lesion after long periods of time, the possibility of radiation necrosis to be considered.

Abstract TP291: Hematoma Retraction and Perihematoma Hypodensity in Neutral Brain Model of Intracerebral Hemorrhage

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Shahram Majidi ◽  
Basit Rahim ◽  
Sarwat I Gilani ◽  
Waqas I Gilani ◽  
Malik M Adil ◽  
...  
Keyword(s):  
Biological Activity ◽  
Intracerebral Hemorrhage ◽  
Ct Scan ◽  
Early Period ◽  
Ct Scans ◽  
Hematoma Expansion ◽  
Human Cadaver ◽  
Fresh Blood ◽  
The Right

Background: The temporal evolution of intracerebral hematomas and perihematoma edema in the ultra-early period on computed tomographic (CT) scans in patients with intracerebral hemorrhage (ICH) is not well understood. We aimed to investigate hematoma and perihematoma changes in “neutral brain” models of ICH. Methods: One human and 6 goat cadaveric heads were used as “neutral brains” to provide physical properties of the brain without any biological activity or new bleeding. ICH was induced by slow injection of 4 ml of fresh blood into the right basal ganglia of the goat brains. Similarly, 20 ml of fresh blood was injected deep into the white matter of the human cadaver head in each hemisphere. Serial CT scans of the heads were performed at 0, 1, 3, and 5 hours after inducing ICH. Analyze software (AnalyzeDirect, Overland Park, KS) was used to measure hematoma and perihematoma hypodensity volumes in the baseline and follow up CT scans. Results: The initial hematoma volumes of 11.6 ml and 10.5 ml in the right and the left hemispheres of the human cadaver brain gradually decreased to 6.6 ml and 5.4 ml at 5 hours, showing 43% and 48% retraction of hematoma, respectively. The volume of the perihematoma hypodensity in the right and left hemisphere increased from 2.6 ml and 2.2 ml in the 1 hour follow up CT scans to 4.9 ml and 4.4 ml in the 5 hour CT scan, respectively. Hematoma retraction was also observed in all six ICH models in the goat brains. The mean ICH volume in the goat heads was decreased from 1.49 ml in the baseline CT scan to 1.01 ml in the 5 hour follow up CT scan showing 29.6% hematoma retraction. Perihematoma hypodensity was visualized in 70% of ICH in goat brains, with an increasing mean hypodensity volume of 0.4 ml in the baseline CT scan to 0.8 ml in the 5 hour follow up CT scan. Conclusion: Our study demonstrated that substantial hematoma retraction and perihematoma hypodensity occurs in intracerebral hematomas in the absence of any new bleeding or biological activity of the surrounding brain. Such observations suggest that active bleeding is underestimated in patients with no or small hematoma expansion and our understanding of perihematoma hypodesity needs to be reconsidered.

scholarly journals SENTUHAN KASIH IBU, UPAYA STIMULASI TUMBUH KEMBANG ANAK DENGAN PIJAT BAYI PADA ANAK USIA 0-3 TAHUN DI DESA SELEBUNG KETANGGA, KECAMATAN KERUAK KABUPATEN LOMBOK TIMUR

2020 ◽  
Vol 4 (1) ◽  
pp. 356
Author(s):  
Catur Esty Pamungkas ◽  
Aulia Amini ◽  
Cyntiya Rahmawati
Keyword(s):  
Community Service ◽  
Motor Development ◽  
Blood Circulation ◽  
Infant Massage ◽  
Post Test ◽  
Good Productivity ◽  
The Right ◽  
The Brain ◽  
Stimulation Of

ABSTRAKBayi dapat tumbuh dan berkembang dengan baik jika kebutuhan dasarnya terpenuhi, yaitu  asah, asih dan asuh. Kebutuhan asah adalah kebutuhan akan stimulasi dini. Pemberian stimulasi dini yang sesuai akan memungkinkan terbentuknya etika, kepribadian yang baik, kecerdasan, kemandirian, keterampilan dan produktivitas yang baik. Efektifitas pijat bayi memberikan manfaat pada perkembangan motorik sangat baik pada anak usia 8-28 hari dibandingkan dengan anak yang tidak diberikan stimulasi pijat bayi (Rizki, 2017). Melalui pemijatan peredaran darah akan lancar, Salah satu zat penting yang dibawa adalah oksigen. Terpenuhinya oksigen diotak secara cukup membuat konsentrasi dan kesiagaan bayi semakin baik(Sembiring, 2017). Solusi permasalahan yang ditawarkan yaitu “Sentuhan Kasih Ibu” Upaya Stimulasi Tumbuh Kembang anak dengan Pijat Bayi yang dilakukan Pada Anak Usia 0-3 Tahun di Desa Selebung Ketangga di Kecamatan Keruak Kabupaten Lombok Timur. Tujuan pengabdian ini memberikan informasi bagi masyarakat terutama orang tua mengenai manfaat setiap langkah dari pijat bayi. Tim PKMS akan memberikan pelatihan langsung kepada ibu yang akan dipraktikkan oleh narasumber yang berpengalaman, memiliki bidang ilmu yang sesuai dan telah mendapatkan pelatihan pijat bayi sebelumnya, sehingga setiap informasi diberikan oleh orang yang tepat. Setelah diberikan pelatihan pijat bayi tersebut, diharapkan ibu dapat mempraktikan sendiri pijat bayi di rumah.Jumlah responden yang mengikuti kegiatan ini sebanyak 32 balita. Hasil pengadian didapatkan terbanyak responden 12-24 sebanyak 19 balita (59,4%). Hasil pre test didapatkan 23 responden memiliki pengetahuan kurang dan post test sebagian besar pengetahuan cukup sebanyak 18 responden. Hasil follow up kemampuan pijat bayi didapatkan 24 reponden mampu melakukan pijat bayi dengan benar. Kata kunci: stimulasi tumbuh kembang; bayi; pijat bayi. ABSTRACTBabies can grow and develop well if their basic needs, which are teasers, love and foster. The need for sharpening is the need for early stimulation. Providing first inspiration appropriate will enable the formation of ethics, a good personality, intelligence, independence, skills and good productivity. The effectiveness of baby massage provides benefits to motor development is very good in children aged 8-28 days compared with children who do not give stimulation of baby massage (Rizki, 2017). Through massage, the blood circulation will be smooth. One of them the essential substance carried is oxygen. Fulfilment of oxygen in the brain is sufficient to make the baby's concentration and alertness are getting better (Sembiring, 2017). The solution to the problem offered is the "Touch of Mother's Love" Efforts to Stimulate Child Development with Infant Massage which was carried out on children aged 0-3 years in Selebung Ketangga Village in Keruak District East Lombok Regency. The purpose of this service is to provide information for the community, especially parents, regarding the benefits of every step of baby massage. The Stimulus Community Service Team (PKMS) will provide training directly to the mother who will be practised by experienced speakers who have fields science according to the training and baby massage before, so every information given by the right person. After being given the baby massage training, it is hoped that the mother can practicing baby massage at home on their own. The number of respondents who participated in this activity was 32 toddler. The results obtained were the most respondents 12-24 as many as 19 toddlers (59.4%). Pre results test found 23 respondents have less knowledge and most of the post-test sufficient knowledge of 18 respondents. The follow-up results of the infant massage ability were obtained 24 respondents are able to massage the baby properly. Keywords: growth and development stimulation; baby; baby massage.

Spontaneous resolution of invasive cerebral aspergillosis following partial resection in a medically untreated infant

2012 ◽  
Vol 10 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Sumit Thakar ◽  
Yasha T. Chickabasaviah ◽  
Alangar S. Hegde
Keyword(s):  
Emergency Services ◽  
Mass Effect ◽  
Cerebral Hemiatrophy ◽  
Right Cerebral Hemisphere ◽  
History Of ◽  
Subcortical Regions ◽  
The Right ◽  
Mri Study ◽  
The Brain

Invasive craniocerebral aspergillosis, often encountered in an immunocompromised setting, is almost uniformly fatal despite radical surgical and medical management, and is frequently a necropsy finding. The authors report a unique, self-resolving clinical course of this aggressive infection in a 10-month-old infant. The infant was brought to the emergency services in altered sensorium with a 1-week history of left-sided hemiparesis, excessive irritability, and vomiting. An MRI study of the brain revealed multiple, heterogeneously enhancing lesions in the right cerebral hemisphere with mass effect. The largest lesion in the frontotemporal cortical and subcortical regions was decompressed on an emergent basis. Histopathological findings were suggestive of invasive aspergillosis, although there was no evidence of the infection in the lungs or paranasal sinuses. Computed tomography–guided aspiration of the remaining lesions and follow-up antifungal therapy were recommended. The parents, however, requested discharge without further treatment. The child was seen at a follow-up visit 3 years later without having received any antifungal treatment. Imaging showed resolution of the infection and features of Dyke-Davidoff-Masson syndrome (cerebral hemiatrophy). This report of invasive cerebral aspergillosis resolving without medical therapy is the first of its kind. Its clinicoradiological aspects are discussed in light of previously reported cases.

scholarly journals Gouty arthritis: decision-making following dual-energy CT scan in clinical practice, a retrospective analysis

2018 ◽  
Vol 37 (7) ◽  
pp. 1879-1884 ◽  
Author(s):  
M. Gamala ◽  
S. P. Linn-Rasker ◽  
M. Nix ◽  
B. G. F. Heggelman ◽  
J. M. van Laar ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Ct Scan ◽  
Retrospective Analysis ◽  
Gouty Arthritis ◽  
Dual Energy ◽  
Dual Energy Ct

Surviving a Self-inflicted Transorbital Pen Intrusion to the Cerebellum: Case Report

2021 ◽  
Author(s):  
David Breuskin ◽  
Ralf Ketter ◽  
Joachim Oertel
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Foreign Bodies ◽  
Routine Procedure ◽  
Low Velocity ◽  
Foreign Objects ◽  
Surgical Exposure ◽  
The Right ◽  
The Brain ◽  
Do So

Abstract Background Although intracranial traumas by penetrating foreign objects are not absolute rarities, the nature of trauma, the kind of object, and its trajectory make them a one of a kind case every time they occur. Whereas high-velocity traumas mostly result in fatalities, it is the low-velocity traumas that demand an individualized surgical strategy. Methods We present a case report of a 33-year-old patient who was admitted to our department with a self-inflicted transorbital pen injury to the brain. The authors recall the incident and the technique of the pen removal. Results Large surgical exposure of the pen trajectory was considered too traumatic. Therefore, we opted to remove the pen and have an immediate postoperative computed tomography (CT) scan. Due to its fragility, the pen case could only be removed with a screwdriver, inserted into the case. Post-op CT scan showed a small bleeding in the right peduncular region, which was treated conservatively. The patient was transferred back to intensive care unit and woken up the next day. She lost visual function on her right eye, but suffered from no further neurologic deficit. Conclusion Surgical management of removal of intracranial foreign bodies is no routine procedure. Although some would favor a large surgical exposure, we could not think of an approach to do so without maximum surgical efforts. We opted for a minimal surgical procedure with immediate CT scan and achieved an optimal result. We find this case to be worth considering when deciding on a strategy in the future.

scholarly journals Incarcerated Lumbar Hernia Complicated by Retroperitoneal Pseudoaneurysm 50 Years after Resection and Radiation Therapy of a Sarcoma

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Oluwatobi Onafowokan ◽  
Dabanjan Bandyopadhyay ◽  
Dale Johnson ◽  
Hugo J. R. Bonatti
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Ct Scan ◽  
Late Complication ◽  
Abdominal Hernia ◽  
Emergency Laparotomy ◽  
Incisional Hernias ◽  
History Of ◽  
The Right

Background. Lumbar hernias are rare abdominal hernias. Surgery is the only treatment option but remains challenging. Posterior incisional hernias are even rarer especially with incarceration of intra-abdominal contents.Case Presentation. A 68-year old female presented with a 3-day history of worsening acute abdominal pain and distension, with multiple episodes of emesis. A CT scan indicated a large incarcerated posterolateral abdominal hernia. The patient had a history of resection of a sarcoma on her back as a child and also received chemotherapy and radiation. During emergency laparoscopy, a hemorrhagic small bowel segment incarcerated in the hernia was reduced and resected, and the distended small bowel was decompressed. An elective hernia repair was scheduled. After temporary clinical improvement, the patient again developed abdominal pain, distention, and emesis. During emergency laparotomy, a large hematoma in the right flank was found and partially evacuated. The right colon was mobilized out of the hernia and the duodenum was kocherized. A20×20cm BIO-A mesh was placed on top of the Gerota fascia and cranially tucked under liver segment VI. Anteriorly, the mesh was fixated with absorbable tacks. The duodenum and colon were placed into the mesh pocket. A postoperative CT scan identified a 2 cm pseudoaneurysm of a side branch of a lumbar artery, and the bleeding source was embolized. The postoperative course was complicated byClostridium difficile-associated colitis, but ultimately, the patient recovered fully. At 6-month follow-up, there was no evidence for a recurrent hernia.Discussion. There is a paucity of literature concerning lumbar incisional hernias. Repair with bioabsorbable mesh seems feasible, but longer follow-up is necessary as the mesh was placed in an unusual fashion due to the retroperitoneal hematoma. The exact cause of the hemorrhage is unclear and may have been caused during the initial incarceration, during surgery, or may be a late complication of her previous radiation.

E84 Identification of Acid Uric Stones with dual energy CT Scan

2015 ◽  
Vol 14 (4) ◽  
pp. 62
Author(s):  
Argáiz R. Castañeda ◽  
R. Salvador-Izquierdo ◽  
P. Luque-Galvez ◽  
B. Paño-Brufau ◽  
A. Ciudin ◽  
...  
Keyword(s):  
Ct Scan ◽  
Dual Energy ◽  
Dual Energy Ct

Convexity Meningioma Presenting as Postpartum Eclampsia

2003 ◽  
Vol 33 (1) ◽  
pp. 53-54 ◽  
Author(s):  
Bello B Shehu ◽  
Nasiru J Ismail
Keyword(s):  
Early Diagnosis ◽  
The Body ◽  
History Of ◽  
Neurological Features ◽  
The Right ◽  
The Brain ◽  
Tomography Scan ◽  
Progressive Weakness ◽  
In Pregnancy

A 37-year-old woman, Para 5+0 presented with a 1 year history of recurrent convulsions and progressive weakness of the right side of the body. She had been treated for postpartum eclampsia in her last delivery but symptoms recurred 3 months later. Evaluation including computerized tomography scan of the brain suggested a parieto-temporal meningioma, which was completely excised at craniotomy. Histology confirmed this to be a meningioma. The patient was well at 8 months of follow up. The growth of meningiomas may increase during pregnancy due to presence of receptors for progestational hormones in the tumour and the meningioma may become symptomatic in pregnancy, presenting as eclampsia. Close follow up of patients with eclampsia is necessary to identify neurological features that may lead to a diagnosis of meningioma. Early diagnosis is essential if a good outcome is to be ensured.

scholarly journals Fracture of the coronoid and pterygoid processes by firearms: case report

2007 ◽  
Vol 18 (2) ◽  
pp. 168-170 ◽  
Author(s):  
David Moraes de Oliveira ◽  
Ricardo José de Holanda Vasconcellos ◽  
José Rodrigues Laureano Filho ◽  
Rafael Vago Cypriano
Keyword(s):  
Ct Scan ◽  
Speech Therapy ◽  
Clinical Signs ◽  
Mouth Opening ◽  
Parotid Region ◽  
Comminuted Fracture ◽  
3D Ct Scan ◽  
The Face ◽  
The Right

A rare case of fracture of the coronoid and the pterygoid process caused by firearms is described. A 28-year-old male was hit by a bullet in the face, resulting in restricted mouth opening, difficulty in chewing and pain when opening the mouth. Clinical examination revealed a perforating wound in the right parotid region and a similar wound on the left side of the same region. A CT scan showed comminuted fracture of the left coronoid process and bilateral comminuted fracture of the pterygoid processes. Treatment was conservative, speech therapy was conducted and it was successful. Details of the clinical signs, radiology (3D-CT scan), treatment and follow-up are presented.

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