scholarly journals Location of hemorrhage with nontraumatic acute subdural hematoma due to ruptured microaneurysm

2021 ◽  
Vol 12 ◽  
pp. 401
Author(s):  
Taro Yanagawa ◽  
Keiichi Yamashita ◽  
Yoichi Harada ◽  
Toru Hatayama ◽  
Takuji Kono
Keyword(s):  
Ct Scan ◽  
Subdural Hematoma ◽  
Distal Part ◽  
Clinical Course ◽  
Histopathological Examination ◽  
Acute Subdural Hematoma ◽  
Contrast Enhanced ◽  
Traumatic Pseudoaneurysm ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Background: Nontraumatic acute subdural hematoma (ASDH) may be caused by rupture of a microaneurysm of a cortical artery. In some cases, microaneurysms may have been caused by earlier trauma. Although it is difficult to detect microaneurysms on contrast-enhanced computed tomography (CT) angiography or digital subtraction angiography, it may be suspected based on the plain CT scan results and the clinical course. Case Description: We experienced three cases presumed to be ASDH due to rupture of a microaneurysm. Plain CT scan showed that the midline shift was smaller than the hematoma thickness, and we judged from the clinical course that there was no trauma immediately before the onset. All three patients had decreased consciousness after arrival and underwent craniotomy for hematoma removal. The source of hemorrhage was in the distal part of the cortical artery, and a microaneurysm was found. In one case, histopathological examination was performed, and traumatic pseudoaneurysm was diagnosed. The postoperative course was good in all three cases. Conclusion: If nontraumatic ASDH is suspected, the source of hemorrhage may be located more distally to the middle cerebral artery than in traumatic ASDH; hence, extensive craniotomy is required to search for the location of hemorrhage.

scholarly journals The Effect of Contrast-enhanced Computed Tomography (CT) Scans on the Calculated Dose of Radiotherapy in a Thorax Phantom

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Athar Ehtiati ◽  
Payman Hejazi ◽  
Mohsen Bakhshandeh ◽  
Ali Jabbary Arfaee ◽  
Eftekhar Rajab Bolookat ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Contrast Media ◽  
Ct Scan ◽  
Treatment Planning ◽  
Tumor Volume ◽  
Ct Scans ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Background: Despite the benefits of contrast-enhanced computed tomography (CT) scans in better tumor volume delineation, it can affect the accuracy of dose calculation in radiation therapy. This study examined this effect on a thorax phantom. Objectives: The influence of different variables including the concentrations of the Visipaque contrast media, tumor sizes, and CT scan energies on the dose measurement was examined. Methods: Transparent cylinders containing the contrast media were inserted in the lung area of the phantom and the CT scans were made. Non-enhanced CT scans were also acquired. Treatment planning using 2 opposite fields was performed on the CT scans and the doses were calculated in the treatment planning system. The results of the 2 sets of enhanced and non-enhanced CT scans were compared. Results: The correlation between concentration and the percentage of mean dose of the tumor volume was significant in 2 of the tumor sizes. The differences in the mean doses of the 2 plans were examined and more than 3% increase was observed in higher concentrations of the contrast media. Conclusions: According to this study, the suitable concentration of the contrast media administered and the CT scan energy should be considered. This would help to decrease the discrepancies between the calculated and delivered dose in radiotherapy treatments to a clinically acceptable level. The importance of time delays for CT scans after administration of the contrast media is emphasized.

Renal pseudoaneurysm after blunt trauma in a 10-year-old girl: A case report

2020 ◽  
pp. 039156031989615
Author(s):  
Simone Sforza ◽  
Giorgio Persano ◽  
Chiara Cini ◽  
Idanna Sforzi ◽  
Antonio Andrea Grosso ◽  
...  
Keyword(s):  
Renal Trauma ◽  
Angiographic Embolization ◽  
Computed Tomography Scan ◽  
Contrast Enhanced ◽  
Traumatic Pseudoaneurysm ◽  
Post Traumatic ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Tomography Scan

Introduction: Renal trauma is a relevant cause of morbidity in children older than 1 year. Most patients are currently managed conservatively, even in case of high-grade traumas; nevertheless, harmful complications may occur even in hemodynamically stable patients. We present a case of grade IV blunt renal trauma complicated by post-traumatic pseudoaneurysm. Case description: A 10-year-old girl was referred to our institution for grade IV trauma of the right kidney. During observation she had persistent hematuria that caused anemia. A second contrast-enhanced computed tomography scan revealed a posttraumatic pseudoaneurysm that was successfully treated by angiographic embolization. Conclusions: Although extremely rare after blunt renal trauma, post-traumatic renal pseudoaneurysm may cause severe blood loss and anemia, and angioembolization is therefore indicated. This condition should be suspected and move physicians to investigate further.

Complicated periorbital cellulitis: case report and literature review

2011 ◽  
Vol 126 (1) ◽  
pp. 94-96 ◽  
Author(s):  
N Parvizi ◽  
N Choudhury ◽  
A Singh
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Lacrimal Gland ◽  
Clinical Course ◽  
Neurological Complications ◽  
Team Approach ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

AbstractObjective:Periorbital cellulitis secondary to rhinosinusitis is common. However, very rarely this can be complicated by a lacrimal gland abscess. We report such a case.Method:We present a case report and literature review concerning lacrimal gland abscess secondary to periorbital cellulitis.Results:Due to the location of this condition, prompt assessment and management is vital to avoid potential ophthalmological and neurological complications. Our patient failed to respond to initial conservative medical treatment, and was subsequently identified as having a lacrimal gland abscess, confirmed on contrast-enhanced computed tomography. Following definitive surgical treatment, the patient's clinical course improved. This case furthers our knowledge of this condition, and adds to the two previously reported paediatric cases.Conclusion:This case emphasises the importance of prompt management, and the fact that failure of clinical improvement following orbital decompression should alert the clinician to the rare possibility of an associated lacrimal gland abscess. The case also emphasises the key role of imaging and a multidisciplinary team approach when managing this condition.

scholarly journals Contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of PVs including carina-

2021 ◽  
Author(s):  
Yusuke Sakamoto ◽  
Hiroyuki Osanai ◽  
Yuki Tanaka ◽  
Shotaro Hiramatsu ◽  
Hikari Matsumoto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Clinical Course ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Early Success ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Abstract Purpose Compared with conventional pulmonary vein isolation (PVI) with radiofrequency ablation, PVI with cryoballoon is an easier and shorter procedure without reconnection, particularly in the superior pulmonary vein. However, the durability of the cryoballoon may be reduced due to anatomical factors and the position of the pulmonary vein (PV). Further, inadequate isolation of the carina leads to recurrence of atrial fibrillation (AF). We aimed to determine whether using contrast-enhanced computed tomography (CT) for patient selection improves the early success rate and prevents the recurrence of AF in PVI with cryoballoon. Methods We evaluated patients who underwent ablation for paroxysmal atrial fibrillation in our hospital between July 2019 and November 2020. After excluding patients with contraindications for cryoablation, 50 patients were selected through visual inspection of the results of preoperative contrast-enhanced CT. A treatment plan was established, and the clinical course and outcomes were followed up. Results Of the 200 PVs of the 50 patients, only 8 PVs (4%) were incompletely isolated with a single cryoablation. Six of the eight PVs were successfully isolated with additional cryoablation. Only 2 patients (4%) underwent additional PVI with radiofrequency ablation. Four patients had AF recurrence within a mean follow-up period of 14.3 ± 5.1 months. The rate of sinus rhythm maintenance was 92%. PV reconnection was observed in 2 patients. None of the patients had postoperative atrial flutter. Conclusions Selecting patients for cryoablation according to contrast-enhanced CT findings made the procedure easier to perform, leading to improved early success rates and clinical course.

scholarly journals Assessment of Imaging Performance and Accuracy for the Diagnostic Evaluation of Wilms Tumor in Kids in the ERA of Contrast Based CT Scan with Histopathological Correlation: A Study in Tertiary Care Hospital

2021 ◽  
Vol 6 (10) ◽  
pp. 668-673
Author(s):  
Ashraf Amirali ◽  
Jaideep Darira ◽  
Hina Pathan ◽  
Sorath Murtaza ◽  
Munaza Irshad
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Predictive Value ◽  
Gold Standard ◽  
Wilms Tumor ◽  
Diagnostic Evaluation ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

The aim of the study is the assessment of accuracy for the diagnostic evaluation of Wilms tumor in the pediatric population in the era of contrast-enhanced CT scan using histopathology as a gold standard. Plain and contrast-enhanced abdominal Computed Tomography including pelvis and chest was performed in suspected patients with multiple axial sections with sagittal and coronal reconstructions. Patients were being followed, data was collected and recorded on proforma after histopathology. The patient's mean age for this study in years was 3.5 ± 1.2. Gender distribution showed 170 patients (54.6%) were male while the remaining 141 patients (45.33%) were female. Contrast-enhanced computed tomography showed sensitivity (90.36%), specificity (51.72%), diagnostic accuracy (72.34%), positive predictive value (68.18%), and negative predictive value (82.42%) confirmed on Histopathology as the gold standard. It is concluded from the results of this study that contrast-enhanced computed tomography proved high diagnostic accuracy positive predictive in the detection of Wilms’ tumor by taking histopathology as the gold standard.

scholarly journals Fluttering cord-like thrombus in the aortic arch: a case report

2021 ◽  
Author(s):  
Yuki Kuroda ◽  
Akira Marui ◽  
Yoshio Arai ◽  
Atsushi Nagasawa ◽  
Shinichi Tsumaru ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Histopathological Examination ◽  
Circulatory Arrest ◽  
Selective Cerebral Perfusion ◽  
Cervical Incision ◽  
Contrast Enhanced ◽  
Aortic Thrombus ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Abstract BackgroundOptimal treatment for aortic thrombus remains to be determined, but surgical treatment is indicated when there is a risk for thromboembolism. Case PresentationA 47-year-old male presented with weakness in his left arm upon awakening. Contrast-enhanced computed tomography and transesophageal echocardiography revealed a mobile pedunculated object suggestive of a thrombus arising from the ascending aorta and extending to the left common carotid artery. It was removed under hypothermic circulatory arrest and direct cannulation of the left carotid artery to avoid carotid thromboembolism. Histopathological examination revealed that the object was a thrombus. The patient had an uneventful postoperative course and was discharged 9 days after surgery. ConclusionWhen a thrombus in the aortic arch extends to the neck arteries, direct cannulation of the neck arteries with selective cerebral perfusion via cervical incision is a useful technique.

scholarly journals Comparison of thyroid gland involvement in contrast enhanced computed tomography of the neck and histopathology and the necessity of thyroidectomy in patients with laryngeal and hypo pharyngeal cancer

2019 ◽  
Vol 5 (5) ◽  
pp. 1335
Author(s):  
Mohamed Abdul Kathar M. ◽  
Rajiv Michael ◽  
Aparna Shyam
Keyword(s):  
Computed Tomography ◽  
Thyroid Gland ◽  
Ct Scan ◽  
Total Laryngectomy ◽  
Histopathological Analysis ◽  
Contrast Enhanced ◽  
Cartilage Erosion ◽  
Cect Scan ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

<p class="abstract"><strong>Background:</strong> The aim of this study is to assess the thyroid gland involvement in the preoperative contrast enhanced computed tomography (CECT) of neck with histopathology (HPE) in determining the indications for ipsilateral thyroidectomy in patients undergoing total laryngectomy in laryngeal and hypopharyngeal cancers.</p><p class="abstract"><strong>Methods:</strong> Forty patients diagnosed clinically with stage 3 laryngeal and hypopharyngeal cancer were subjected to CECT of neck. Patients with cartilage erosion and extra laryngeal spread on CECT (T3, T4a) were routinely taken for total laryngectomy, partial pharyngectomy and hemi thyroidectomy. Specimens were sent for histopathological analysis and which was compared with preoperative CECT scan.  </p><p class="abstract"><strong>Results:</strong> Of the forty cases, only four patients had thyroid gland involvement in CECT scan and 2 of the 40 had thyroid gland involvement in histopathology. Of the four patients where the CT scan which showed infiltration of the thyroid gland, none had thyroid gland involvement in histopathology. In two patients where thyroid gland was involved in histopathology, CT scan failed to pick up the thyroid gland involvement. Those two patients with histologically proven thyroid gland involvement identify as transglottic malignancy with cartilage erosion and extra laryngeal spread.</p><p class="abstract"><strong>Conclusions:</strong> Our study concludes that an ipsilateral hemi-thyroidectomy is probably still indicated in transglottic cancer with cartilage invasion and/or extra laryngeal spread.</p>

scholarly journals A case of atypical leiomyoma mimicking as endometrial cancer

2020 ◽  
Vol 10 (1) ◽  
pp. 416
Author(s):  
Priyanka Bhadana ◽  
Abha Kiran ◽  
Kriti Bhakuni ◽  
Veena G. Malla
Keyword(s):  
Histopathological Examination ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Lower Abdomen ◽  
Contrast Enhanced ◽  
Mitotic Figures ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Nuclear Enlargement

Atypical leiomyoma or leiomyoma with bizarre nucleus is diagnosed on histopathological examination characterized by severe cytological atypia in the form of nuclear enlargement, multi nucleation, hyperchromasia, coarse chromatin and prominent nuclei. These tumours do not have typical features of necrosis or mitotic figures to characterize them as leiomyosarcoma. There are 2% risk of these tumours to convert to leiomyosarcoma. 50-year P3L3A1 postmenopausal for past 6 years presented to gynaecology outpatient department (GOPD) with complains of pain in lower abdomen for past 1 year. Patient was examined and investigated. On clinical examination there was no apparent finding. On radiological examination a well-defined hypoechoic lesion of 6.4×5.7 cm2 was found arising from uterus. Contrast enhanced computed tomography (CECT) abdomen showed heterogenous mass involving endometrium and myometrium likely neoplastic. Total abdominal hysterectomy with bilateral salpingoophrectomy was done. Histopathological examination (HPE) report revealed features of atypical leiomyoma. Patient is under follow up in GOPD.

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