Postoperative Extradural Hematomas: Computed Tomographic Survey of 1105 Intracranial Operations

Neurosurgery ◽  
1986 ◽  
Vol 19 (4) ◽  
pp. 589-593 ◽  
Author(s):  
Akira Fukamachi ◽  
Hidehito Koizumi ◽  
Yoshishige Nagaseki ◽  
Hideaki Nukui
Keyword(s):  
Brain Tumor ◽  
Postoperative Period ◽  
Ventricular Dilatation ◽  
Systemic Hypertension ◽  
Intracerebral Hematoma ◽  
Causal Factors ◽  
Computed Tomographic ◽  
The Brain ◽  
Shunting Procedure ◽  
Ventricular Shunting

Abstract We reviewed the computed tomographic findings after 1055 intracranial operations to determine the incidence of postoperative extradural hematomas. There were 11 medium and 5 large hematomas after 1055 operations (1.0%). Ten of the 16 hematomas were operated upon (10/1055, 0.9%). Four of the 10 hematomas were seen after 278 brain tumor removals (1.4%), another four after 190 aneurysmal operations (2.1%), one after 14 intracerebral hematoma removals (7.1%), and the last one after 251 ventricular shunting or drainage procedures (0.4%). In 4 of the 10 operated hematomas, sites were regional, in five sites were adjacent, and in one the site was distant. All of the five adjacent hematomas extended downward from a lower rim of the operative locus. Causes were analyzed in the three types of the hematomas. In case of the regional hematomas, the causes were incomplete hemostasis of the dura mater or the bone in all four patients, nonperformance of central stay sutures in three, systemic hypertension in one, and hypofibrinogenemia in one. In the adjacent hematomas, we could find dural separation at an edge of craniotomy in all five patients, abrupt collapse of the brain in all, ventricular dilatation in two, and systemic hypertension during immediate postoperative period in two. In one distant hematoma, ventricular dilatation and ventricular shunting procedure were themselves thought to be the causal factors.

The prognostic importance of tumor size in malignant gliomas: a computed tomographic scan study by the Brain Tumor Cooperative Group.

1988 ◽  
Vol 6 (2) ◽  
pp. 338-343 ◽  
Author(s):  
J R Wood ◽  
S B Green ◽  
W R Shapiro
Keyword(s):  
Brain Tumor ◽  
Tumor Size ◽  
Residual Tumor ◽  
Study Group ◽  
Karnofsky Performance Score ◽  
Cooperative Group ◽  
Computed Tomographic ◽  
Prognostic Importance ◽  
The Difference ◽  
The Brain

The prognostic importance of tumor size was studied in 510 patients with malignant glioma (80% with glioblastoma multiforme) in the Valid Study Group of Study 80-01 of the Brain Tumor Study Group (now the Brain Tumor Cooperative Group [BTCG]). The endpoint was length of survival from randomization, which occurred within 3 weeks of definitive surgery. Following randomization, patients were scheduled to receive radiotherapy (RT) (6,020 cGy) during a 7-week period, along with continuing courses of chemotherapy. Computed tomographic (CT) scan information was available for 124 patients preoperatively, 300 patients postoperatively (preradiation), and 218 patients 9 weeks post-RT (+/- 3 weeks). Tumor size was determined as area (length x width) on the contrast-enhanced scan and survival was compared by log rank statistics. Preoperative tumor area was unrelated to survival (P = .48), but postoperative area was significantly prognostic (P less than .0001); the smaller the residual tumor, the longer the patient lived. Patients with a 75% or greater resection, as determined by measuring the difference between the preoperative and the postoperative scans, tended to have better survival, but the difference was not significant (P = .16). The post-RT area was strongly related to survival (P less than .00001). The percent change in area between the pre- and post-RT scans was also prognostic. Tumor size was of prognostic importance independent of the other known prognostic variables: age, Karnofsky performance score, and whether the tumor was glioblastoma or anaplastic astrocytoma. We conclude that the amount of tumor remaining after surgery is an important baseline variable at the start of RT, and that the tumor size 9 weeks following RT is also prognostic. Surgical resection is most important when it leaves the least amount of residual tumor.

Circulatory disturbances and changes in body temperature during anesthesia in brain surgery

1986 ◽  
Vol 67 (3) ◽  
pp. 194-195
Author(s):  
F. N. Kazantsev ◽  
E. Kh. Kamalov
Keyword(s):  
Nitrous Oxide ◽  
Brain Tumor ◽  
Body Temperature ◽  
Postoperative Period ◽  
Brain Surgery ◽  
Central Hemodynamics ◽  
Surgical Interventions ◽  
Balanced Anesthesia ◽  
The Brain ◽  
Circulatory Disturbances

To assess the adequacy of anesthetic protection during surgical interventions on the brain and in the postoperative period, it is necessary to monitor the central hemodynamics and body temperature regime. Therefore, we performed such control in 52 patients aged from 17 to 60 years old during the operative interventions on the brain under the conditions of intravenous balanced anesthesia with the use of sodium oxybutyrate or nitrous oxide and during 14-16 days in the postoperative period. All patients underwent bone-plastic craniotomy with opening of the dura mater. In 32 patients a brain tumor was removed, in 20 patients a subdural hematoma and cerebral detritus were removed.

scholarly journals Head Trauma in Hemophilia: Value of Computer Tomography of The Brain in Localizing Multiple Hematomas

1977 ◽  
Author(s):  
D. Green ◽  
P. Weinberg ◽  
L. Cerullo ◽  
D. McLone
Keyword(s):  
Head Trauma ◽  
Intracerebral Hematoma ◽  
Computed Tomographic ◽  
Cranial Trauma ◽  
Post Operative Period ◽  
Subdural Hematomas ◽  
Neurological Defect ◽  
Ct Brain ◽  
Burr Holes ◽  
The Brain

A 20 year old man with classical hemophilia (Factor VIII, 3%) was found unconscious in an alley after being struck on the head with a baseball bat. He transiently regained consciousness in the Emergency Room, but then became comatose and developed a right 3rd nerve palsy. He was immediately given AHF concentrate, 50 units per Kg, and had a computed tomographic (CT.) brain scan which revealed bilateral fronto-parietal subdural hematomas. These were removed through burr-holes and a right fronto-parieta1 craniotomy. He was maintained on 12-hourly doses of AHF concentrate, 50 u/per Kg, and did well for the first 3 post-operative days. Signs of increasing intracranial pressure then developed, and a repeat CT scan disclosed a right intracerebral hematoma. This was surgically evacuated and the remainder of his post-operative course was uneventful. He was discharged after 6 weeks of hospitalization with no residual neurological defect. A second patient, seen 6 years earlier for subdural hematomas following cranial trauma, also had evidence of deterioration in the early post-operative period. At that time, C.T. scans were not available, and the site of the new hematoma was not established. Although the patient recovered, there was a severe residual neurologic defect. Our experiences indicate that C.T. scans of the brain are valuable adjuncts in the management of head trauma in hemophilia, and, when combined with vigorous neurosurgical intervention, offer an improved prognosis.

Results of Stereotactic Aspiration in 175 Cases of Putaminal Hemorrhage

Neurosurgery ◽  
1989 ◽  
Vol 24 (6) ◽  
pp. 814-819 ◽  
Author(s):  
Hiroshi Niizuma ◽  
Yukihiko Shimizu ◽  
Tsutomu Yonemitsu ◽  
Nobukazu Nakasato ◽  
Jiro Suzuki
Keyword(s):  
Intracerebral Hematoma ◽  
Entire Series ◽  
Stereotactic Aspiration ◽  
Computed Tomographic ◽  
Consciousness Level ◽  
Therapeutic Results ◽  
Putaminal Hemorrhage ◽  
Minimal Invasion ◽  
The Brain ◽  
Definite Role

Abstract Believing that improved therapeutic results in cases of intracerebral hematoma might be obtained by minimal invasion of the brain, we used computed tomographic-guided stereotactic aspiration in 175 of 241 patients with putaminal hemorrhage. These patients, who were treated 6 or more hours after onset, had hematomas larger than 8 ml and were unable to raise an arm and/or leg on the affected side. Craniotomy was performed in 15 other patients, most of whom were brought to the hospital with large hematomas within 6 hours of onset. The remaining patients either had mild deficits of consciousness (33 patients) or severe deficits and/or were elderly (18 patients) and were treated conservatively. Thirteen patients (7.4%) showed rebleeding after stereotactic aspiration (6 instances of major and 7 instances of minor rebleeding). Craniotomy and removal of the hematoma were required in three of these patients. Aspiration should be avoided in patients who have a tendency for bleeding, even if mild, because rebleeding occurred in 6 of 23 such patients (26%) in these study. The consciousness level improved in 66 patients (38%), was unchanged in 103 patients (59%), and was worse in 6 patients (3%) 1 week postoperatively. Motor function of the arm improved in 55 patients (31%) and was worse in 23 patients (14%). Six months after surgery, the results for the 175 patients who underwent stereotactic aspiration were: 19% excellent, 32% good, 35% fair, 7% poor, 6% dead, and 1% unknown. For the entire series of 241 patients, the results were: 24% excellent, 26% good, 31% fair, 7% poor, 11% dead, and 1% unknown. These results seem to indicate that stereotactic aspiration can play a definite role in the treatment of spontaneous intracerebral hematoma.

Communicating Hydrocephalus in Adults: Prediction of Outcome after Ventricular Shunting Procedures

Neurosurgery ◽  
1990 ◽  
Vol 26 (4) ◽  
pp. 655-660 ◽  
Author(s):  
Edward C. Benzel ◽  
Allen L. Pelletier ◽  
Pamela G. Levy
Keyword(s):  
High Pressure ◽  
Communicating Hydrocephalus ◽  
Ventricular Enlargement ◽  
Prediction Of Outcome ◽  
Additional Information ◽  
Computed Tomographic ◽  
Preoperative Diagnostic ◽  
Clinical Triad ◽  
Shunting Procedure ◽  
Ventricular Shunting

Abstract A series of adult patients with idiopathic hydrocephalus in whom shunts were placed are presented. Preoperative diagnostic and prognostic criteria were evaluated. Findings on computed tomographic scans (significant ventricular enlargement, the absence of gyral atrophy, and the absence of sylvian fissure enlargement) and the clinical triad associated with hydrocephalus in adults (dementia, ataxia, and especially incontinence of urine) all contributed individually and in combination to the diagnosis of hydrocephalus that could be corrected by surgery. The use of radionucleotide cisternography did not add any additional information. Its use as a diagnostic or prognostic aid is, therefore, suspect. The use of high-pressure shunting systems for the initial shunting procedure is emphasized.

A Survey on Detection and Classification of Brain Tumor Using Image Processing Techniques

2020 ◽  
pp. 967-973
Author(s):  
V. Deepika ◽  
T. Rajasenbagam
Keyword(s):  
Image Processing ◽  
Brain Tumor ◽  
Soft Tissues ◽  
Tumor Detection ◽  
Tumor Classification ◽  
Normal Brain ◽  
Image Processing Techniques ◽  
Normal Brain Function ◽  
Processing Techniques ◽  
The Brain

A brain tumor is an uncontrolled growth of abnormal brain tissue that can interfere with normal brain function. Although various methods have been developed for brain tumor classification, tumor detection and multiclass classification remain challenging due to the complex characteristics of the brain tumor. Brain tumor detection and classification are one of the most challenging and time-consuming tasks in the processing of medical images. MRI (Magnetic Resonance Imaging) is a visual imaging technique, which provides a information about the soft tissues of the human body, which helps identify the brain tumor. Proper diagnosis can prevent a patient's health to some extent. This paper presents a review of various detection and classification methods for brain tumor classification using image processing techniques.

Novel Phospholipid-Based Labrasol Nanomicelles Loaded Flavonoids for Oral Delivery with Enhanced Penetration and Anti-Brain Tumor Efficiency

2020 ◽  
Vol 17 (3) ◽  
pp. 229-245
Author(s):  
Gang Wang ◽  
Junjie Wang ◽  
Rui Guan
Keyword(s):  
Drug Delivery ◽  
Brain Tumor ◽  
Oral Delivery ◽  
Safe Delivery ◽  
Drug Delivery Vehicles ◽  
Therapeutic Benefits ◽  
Delivery Vehicles ◽  
The Brain

Background: Owing to the rich anticancer properties of flavonoids, there is a need for their incorporation into drug delivery vehicles like nanomicelles for safe delivery of the drug into the brain tumor microenvironment. Objective: This study, therefore, aimed to prepare the phospholipid-based Labrasol/Pluronic F68 modified nano micelles loaded with flavonoids (Nano-flavonoids) for the delivery of the drug to the target brain tumor. Methods: Myricetin, quercetin and fisetin were selected as the initial drugs to evaluate the biodistribution and acute toxicity of the drug delivery vehicles in rats with implanted C6 glioma tumors after oral administration, while the uptake, retention, release in human intestinal Caco-2 cells and the effect on the brain endothelial barrier were investigated in Human Brain Microvascular Endothelial Cells (HBMECs). Results: The results demonstrated that nano-flavonoids loaded with myricetin showed more evenly distributed targeting tissues and enhanced anti-tumor efficiency in vivo without significant cytotoxicity to Caco-2 cells and alteration in the Trans Epithelial Electric Resistance (TEER). There was no pathological evidence of renal, hepatic or other organs dysfunction after the administration of nanoflavonoids, which showed no significant influence on cytotoxicity to Caco-2 cells. Conclusion: In conclusion, Labrasol/F68-NMs loaded with MYR and quercetin could enhance antiglioma effect in vitro and in vivo, which may be better tools for medical therapy, while the pharmacokinetics and pharmacodynamics of nano-flavonoids may ensure optimal therapeutic benefits.

A Review of Various Machine Learning Techniques for Brain Tumor Detection from MRI Images

2020 ◽  
Vol 16 (8) ◽  
pp. 937-945
Author(s):  
Aaishwarya Sanjay Bajaj ◽  
Usha Chouhan
Keyword(s):  
Machine Learning ◽  
Brain Tumor ◽  
Ct Scan ◽  
Imaging Techniques ◽  
Critical Evaluation ◽  
Tumor Detection ◽  
Machine Learning Techniques ◽  
X Rays ◽  
Detection Techniques ◽  
The Brain

Background: This paper endeavors to identify an expedient approach for the detection of the brain tumor in MRI images. The detection of tumor is based on i) review of the machine learning approach for the identification of brain tumor and ii) review of a suitable approach for brain tumor detection. Discussion: This review focuses on different imaging techniques such as X-rays, PET, CT- Scan, and MRI. This survey identifies a different approach with better accuracy for tumor detection. This further includes the image processing method. In most applications, machine learning shows better performance than manual segmentation of the brain tumors from MRI images as it is a difficult and time-consuming task. For fast and better computational results, radiology used a different approach with MRI, CT-scan, X-ray, and PET. Furthermore, summarizing the literature, this paper also provides a critical evaluation of the surveyed literature which reveals new facets of research. Conclusion: The problem faced by the researchers during brain tumor detection techniques and machine learning applications for clinical settings have also been discussed.

Brain Tumor Detection via Asymmetry Quantification across Mid Sagittal Plane

2020 ◽  
Vol 13 ◽  
Author(s):  
Shoaib Amin Banday ◽  
Mohammad Khalid Pandit
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Sagittal Plane ◽  
Early Stage ◽  
Imaging Techniques ◽  
Complex Structure ◽  
Magnetic Resonance Images ◽  
Absolute Difference ◽  
Brain Hemispheres ◽  
The Brain

Introduction: Brain tumor is among the major causes of morbidity and mortality rates worldwide. According to National Brain Tumor Foundation (NBTS), the death rate has nearly increased by as much as 300% over last couple of decades. Tumors can be categorized as benign (non-cancerous) and malignant (cancerous). The type of the brain tumor significantly depends on various factors like the site of its occurrence, its shape, the age of the subject etc. On the other hand, Computer Aided Detection (CAD) has been improving significantly in recent times. The concept, design and implementation of these systems ascend from fairly simple ones to computationally intense ones. For efficient and effective diagnosis and treatment plans in brain tumor studies, it is imperative that an abnormality is detected at an early stage as it provides a little more time for medical professionals to respond. The early detection of diseases has predominantly been possible because of medical imaging techniques developed from past many decades like CT, MRI, PET, SPECT, FMRI etc. The detection of brain tumors however, has always been a challenging task because of the complex structure of the brain, diverse tumor sizes and locations in the brain. Method: This paper proposes an algorithm that can detect the brain tumors in the presence of the Radio-Frequency (RF) inhomoginiety. The algorithm utilizes the Mid Sagittal Plane as a landmark point across which the asymmetry between the two brain hemispheres is estimated using various intensity and texture based parameters. Result: The results show the efficacy of the proposed method for the detection of the brain tumors with an acceptable detection rate. Conclusion: In this paper, we have calculated three textural features from the two hemispheres of the brain viz: Contrast (CON), Entropy (ENT) and Homogeneity (HOM) and three parameters viz: Root Mean Square Error (RMSE), Correlation Co-efficient (CC), and Integral of Absolute Difference (IAD) from the intensity distribution profiles of the two brain hemispheres to predict any presence of the pathology. First a Mid Sagittal Plane (MSP) is obtained on the Magnetic Resonance Images that virtually divides brain into two bilaterally symmetric hemispheres. The block wise texture asymmetry is estimated for these hemispheres using the above 6 parameters.

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