Comparison of Lumbar Puncture with Computed Tomography Scan as an Indicator of Intracerebral Hemorrhage in the Preterm Infant

Computed tomography (CT) scan is the most accurate method for diagnosing intracerebral hemorrhage in the high-risk preterm infant. The present study was undertaken to evaluate lumbar puncture (LP) as a reliable means of diagnosing such hemorrhages. Forty eight infants less than 35 weeks gestation, requiring intensive care, were evaluated by CT scan at 48 to 96 hours of life, and serial LPs were performed. The initial LP preceded the CT scan by one to four hours and repeat LPs were done three and five days later if the initial CT scan revealed intracerebral hemorrhage. The initial LP was successfully performed in 28 of 48 infants. Of these 48 infants, 15 had hemorrhage by CT scan. The initial LP was consistent with the diagnosis on scan in eight of these 15. In the other seven infants, initial LP was normal in three, traumatic in one, and unsuccessful in three. The second LP was consistent with hemorrhage in four of the latter seven. Thus, in only eight of 15 infants, in whom CT scans revealed intracerebral hemorrhage, was the initial LP useful in confirming the diagnosis. Furthermore, LPs showed bloody cerebrospinal fluid in 10 of 18 infants whose CT scans were normal. At the present time LP cannot be considered a reliable means of identifying infants with subependymal-intraventricular hemorrhage.

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CT Scans, Ultrasound, and Lumbar Puncture

PEDIATRICS ◽

10.1542/peds.68.1.144 ◽

1981 ◽

Vol 68 (1) ◽

pp. 144-144

Author(s):

Joseph J. Volpe

Keyword(s):

Computed Tomography ◽

Intracerebral Hemorrhage ◽

Ct Scan ◽

Preterm Infant ◽

Lumbar Puncture ◽

Intraventricular Hemorrhage ◽

Ct Scans ◽

Computed Tomography Scan ◽

Stated Purpose ◽

Tomography Scan

I read with interest the article by Silverboard et al, "Comparison of Lumbar Puncture with Computed Tomography Scan as an Indicator of Intracerebral Hemorrhage in the Preterm Infant."1 Although the report provides interesting and useful information, I believe that the authors' conclusions might be misinterpreted. I write to offer a few comments. The authors' stated purpose was "to evaluate the reliability of lumbar puncture in comparison with [computed tomography] CT scan in the diagnosis of [subependymal/intraventricular hemorrhage] SEH/IVH."1

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Letters to the Editor

PEDIATRICS ◽

10.1542/peds.68.1.145 ◽

1981 ◽

Vol 68 (1) ◽

pp. 145-146

Author(s):

Peter A. Ahmann ◽

Anthony Lazzara ◽

Francine Dykes ◽

Gerald Silverboard

Keyword(s):

Computed Tomography ◽

Subarachnoid Hemorrhage ◽

High Risk ◽

Intracerebral Hemorrhage ◽

Ct Scan ◽

Preterm Infants ◽

False Positive ◽

Intraventricular Hemorrhage ◽

Ct Scans ◽

Letters To The Editor

We appreciate the interest that Dr Volpe has shown in our articles1,2 comparing lumbar puncture (LP) to computed tomography (CT) scan as an indicator of intracerebral hemorrhage. We find ourselves in disagreement with some of his conclusions and implications. First, in regard to Volpe's comment concerning false-positive LPs. We have now performed more than 400 CT scans on high-risk preterm infants and have found CT evidence of isolated subarachnoid hemorrhage in very few. Also evidence of hemorrhage other than subependymal/intraventricular hemorrhage (SE/IVH) is very rare on CT scan.

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429 Risk of Intracerebral Hemorrhage on Repeat Head Computed Tomography Scan in Anticoagulated Patients

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2012.06.461 ◽

2012 ◽

Vol 60 (4) ◽

pp. S151 ◽

Cited By ~ 1

Author(s):

C. Swap ◽

M. Silver ◽

W. Krauss ◽

M. Sidell ◽

R. Ogaz

Keyword(s):

Computed Tomography ◽

Intracerebral Hemorrhage ◽

Computed Tomography Scan ◽

Head Computed Tomography ◽

Anticoagulated Patients ◽

Tomography Scan

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Prospective Study of the Correlation Between Postoperative Computed Tomography Scan and Primary Surgeon Assessment in Patients With Advanced Ovarian, Tubal, and Peritoneal Carcinoma Reported to Have Undergone Primary Surgical Cytoreduction to Residual Disease 1 cm or Less

Journal of Clinical Oncology ◽

10.1200/jco.2007.12.2317 ◽

2007 ◽

Vol 25 (31) ◽

pp. 4946-4951 ◽

Cited By ~ 44

Author(s):

Dennis S. Chi ◽

Pedro T. Ramirez ◽

Jerrold B. Teitcher ◽

Svetlana Mironov ◽

Debra M. Sarasohn ◽

...

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Residual Disease ◽

Advanced Ovarian Cancer ◽

Ct Scans ◽

Eligibility Criteria ◽

Primary Surgery ◽

The Right ◽

Analysis Scale ◽

Tomography Scan

Purpose To compare surgeons' operative assessments of residual disease (RD) to those identified on postoperative computed tomography (CT) scans in patients with advanced ovarian carcinoma reported to have undergone optimal primary cytoreduction. Patients and Methods All patients at one of two institutions, who were scheduled to have primary surgery for presumed advanced ovarian cancer, were asked to consent to a postoperative CT scan if cytoreduction to ≤ 1 cm RD was reported. CT scan findings were graded using a qualitative analysis scale from 1 (normal) to 5 (definitely malignant). Results From January 2001 to September 2006, 285 patients were enrolled. A total of 78 patients met eligibility criteria and had postoperative CT scans. In 41 cases (52%), postoperative scan findings correlated with the surgical report of no RD more than 1 cm, and in seven cases (9%), the CT findings were indeterminate. In 10 cases (13%), more than 1 cm RD was noted by the radiologist as probably malignant, and in 20 cases (26%), definitely malignant. In these 30 cases, the radiologically reported median largest residual mass was 1.9 cm (range, 1.1 to 5.1), with RD more than 1 cm reported most commonly in the right upper quadrant (15 patients [50%]) and central abdomen (nine patients [30%]). Conclusion There was only a 52% correlation between surgeons' assessments and postoperative CT scan evaluations of RD in patients reported to have undergone optimal cytoreduction. Further study is required to determine whether this lack of correlation is due to rapid interval tumor regrowth, RD underestimated by the surgeons, and/or overestimated by the radiologists; and to determine the clinical implications of these discrepancies.

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Is a Negative Computed Tomography Scan of the Head and a Negative Lumbar Puncture Sufficient to Rule Out a Subarachnoid Hemorrhage?

Academic Emergency Medicine ◽

10.1197/j.aem.2005.03.145 ◽

2005 ◽

Vol 12 (Supplement 1) ◽

pp. 53-54

Author(s):

J. J. Perry

Keyword(s):

Computed Tomography ◽

Subarachnoid Hemorrhage ◽

Lumbar Puncture ◽

Computed Tomography Scan ◽

Tomography Scan ◽

Rule Out

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Fatal Cerebral Herniation After Lumbar Puncture in a Patient With a Normal Computed Tomography Scan

PEDIATRICS ◽

10.1542/peds.103.6.1284 ◽

1999 ◽

Vol 103 (6) ◽

pp. 1284-1286 ◽

Cited By ~ 36

Author(s):

Avinash K. Shetty ◽

Bonnie C. Desselle ◽

Randall D. Craver ◽

Russell W. Steele

Keyword(s):

Computed Tomography ◽

Lumbar Puncture ◽

Computed Tomography Scan ◽

Cerebral Herniation ◽

Tomography Scan

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Hubungan Antara Kadar DNA Plasma Virus Epstein Barr Dengan Stadium Klinis Karsinoma Nasofaring WHO Tipe 3

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v48i2.277 ◽

2019 ◽

Vol 48 (2) ◽

pp. 165

Author(s):

Putranti Dyahayu Roziaty ◽

Soehartono Soehartono ◽

Hendradi Surjotomo

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Epstein Barr Virus ◽

Tumor Type ◽

Computed Tomography Scan ◽

Cross Sectional ◽

Barr Virus ◽

Ebv Dna ◽

Epstein Barr ◽

Tomography Scan

Latar Belakang: Karsinoma nasofaring (KNF) merupakan keganasan yang tersering ditemukan, dan berdampak pada penurunan kualitas hidup serta memiliki mortalitas tinggi. Penanganan KNF selama ini terkendala oleh waktu tunggu yang cukup lama dalam menentukan staging KNF terutama untuk antrian pemeriksaan computed tomography scan (CT scan) dan Ultrasonography (USG). Pemeriksaan kadar DNA EBV (Deoxyribonucleic acid Epstein-Barr Virus) pada pasien yang relatif lebih mudah dan terjangkau dapat digunakan untuk memprediksi stadium dan prognosis KNF. Dengan mengetahui prognosis KNF lebih dini, maka diharapkan penanganan terhadap KNF dapat segera dilakukan. Tujuan: Mengetahui apakah kadar DNA EBV dapat dipakai untuk memprediksi stadium dan prognosis KNF dengan cara mencari hubungan antara kadar DNA EBV dengan stadium KNF. Metode: Penelitian cross sectional melibatkan 15 subjek penelitian yang terdiagnosis KNF WHO tipe 3 kemudian dilakukan staging dengan CT scan, USG abdomen, dan foto toraks, serta diambil sampel darah untuk diukur kadar DNA EBV. Hasil: Seluruh subjek penelitian mengalami peningkatan kadar DNA EBV sesuai dengan peningkatan stadium KNF. Peningkatan stadium KNF berhubungan signifikan dengan peningkatan kadar DNA EBV (p=0,001). Ukuran tumor (T) berhubungan signifikan dengan kadar DNA EBV (p=0,023), ukuran nodul (N) berhubungan signifikan dengan kadar DNA EBV (p=0,005), ada tidaknya metastasis tidak berhubungan signifikan dengan kadar DNA EBV (p=0,398). Nilai cut off kadar DNA EBV sebesar 952 kopi/ml. Kesimpulan: Terdapat hubungan yang signifikan antara kadar DNA EBV dengan stadium klinis, dengan demikian kadar DNA EBV dapat dipertimbangkan untuk digunakan sebagai prediktor stadium dan prognosis KNF. Background: Nasopharyngeal carcinoma (NPC) is the predominant tumor type arising in the nasopharynx, with a high mortality and affecting quality of life. NPC treatment management is hindered by long queues of Computed Tomography Scan (CT scan) and Ultrasonography (USG) examinations to ascertain the NPC staging. The examination of Epstein-Barr Virus (EBV) DNA level is relatively simpler and inexpensive to predict the NPC staging and prognosis, thus, it can speed up NPC treatment. Objective: To determine whether EBV DNA level can be used to predict the NPC stage and prognosis by finding a correlation between EBV DNA level and NPC stage. Method: This was a cross-sectional study involving 15 respondents who were diagnosed as WHO type 3 NPC, and examined by CT scan, abdominal ultrasound, chest X-ray, and blood test for measuring the levels of EBV DNA to determine the stage. Results: All respondents had elevated levels of EBV DNA in accordance with NPC stage elevation. Increased NPC stages were significantly correlated with elevated levels of EBV DNA (p=0.001). The size of tumor (T) was significantly correlated with EBV DNA (p=0.023), the size of nodule (N) was significantly correlated with EBV DNA (p=0.005). The presence or absence of metastasis did not significantly correlate with EBV DNA (p=0.398). The EBV DNA cut off value was 952 copies/ml. Conclusions: There was a significant correlation between EBV DNA levels and clinical stages, hence EBV DNA can be considered to be used as NPC staging and prognosis predictor.

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Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1255 ◽

2016 ◽

Vol 9 (1) ◽

pp. 13-17

Author(s):

Priyanko Chakraborty ◽

Rajiv K Jain ◽

Purnima Joshi ◽

Rakhi Kumari ◽

Sidharth Pradhan

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Chronic Rhinosinusitis ◽

Sinus Surgery ◽

Anatomic Variations ◽

Review Of Literature ◽

Computed Tomography Scan ◽

Diagnostic Endoscopy ◽

The Mean ◽

Tomography Scan

ABSTRACT Background Chronic rhinosinusitis (CRS) refers to a group of disorders characterized by inflammation of the mucosa of the paranasal sinuses. Nasal endoscopy and computed tomography (CT) scans are successfully used as diagnostic modalities of nose and paranasal sinus diseases. There have been many studies regarding the anatomic variations leading to pathogenesis of paranasal sinus diseases. Considerable progress has been made in the medical and surgical control of these conditions; however, a large number of questions relating to the diagnosis, evaluation, and treatment of the diseases remain unanswered. Materials and methods The study included 82 clinically diagnosed cases of CRS who underwent CT scan and were advised to undergo diagnostic endoscopy. The anatomical findings of the nose were compared to see correlation between nasal endoscopy and CT scan. Results The mean age (±standard error of the mean) of presentation was 34.11 (±1.42) years, while most patients were from the age group of 18 to 30 years. Males were predominating the study group with 62.2%, while 37.8% were females. The most common anatomic variation was deviated nasal septum with 92.68% CT reported patients. This was followed by inferior turbinate hypertrophy, septal spur, concha bullosa, and agger nasi cells. Conclusion Computed tomography scan is considered the gold standard for sinonasal imaging. Diagnostic endoscopy and CT scan are a must prior to any functional endoscopic sinus surgery. They help in assessing the extent of sinus disease and to know the variations and vital relations of the paranasal sinuses. Computed tomography scan assists the surgeon as a “road map” during endoscopic sinus surgery. How to cite this article Chakraborty P, Jain RK, Joshi P, Kumari R, Pradhan S. Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature. Clin Rhinol An Int J 2016;9(1):13-17.

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