Supratentorial intracerebral hemorrhage following posterior fossa surgery

1978 ◽  
Vol 49 (6) ◽  
pp. 881-886 ◽  
Author(s):  
Stephen J. Haines ◽  
Joseph C. Maroon ◽  
Peter J. Jannetta

✓ Five cases of supratentorial intracerebral hemorrhage following posterior fossa surgery are reported. Possible etiologies are discussed, but in only one case can a definite etiology (hypertension) be found. The differential diagnosis of declining level of consciousness after posterior fossa surgery must include supratentorial intracerebral hemorrhage, and computerized tomography seems to be the diagnostic method of choice.

1981 ◽  
Vol 55 (5) ◽  
pp. 841-844 ◽  
Author(s):  
Angelo Gandolfi ◽  
Riccardo E. Brizzi ◽  
Filomeno Tedeschi ◽  
Paolo Paini ◽  
Pellegrino Bassi

✓ Symptomatic subependymomas of the fourth ventricle are rare and usually not included in the preoperative differential diagnosis of tumors in this region. The case of a 63-year-old man with fourth ventricle subependymoma is described. For several years he had suffered with nausea and vomiting, and now presented signs of direct involvement of the posterior fossa. He was investigated preoperatively with computerized tomography, but the ultimate diagnosis was not suspected at that time. The tumor was diagnosed as an subependymoma at operation and was totally excised. This tumor type can easily be recognized on intraoperative frozen section, and its diagnosis should always lead to an attempt at complete surgical removal.


1989 ◽  
Vol 71 (2) ◽  
pp. 175-179 ◽  
Author(s):  
David W. Newell ◽  
Peter D. LeRoux ◽  
Ralph G. Dacey ◽  
Gary K. Stimac ◽  
H. Richard Winn

✓ Computerized tomography (CT) infusion scanning can confirm the presence or absence of an aneurysm as a cause of spontaneous intracerebral hemorrhage. Eight patients who presented with spontaneous hemorrhage were examined using this technique. In five patients the CT scan showed an aneurysm which was later confirmed by angiography or surgery; angiography confirmed the absence of an aneurysm in the remaining three patients. This method is an easy effective way to detect whether an aneurysm is the cause of spontaneous intracerebral hemorrhage.


1986 ◽  
Vol 65 (5) ◽  
pp. 713-715 ◽  
Author(s):  
J. Frederick Harrington ◽  
Timothy B. Mapstone ◽  
Warren R. Selman ◽  
Pamela Galloway ◽  
Carl Bundschuh

✓ A case of lead encephalopathy with clinical and computerized tomography evidence of a midline posterior fossa mass is presented. The pathophysiology and the predilection for posterior fossa involvement are discussed.


2001 ◽  
Vol 95 (2) ◽  
pp. 292-297 ◽  
Author(s):  
Takeo Kondo ◽  
Toshihiro Kumabe ◽  
Shin Maruoka ◽  
Takashi Yoshimoto

Object. The 201Tl uptake index was evaluated for its usefulness in formulating a diagnosis of hemangioblastoma. Thallium-201—single-photon emission computerized tomography (SPECT) studies were performed in nine patients harboring hemangioblastomas in the posterior fossa and in five patients (six lesions) with gliomas in the posterior fossa. Methods. The 201Tl uptake index was defined as the ratio of mean counts of isotope per pixel in the tumor to mean counts of isotope per pixel in the homologous region of the healthy brain. The 201Tl uptake indices of the early image (TlE) and that of the delayed image (TlD) were calculated. The isotope retention index (RI) was calculated as (TlE − TlD)/TlE. The TlE was 2.7 ± 0.7 in hemangioblastomas and 2.9 ± 1.7 in gliomas (mean ± standard deviation). The TlD was 1.5 ± 0.4 in hemangioblastomas and 2.4 ± 1.6 in gliomas. There were no significant differences between hemangioblastomas and gliomas when TlEs and TlDs were compared. The isotope RI was 0.43 ± 0.07 in hemangioblastomas and 0.15 ± 0.1 in gliomas, showing a significantly higher RI in hemangioblastomas compared with gliomas (p < 0.01). Conclusions. Thallium-201 washout is significantly faster in hemangioblastomas. Hemangioblastoma is biologically benign, but contains a rich capillary network that forms a hypervascular tumor bed. Variations in its appearance on magnetic resonance images may cause difficulties in the differential diagnosis of hemangioblastoma. Thallium-201 SPECT studies can be used to distinguish hemangioblastomas from gliomas in the posterior fossa.


1998 ◽  
Vol 89 (1) ◽  
pp. 155-156 ◽  
Author(s):  
Edward J. Kosnik

✓ The technique of harvesting the ligamentum nuchae and its use in posterior fossa surgery are discussed. By using this technique the author has avoided postoperative cerebrospinal fluid leakage in more than 200 procedures.


1999 ◽  
Vol 91 (3) ◽  
pp. 424-431 ◽  
Author(s):  
Yasuo Murai ◽  
Ryo Takagi ◽  
Yukio Ikeda ◽  
Yasuhiro Yamamoto ◽  
Akira Teramoto

Object. The authors confirm the usefulness of extravasation detected on three-dimensional computerized tomography (3D-CT) angiography in the diagnosis of continued hemorrhage and establishment of its cause in patients with acute intracerebral hemorrhage (ICH).Methods. Thirty-one patients with acute ICH in whom noncontrast and 3D-CT angiography had been performed within 12 hours of the onset of hemorrhage and in whom conventional cerebral angiographic studies were obtained during the chronic stage were prospectively studied. Noncontrast CT scanning was repeated within 24 hours of the onset of ICH to evaluate hematoma enlargement.Findings indicating extravasation on 3D-CT angiography, including any abnormal area of high density on helical CT scanning, were observed in five patients; three of these demonstrated hematoma enlargement on follow-up CT studies. Thus, specificity was 60% (three correct predictions among five positives) and sensitivity was 100% (19 correct predictions among 19 negatives). Evidence of extravasation on 3D-CT angiography indicates that there is persistent hemorrhage and correlates with enlargement of the hematoma.Regarding the cause of hemorrhage, five cerebral aneurysms were visualized in four patients, and two diagnoses of moyamoya disease and one of unilateral moyamoya phenomenon were made with the aid of 3D-CT angiography. Emergency surgery was performed without conventional angiography in one patient who had an aneurysm, and it was clipped successfully.Conclusions. Overall, 3D-CT angiography was found to be valuable in the diagnosis of the cause of hemorrhage and in the detection of persistent hemorrhage in patients with acute ICH.


1986 ◽  
Vol 65 (6) ◽  
pp. 779-783 ◽  
Author(s):  
R. Michael Scott ◽  
Samuel M. Wolpert ◽  
Louis E. Bartoshesky ◽  
Seymour Zimbler ◽  
George T. Klauber

✓ Four children with previously repaired myelomeningoceles presented toward the end of the first decade or early in the second decade of life with deteriorating lower-extremity and bladder function. Myelography and computerized tomography scanning demonstrated irregular filling defects at the area of the myelomeningocele repair, and surgical exploration disclosed dermoid tumors that were adherent to the placode and adjacent roots. Dermoid tumors should be considered in the differential diagnosis of neurological deterioration in children with a repaired myelomeningocele.


1984 ◽  
Vol 60 (3) ◽  
pp. 630-632 ◽  
Author(s):  
Hamid Rahmat ◽  
Kazem Abbassioun ◽  
Abbass Amirjamshidi

✓ A case of pulsating unilateral exophthalmos is presented. It was caused by a traumatic aneurysm of the intraorbital ophthalmic artery, secondary to missile injury. Evolution of the aneurysm was observed clinically, by angiography, and by computerized tomography. The differential diagnosis of pulsating exophthalmos and the pathogenesis of such aneurysms are briefly discussed.


1986 ◽  
Vol 65 (2) ◽  
pp. 253-255 ◽  
Author(s):  
Stanley L. Barnwell ◽  
Michael S. B. Edwards

✓ The case of an 11-year-old boy is reported in whom two intramedullary lesions developed at the thoracic-cervical and thoracic-lumbar junctions 2½ years after resection and irradiation of a medulloblastoma in the posterior fossa. There was no evidence of subarachnoid spread of the tumor. Magnetic resonance imaging was used to localize these lesions, and provided much better diagnostic information than either computerized tomography scans or myelograms.


1983 ◽  
Vol 58 (1) ◽  
pp. 109-111 ◽  
Author(s):  
Young J. Yu ◽  
David R. Cooper ◽  
David E. Wellenstein ◽  
Brian Block

✓ A case of reversible cerebral angiitis and intracerebral hemorrhage is reported in a methamphetamine abuser. Characteristic radiographic changes were demonstrated by selective cerebral angiography and computerized tomography. These vascular abnormalities disappeared after 1 month of treatment with prednisone, during which time the patient denied further drug abuse.


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