CT Scan in Intraventricular Hemorrhage

Neurosurgery ◽  
1978 ◽  
Vol 3 (1) ◽  
pp. 22-25 ◽  
Author(s):  
J.E. McCallum ◽  
Dolores LoDolce ◽  
Manfred Boehnke
Keyword(s):  
Intraventricular Hemorrhage ◽  
Arteriovenous Malformations ◽  
Clinical Course ◽  
The Other ◽  
Ct Scans ◽  
Midline Shift ◽  
Predicting Outcome ◽  
Time Of Admission ◽  
Neurologically Intact

Abstract Twenty-three adults who had evidence of intraventricular hemorrhage were identified, and their charts were reviewed. Thirteen patients died and 10 survived. Eleven of the 13 who died were hypertensive. All had severe neurological deficit and evidence of brain stem dysfunction at the time of admission and progressed rapidly to coma and death. Two of the survivors had periventricular arteriovenous malformations. They presented neurologically intact and remained so. The other eight survivors had a distinct clinical course. They presented with focal deficits and abnormalities of mental status. These persisted, and at follow-up 3 to 20 months later they all had profound deficits of recent memory and intellect, and none was capable of daily self-care. Computerized tomographic (CT) scans were not useful in predicting outcome. The presence of parenchymal clot, multiple chamber involvement, 3rd ventricular involvement, ventriculomegaly, and midline shift were seen in all groups. Illustrative examples are presented.

Neurologic Sequelae in the Survivors of Neonatal Intraventricular Hemorrhage

PEDIATRICS ◽  
1979 ◽  
Vol 64 (2) ◽  
pp. 233-237
Author(s):  
K. S. Krishnamoorthy ◽  
D. C. Shannon ◽  
G. R. DeLong ◽  
I. D. Todres ◽  
K. R. Davis
Keyword(s):  
Intraventricular Hemorrhage ◽  
The Other ◽  
Neurologic Outcome ◽  
Ct Scans ◽  
Brain Scan ◽  
Neurologic Sequelae ◽  
Ct Brain

We report our experience with the neurologic sequelae (at a mean follow-up of 24 months) among the 15 surviving infants who have had neonatal intraventricular hemorrhage (IVH) documented by computerized tomographic (CT) brain scan. Neurologically six infants (40%) are normal, six infants (40%) mildly impaired, and three infants (20%) moderate to severely impaired. The neurologic outcome correlated to the degree of hemorrhage seen in the CT scans when IVH was classified into four grades. None of the other neonatal factors examined showed significant correlation with the outcome.

Natural course of unoperated intracranial arteriovenous malformations: study of 50 cases

1989 ◽  
Vol 71 (6) ◽  
pp. 805-809 ◽  
Author(s):  
Youichi Itoyama ◽  
Syouzaburou Uemura ◽  
Yukitaka Ushio ◽  
Jun-Ichi Kuratsu ◽  
Nobuhito Nonaka ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Poor Prognosis ◽  
Clinical Course ◽  
Initial Symptom ◽  
Intracranial Arteriovenous Malformations ◽  
Good Clinical Outcome ◽  
Content Type ◽  
Initial Rupture ◽  
High Incidence

✓ The clinical course of 50 patients with conservatively treated intracranial arteriovenous malformations (AVM's) was followed, most of them for more than 5 years. The average follow-up period was 13.4 years. The initial symptom was intracranial bleeding in 29 patients (58%) and seizure in 15 patients (30%). Small and deep-seated AVM's were associated with a high incidence of bleeding; however, repeated hemorrhages were not necessarily indicative of a poor prognosis. Children younger than 15 years had a better prognosis than adults. There was no correlation between pregnancy and bleeding. In the hemorrhage group, the incidence of rebleeding was 6.9% in the 1st year after initial rupture, 1.91% per year after 5 years, and 0.92% per year after 15 years. The overall incidence of rebleeding was 34.5% in the hemorrhage group. Of the 50 patients, 37 (74%) had a good clinical outcome, four (8%) had a fair outcome, and four (8%) had a poor outcome; five patients died.

scholarly journals Computed tomography patterns predict clinical course of idiopathic pulmonary fibrosis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Byoung Soo Kwon ◽  
Jooae Choe ◽  
Kyung Hyun Do ◽  
Hee Sang Hwang ◽  
Eun Jin Chae ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Function ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Exercise Capacity ◽  
Clinical Course ◽  
Usual Interstitial Pneumonia ◽  
The Other ◽  
Hrct Patterns

Abstract Background A new clinical guideline for idiopathic pulmonary fibrosis (IPF) uses high-resolution computed tomography (HRCT) patterns for diagnostic purposes. However, it is unknown how they relate to the IPF clinical course. We aimed to investigate whether HRCT patterns could be used to predict lung function changes and survival in patients with IPF. Methods Clinical data were retrospectively reviewed in 337 patients with IPF (all biopsy-proven cases). HRCT patterns were classified according to the 2018 IPF diagnostic criteria. Results The median follow-up was 46.9 months. The mean age was 62.5 years, and 74.2% were men. Among the HRCT patterns, usual interstitial pneumonia (UIP), probable UIP, indeterminate for UIP, and an alternative diagnosis were identified in 163 (48.4%), 110 (32.6%), 33 (9.8%), and 31 (9.2%) patients, respectively. The indeterminate for UIP group showed higher lung function and exercise capacity and better prognosis than the other groups. They also had a lesser decline in lung function than the other groups during follow-up. In the multivariate Cox analysis, which was adjusted by age, smoking status, lung function, exercise capacity, and use of antifibrotic agents, indeterminate for UIP pattern was found to be an independent prognostic factor (hazard ratio 0.559, 95% confidence interval 0.335–0.933, P = 0.026). However, the probable UIP group had similar lung function changes and prognosis when compared the UIP group. Conclusions Our results suggest that indeterminate for UIP pattern on HRCT may predict a more favorable clinical course in patients with IPF, supporting the validity of the new IPF diagnostic guidelines.

scholarly journals Cyst Formation Following Radiosurgery for AVMs: Report of 3 Cases

2011 ◽  
Vol 38 (5) ◽  
pp. 734-740 ◽  
Author(s):  
Q. Al Hinai ◽  
D. Tampieri ◽  
L. Souhami ◽  
A. Sadikot ◽  
D. Sinclair ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Radiation Dosage ◽  
Clinical Presentation ◽  
Late Complication ◽  
Cyst Formation ◽  
The Other ◽  
Treatment Site ◽  
Long Term Follow Up

ABSTRACT:Background:Stereotactically-focused radiosurgery (SRS) for the treatment of arteriovenous malformations (AVM) has been in widespread use for over two decades. Over this timeframe the indications for treatment, standardization of radiation dosage, and the results expected from treatment have been elaborated. Less well known are the long-term complications associated with SRS. We report three patients who had SRS for the treatment of AVM who developed a cyst at the site of treatment as a late complication.Methods:From 201 patients treated by SRS for an AVM, three developed a cyst at the treatment site. Their clinical presentation, the characteristics of the AVMs and the treatment were reviewed, as well as similar cases gleaned from the literature.Results:Three women, aged 28-43 years, had an AVM treated by: craniotomy and clipping of arterial feeders followed by SRS, by craniotomy for resection followed by SRS or by endo vascular embolization and SRS. The patients did well following treatment but two of them developed a symptomatic and the other an asymptomatic cyst at the treatment site 3-19 years later. The symptomatic patients underwent marsupialization of the cyst and the other is under observation.Conclusion:Stereotactic radiosurgery is an established and safe treatment for patients with AVMs. Delayed cyst formation can occur many years after treatment and long term follow-up is indicated in patients whose AVM has been treated with SRS.

Occurrence of severe vasospasm following intraventricular hemorrhage from an arteriovenous malformation

1997 ◽  
Vol 87 (3) ◽  
pp. 436-439 ◽  
Author(s):  
Keiichiro Maeda ◽  
Hiroki Kurita ◽  
Tsuneo Nakamura ◽  
Masaaki Usui ◽  
Kazuo Tsutsumi ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intraventricular Hemorrhage ◽  
Arteriovenous Malformations ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
The Other ◽  
Content Type ◽  
Radiological Features ◽  
Internal Carotid Arteries ◽  
Fine Print

✓ The authors present two rare cases of severe cerebral vasospasm following the rupture of arteriovenous malformations (AVMs). Computerized tomography revealed intracerebral hemorrhage in the thalamus in one case and in the putamen in the other, both accompanied by cast formation of intraventricular clots without radiological evidence of subarachnoid hemorrhage. Initial angiograms showed arterial narrowing of the bilateral internal carotid arteries in the supraclinoid portion but failed to demonstrate an arteriovenous shunt. Subsequent angiograms clearly demonstrated the existence of an AVM. Radiological features and possible mechanisms are discussed.

Retrospective analysis of unstaged and staged Gamma Knife surgery with and without preceding embolization for the treatment of arteriovenous malformations

2008 ◽  
Vol 109 (Supplement) ◽  
pp. 57-64 ◽  
Author(s):  
Adam G. Back ◽  
Dennis Vollmer ◽  
Otto Zeck ◽  
Clive Shkedy ◽  
Peter M. Shedden
Keyword(s):  
Retrospective Study ◽  
Retrospective Analysis ◽  
Gamma Knife ◽  
Arteriovenous Malformations ◽  
Gamma Knife Surgery ◽  
Ct Scans ◽  
Treatment Modalities ◽  
Mr Images ◽  
Obliteration Rate

Object The authors conducted a retrospective study to examine data on rates of obliteration of arteriovenous malformations (AVMs) with use of various combinations of treatment modalities based on Gamma Knife surgery (GKS). The authors believe that this study is the first to report on patients treated with embolization followed by staged GKS. Methods The authors identified 150 patients who underwent GKS for treatment of AVMs between 1994 and 2004. In a retrospective study, 4 independent groups emerged based on the various combinations of treatment: 92 patients who underwent unstaged GKS, 28 patients who underwent embolization followed by unstaged GKS, 23 patients who underwent staged GKS, and 7 patients who underwent embolization followed by staged GKS. A minimum of 3 years of follow-up after the last GKS treatment was required for inclusion in the retrospective analysis. Angiograms, MR images, or CT scans at follow-up were required for calculating rates of obliteration of AVMs. Results Fifty-seven of 150 patients (38%) supplied angiograms, and overall obliteration was confirmed in 43 of these 57 patients (75.4%). An additional 37 patients had follow-up MR images or CT scans. The overall obliteration rate, including patients with follow-up angiograms and patients with follow-up MR images or CT scans, was 68 of 94 (72.3%). Patients who underwent unstaged GKS had a follow-up rate of 58.7% (54 of 92) and an obliteration rate of 75.9% (41 of 54). Patients who underwent embolization followed by unstaged GKS had a follow-up rate of 53.5% (15 of 28) and an obliteration rate of 60.0% (9 of 15). Patients who underwent staged GKS had a follow-up rate of 82.6% (19 of 23) and an obliteration rate of 73.7% (14 of 19). Patients who underwent embolization followed by staged GKS had a follow-up rate of 85.7% (6 of 7) and an obliteration rate of 66.7% (4 of 6). Conclusions Gamma Knife surgery is an effective means of treating AVMs. Embolization prior to GKS may reduce AVM obliteration rates. Staged GKS is a promising method for obtaining high obliteration rates when treating larger AVMs in eloquent locations.

A Clinico-Pathologic Study of Clear-Cell Hepatocellular Carcinoma

1987 ◽  
Vol 73 (4) ◽  
pp. 389-395 ◽  
Author(s):  
Riccardo A. Audisio ◽  
Luigia Bombelli ◽  
Luciano Lombardi ◽  
Salvatore Andreola
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Cells ◽  
Clinical Features ◽  
Ultrastructural Study ◽  
Lipid Droplets ◽  
Clear Cell ◽  
Clinical Course ◽  
The Other ◽  
Hepatocellular Carcinomas

We reviewed the pathologic and clinical features of 7 cases of clear-cell hepatocellular carcinomas. Tumor cells had a typical clear, empty cytoplasm due to prominent accumulation of glycogen and lipid droplets, as demonstrated by ultrastructural study in one of our cases. Follow-up of the 7 patients did not confirm the better prognosis of this tumor reported by other investigators. The clinical course of our cases was more unfavorable than that of the other 130 cases of usual hepatocellular carcinomas treated at this Institute.

Spinal cord arteriovenous malformations with significant intramedullary components

1983 ◽  
Vol 59 (3) ◽  
pp. 471-478 ◽  
Author(s):  
Philip Cogen ◽  
Bennett M. Stein
Keyword(s):  
Arteriovenous Malformations ◽  
The Other ◽  
Neurological Deficits ◽  
Content Type ◽  
Postoperative Course ◽  
Microsurgical Techniques ◽  
Spinal Arteriovenous Malformations ◽  
High Degree ◽  
Fine Print

✓ Few neurosurgeons have stressed the occurrence, manifestations, and resectability of intramedullary spinal arteriovenous malformations (AVM's). In six of 17 patients in the authors' series of operable spinal AVM's, the lesions had major intramedullary components. Three of these six patients presented with subarachnoid hemorrhage, and all had catastrophic neurological deficits which gradually improved. The hemorrhages appeared to originate from large venous varices lying adjacent to the intramedullary portion of the AVM. The mechanism explaining the sudden neurological deficit in the other three patients was presumed to be thrombosis within the venous varices associated with their AVM's. The reliability of the various radiographic procedures in identifying the intramedullary components of these AVM's is discussed. These malformations may be removed totally with a high degree of safety using microsurgical techniques. The postoperative course in this series of patients was gratifying in terms of improvement of neurological deficits. Postoperative angiography was not performed on all of these patients. However, the follow-up period averaged 5 years.

Radiographic Characteristics Fail to Predict Clinical Course after Subdural Electrode Placement

Neurosurgery ◽  
2006 ◽  
Vol 58 (1) ◽  
pp. 120-125 ◽  
Author(s):  
J Mocco ◽  
Ricardo J. Komotar ◽  
Amos K. Ladouceur ◽  
Brad E. Zacharia ◽  
Robert R. Goodman ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Course ◽  
Ct Scans ◽  
Motor Deficit ◽  
Speech Impairment ◽  
Midline Shift ◽  
Brain Functions ◽  
Significant Difference ◽  
Maximal Thickness ◽  
Subdural Electrode

Abstract OBJECTIVE: Subdural arrays of grid and strip electrodes are frequently used in epilepsy patients to localize the seizure focus and determine the location of critical brain functions via stimulation mapping. Postoperatively, the majority of patients with implanted subdural electrodes develop subacute extra-axial collections (EACs). Although conservative management is appropriate in most of these cases, occasionally patients manifest neurological symptoms that may necessitate reoperation for collection evacuation. Currently, there is little information available regarding the range of EAC size and the potential correlation between EAC size and symptom development. To facilitate treatment decision-making in postoperative subdural electrode patients, we reviewed and compared the computed tomographic (CT) features of postelectrode placement EACs in asymptomatic and symptomatic patients. METHODS: We retrospectively reviewed the medical records and CT scans of 22 consecutive patients who underwent craniotomy for placement of subdural grid and strip electrodes at Columbia University Medical Center. Medical records were reviewed for neurological complications from the time of grid placement until its removal. Each EAC was measured on CT for volume (% of total cranial volume), maximal thickness, and midline shift. One patient was excluded secondary to the development of an intracerebral hemorrhage. RESULTS: Thirteen of 21 patients remained asymptomatic or minimally symptomatic during their hospitalization, with only mild to moderate, intermittent, postoperative headaches. The remaining eight developed symptoms such as persistent and severe headache, transient motor deficit, or speech impairment. Two of these patients underwent reoperation for hematoma evacuation. EACs in asymptomatic patients had a mean volume, maximal thickness, and midline shift of 5.7%, 1.25 cm, and 0.33 cm, respectively. EACs in symptomatic patients had a mean volume, maximal thickness, and midline shift of 7.7%, 1.46 cm, and 0.5 cm, respectively. Differences between maximal thickness and midline shift did not approach statistical significance. Despite this, the difference between the mean volume of symptomatic and asymptomatic EACs was statistically significant (P = 0.04). CONCLUSION: The conventional methods of midline shift and maximal thickness for assessing EAC size did not adequately differentiate symptomatic and asymptomatic subdural electrode patients with EACs. Although total volume calculation using digital planimetric analysis demonstrated a statistically significant difference, we found no clear threshold volume that correlated with clinical course. Therefore, the appearance of EACs on CT scans is of limited use in predicting the development of symptoms and possible postoperative complications after subdural grid placement. Clinical judgment must guide management and determine the potential need for reoperation.

scholarly journals Primary Intraventricular Hemorrhage in Pediatric Patients: Causes, Characteristics, and Outcomes

2019 ◽  
Author(s):  
Rui Guo ◽  
Chaofeng Fan ◽  
Ruiqi Chen ◽  
Zhiyuan Yu ◽  
Rui Tian ◽  
...  
Keyword(s):  
Intraventricular Hemorrhage ◽  
Arteriovenous Malformations ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Unfavorable Outcome ◽  
Rare Type ◽  
Long Time ◽  
The Mean ◽  
Short Time

Abstract Background: Primary intraventricular hemorrhage is a rare type of stroke and little is known its causes, characteristics and outcomes in children. Methods: We retrospectively analyzed the clinical characteristics of patients aged one month to 21 years during seven consecutive years with primary intraventricular hemorrhage. Primary intraventricular hemorrhage was defined as bleeding confined to the ventricular system without parenchymal or subarachnoid hemorrhage involved. Results: Of the included eighteen patients, 55.6% were female, and the mean age was 13.8 ± 6.0 years. The most common symptoms on presentation were headache (77.8%) and vomiting (33.3%). Fifteen patients (83.3%) were diagnosed with known etiologies, including arteriovenous malformations (66.7%), Moyamoya disease (11.1%), and aneurysms (5.6%). Idiopathic PIVH was diagnosed in only 3 patients (16.7%). Fifteen patients (83.3%) underwent surgical intervention, and 3 patients (16.7%) received conservative treatment. Four patients (28.6%) had an unfavorable outcome at discharge and unfavorable was observed in 3 patients (16.7%) at the 3-month follow-up. Higher Graeb score was associated with an unfavorable outcome both in short-time and long-time follow-up. Conclusions: Most primary intraventricular hemorrhage patients were diagnosed with arteriovenous malformations in the pediatric population. Specific surgical treatment of underlying etiologies should be required to increase clinical improvement. The children with higher Graeb score at admission tended to have poor early and late outcome. Keywords: Primary intraventricular hemorrhage; pediatric; surgery; vascular disorders.

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