Neurodiagnostic Tests in Children With Brain Tumors: Changing Patterns of Use and Impact on Cost

PEDIATRICS ◽  
1978 ◽  
Vol 61 (6) ◽  
pp. 847-852
Author(s):  
Ken R. Winston
Keyword(s):  
Computed Tomography ◽  
Brain Tumors ◽  
Cerebral Angiography ◽  
Third Party ◽  
Patterns Of Use ◽  
Initial Work ◽  
Changing Patterns ◽  
Work Up

The utilization of neurodiagnostic tests in the initial work-up in children with brain tumors was relatively stable during the three years before computed tomography (CT) became available. After this test became available there was a significant (P < .05) reduction in the utilization of cerebral angiography, echoencephalography, electroencephalography, and ventriculography in children with tumors below the tentorium. In children with tumors above the tentorium, only a reduction in the use of cerebral angiography and radioisotopic scanning was demonstrated. These changes have resulted in a significant (P < .05) reduction in cost to the patient (or third party) for the initial neurodiagnostic work-up. Since CT became available, children with brain tumors undergo fewer tests, and the greatest reduction has been in tests that have the greatest cost.

scholarly journals Findings in an Elderly Patient after a Fall

2017 ◽  
Vol 24 (3) ◽  
pp. 51-54
Author(s):  
Qasem M. Aljabr
Keyword(s):  
Computed Tomography ◽  
Neck Pain ◽  
Treatment Options ◽  
Limited Range ◽  
Computed Tomography Scan ◽  
Limited Range Of Motion ◽  
Initial Work ◽  
Life Threatening ◽  
Work Up ◽  
Tomography Scan

A 76-year-old male presented with neck pain beginning a month earlier, when he tripped over a ledge while exiting his truck. The patient landed on his face and lost consciousness. In the emergency room, the initial work up, including a head computed tomography scan, came back negative, but the fall work-up was incomplete. He was discharged with a physical therapy appointment to manage his neck pain but did not go. The patient’s pain continued for another four weeks before he went to the clinic. The pain was located at the midline of his posterior cervical spine with limited range of motion. He was otherwise asymptomatic. A more comprehensive fall assessment and work-up was completed. An immediate neck computed tomography scan was ordered and revealed subacute Stage 2 odontoid fractures. The patient was placed in a neck collar. An urgent appointment with the neurosurgery clinic was requested. The neurosurgeon reviewed the neck computed tomography scan; a follow up by magnetic resonance imaging confirmed the findings. After discussing treatment options, the patient agreed to proceed with fusion surgery. This case demonstrates the importance of performing a complete fall assessment and workup to ensure early detection and prevention of serious or life-threatening injuries.

The Usefulness of Computed Tomography During and After Radiation Therapy in Patients with Brain Tumors

Radiology ◽  
1976 ◽  
Vol 121 (1) ◽  
pp. 79-83 ◽  
Author(s):  
Norman T. Pay ◽  
Richard J. Carella ◽  
Joseph P. Lin ◽  
Irvin I. Kricheff
Keyword(s):  
Computed Tomography ◽  
Radiation Therapy ◽  
Brain Tumors

Linear Accelerator as a Neurosurgical Tool for Stereotactic Radiosurgery

Neurosurgery ◽  
1988 ◽  
Vol 22 (3) ◽  
pp. 454-464 ◽  
Author(s):  
Ken R. Winston ◽  
Wendell Lutz
Keyword(s):  
Computed Tomography ◽  
Cerebral Angiography ◽  
Linear Accelerator ◽  
Photon Radiation ◽  
Entire System ◽  
High Doses ◽  
Design And Testing ◽  
Stereotactic Apparatus ◽  
The Brain ◽  
New System

Abstract A new system has been developed for stereotactically delivering prescribed high doses of radiation to precisely located volumes of approximately 0.6 to 10.0 ml within the brain. A Brown-Roberts-Wells stereotactic apparatus and a 6-MeV linear accelerator equipped with a special collimator (12.5 to 30 mm in diameter) have been adapted. The 20-mm collimator allows treatment of a nearly spherical volume of 2.1 ml. Outside the treatment field, the dosage declines to 80% of the dose prescribed for the periphery of the lesion over a distance of 1.8 mm and to 50% over the next 3.4 mm. Localization can be accomplished via computed tomography or cerebral angiography. Treatment is accomplished with an arcing beam of photon radiation with the turntable (couch) in each of four positions. The entire system has been extensively tested for accuracy in alignment and distribution of radiation. Errors have been measured for the alignment of the apparatus and for the process of localization. Safety of operation was emphasized throughout the design and testing phase. (Neurosurgery 22:454-464, 1988)

scholarly journals Intracranial Germ Cell Tumors with Special Emphasis on Computed Tomography and Cerebral Angiography

1984 ◽  
Vol 24 (10) ◽  
pp. 767-773
Author(s):  
Tomohiro IMAI ◽  
Kazuo MIYASAKA ◽  
Satoru ABE ◽  
Hidetoshi TAKEI ◽  
Toshimitsu AIDA ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Germ Cell ◽  
Cerebral Angiography ◽  
Germ Cell Tumors ◽  
Intracranial Germ Cell Tumors
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