Hemostasis and computerized tomography in head injury

1981 ◽  
Vol 55 (5) ◽  
pp. 718-724 ◽  
Author(s):  
J. Jaap van der Sande ◽  
Jan J. Veltkamp ◽  
Ria J. Boekhout-Mussert ◽  
G. Jan Vielvoye
Keyword(s):  
Head Injury ◽  
Computerized Tomography ◽  
Degradation Product ◽  
Ct Scanning ◽  
Mass Effect ◽  
Ct Scans ◽  
Fibrinogen Degradation Product ◽  
Content Type ◽  
Study Results ◽  
Coagulation Study

✓ Coagulation studies (plasma fibrinogen, ethanol gelation test, and fibrin-fibrinogen degradation product concentration) and computerized tomography (CT) scan examinations were performed in 55 patients with blunt head injury. The frequency of abnormalities in both coagulation study results and CT scans was higher in patients with severe clinical features and clinical course than in less severely injured patients; in these same patients the coagulation results were abnormal (64%) more frequently than the CT scans (40%). Very high fibrin-fibrinogen degradation product (FDP) concentrations were found to be associated with combined hemorrhagic lesions and mass effect on CT scans, but not with a specific localization of braintissue damage. It was concluded that: 1) FDP concentration reflects the amount of brain-tissue damage rather than its location, and 2) in the absence of other possible causes of disseminated intravascular coagulation, coagulation studies may be more sensitive than CT scanning in demonstrating brain contusion.

Hemostasis and intracranial surgery

1983 ◽  
Vol 58 (5) ◽  
pp. 693-698 ◽  
Author(s):  
J. Jaap van der Sande ◽  
Jan J. Veltkamp ◽  
Marijke L. Bouwhuis-Hoogerwerf
Keyword(s):  
Head Injury ◽  
Surgical Procedures ◽  
Degradation Product ◽  
Product Concentration ◽  
Fibrinogen Degradation Product ◽  
Content Type ◽  
Intracranial Surgery ◽  
Coagulation Abnormalities ◽  
Fine Print

✓ Preoperative and postoperative coagulation studies were performed in 25 patients undergoing various intracranial surgical procedures. Coagulation abnormalities, mostly consisting of an increase of fibrin/fibrinogen degradation product concentration, either appeared or increased postoperatively in 18 patients. This incidence of postoperative appearance or increase of coagulation abnormalities is higher than that reported in a comparable study of patients after general surgical procedures, and also higher than that of coagulation abnormalities in a previous study of patients after blunt head injury. Although the coagulation abnormalities after intracranial surgery were usually small, they tended to be larger in patients with more extensive intracranial procedures.

Intracranial cavernous angioma: presentation and management

1986 ◽  
Vol 64 (5) ◽  
pp. 720-723 ◽  
Author(s):  
Patricio Tagle ◽  
Isidro Huete ◽  
Jorge Méndez ◽  
Sergio del Villar
Keyword(s):  
Cerebellopontine Angle ◽  
Unusual Case ◽  
Clinical Presentation ◽  
Ct Scanning ◽  
Cavernous Angioma ◽  
Mass Effect ◽  
Ct Scans ◽  
Content Type ◽  
Neurological Signs ◽  
Fine Print

✓ Thirteen cases of cerebral cavernous angiomas are reported, and their radiological and pathological features are reviewed. The clinical presentation was variable: 53.8% of patients had seizures, 30.8% intracerebral hemorrhage, and 15.4% focal neurological signs, including one unusual case that presented as a cerebellopontine angle tumor. The computerized tomography (CT) scans were abnormal in all cases. Angiography was positive only when there was mass effect due to associated hematoma. Surgery was performed in 12 cases with good results. The prognosis of the 13 cases was favorable, with no mortality in this series. These data suggest that the combination of a recent seizure disorder with a hyperdense intracerebral nodule on the CT scanning should alert the neurosurgeon to the possibility of a cavernous angioma.

Intracranial tuberculoma and the CT scan

1986 ◽  
Vol 64 (4) ◽  
pp. 568-574 ◽  
Author(s):  
Umesh S. Vengsarkar ◽  
Ramkrishna Prasad Pisipaty ◽  
Bharat Parekh ◽  
Venilal G. Panchal ◽  
Manohar N. Shetty
Keyword(s):  
Ct Scanning ◽  
Mass Effect ◽  
Ct Scans ◽  
Complete Disappearance ◽  
Antituberculous Therapy ◽  
Content Type ◽  
Diagnosis And Management ◽  
Intracranial Tuberculoma ◽  
Serial Ct ◽  
Fine Print

✓ Computerized tomography (CT) has greatly influenced the diagnosis and management of intracranial tuberculomas and has helped us to formulate guidelines for the management of these lesions. Solid and ringenhancing lesions seen on CT scans are diagnostic of tuberculoma if supported by other clinical and ancillary criteria. Conservative management of intracranial tuberculoma is usually indicated because serial CT scans have shown complete disappearance of these lesions with antituberculous therapy. Only lesions associated with raised intracranial pressure and CT evidence of a mass effect should be considered for surgery. Nonresponse to antituberculous therapy, as judged by serial CT scanning, should raise doubts regarding the diagnosis of a tuberculomatous lesion, and therefore such lesions should be subjected to surgery and histopathological confirmation. Representative clinical cases illustrating the principles of diagnosis and management of intracranial tuberculoma with the help of CT scanning are briefly described and discussed.

CT-assisted stereotaxic aspiration of colloid cysts of the third ventricle

1985 ◽  
Vol 62 (2) ◽  
pp. 238-242 ◽  
Author(s):  
Juan J. Rivas ◽  
Ramiro D. Lobato
Keyword(s):  
Computerized Tomography ◽  
Third Ventricle ◽  
Ct Scanning ◽  
Ct Scans ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
Reproducible Method ◽  
Inner Diameter ◽  
Fine Print

✓ A technique is reported for the stereotaxic evacuation of colloid cysts of the third ventricle using a stereotaxic system adapted for computerized tomography (CT) scanning. This is an accurate, simple, and reproducible method that avoids the risks of direct approaches. Successful intracystic aspiration resulting in the cure of the patient may be difficult when the viscosity of the cyst contents is high. Thus, the authors use a large cannula (1.8 mm in inner diameter) to evacuate cysts that appear hyperdense on CT scans; these seem to contain a thicker colloid material than hypodense or isodense cysts.

Moderate head injury: a guide to initial management

1992 ◽  
Vol 77 (4) ◽  
pp. 562-564 ◽  
Author(s):  
Sherman C. Stein ◽  
Steven E. Ross
Keyword(s):  
Head Injury ◽  
Head Injuries ◽  
Ct Scanning ◽  
Ct Scans ◽  
Initial Examination ◽  
Content Type ◽  
Injury Group ◽  
Intracranial Lesions ◽  
Gcs Score ◽  
Fine Print

✓ The purpose of this study is to determine the initial treatment of patients who appear to have sustained moderate head injuries when first evaluated. The authors reviewed the records of 341 patients whose initial Glasgow Coma Scale (GCS) scores ranged from 9 to 12, as well as another 106 patients with GCS scores of 13. All patients underwent cranial computerized tomography (CT) at the time of admission. In 40.3% of these patients the CT scans were abnormal (30.6% had intracranial lesions), and 8.1 % required neurosurgical intervention (craniotomies for hematoma in 12, elevation of depressed fractures in five, and insertion of intracranial pressure monitors in 19). Four patients died of their intracranial injuries. A similar incidence of lesions found on CT and at surgery suggests that an initial GCS score of 13 be classified with the moderate head injury group. Skull fractures were found to be poor indicators of intracranial abnormalities. These results suggest that all patients with head injury thought to be moderate on initial examination be admitted to the hospital and undergo urgent CT scanning. Patients with intracranial lesions require immediate neurosurgical consultation, surgery as needed, and admission to a critical-care unit. Scans should be repeated in patients whose recovery is less rapid than expected and in all patients with evidence of clinical deterioration; this was necessary in almost half of the patients in this group, and 32% were found to have progression of radiological abnormalities on serial CT scans.

Head injury and coagulation disorders

1978 ◽  
Vol 49 (3) ◽  
pp. 357-365 ◽  
Author(s):  
J. Jaap van der Sande ◽  
Jan J. Veltkamp ◽  
Ria J. Boekhout-Mussert ◽  
Marijke L. Bouwhuis-Hoogerwerf
Keyword(s):  
Head Injury ◽  
Disseminated Intravascular Coagulation ◽  
Degradation Product ◽  
Conclusive Evidence ◽  
Control Group ◽  
Tissue Destruction ◽  
Fibrinogen Degradation Product ◽  
Content Type ◽  
Intravascular Coagulation ◽  
Level Of Consciousness

✓ Coagulation studies (plasma fibrinogen, ethanol gelation test, and fibrin/fibrinogen degradation product concentration) were done in 150 patients who were admitted after blunt head injury. Results were abnormal in 60 patients and were found to be correlated with the level of consciousness and with the presence of neurological signs. Many of these patients had fractures, but findings in a control group of 26 patients with major fractures without head injury indicate that fractures were not of paramount importance in causing clotting changes. Conclusive evidence of disseminated intravascular coagulation was found in 12 patients. Cases with a fatal clinical course were mostly associated with very high fibrin/fibrinogen degradation product concentrations. Some case histories are reported, confirming the hypothesized correlation between coagulation results and brain tissue destruction rather than brain compression. It was concluded that some degree of disseminated intravascular coagulation in patients with blunt head injury occurs more often than expected and that coagulation studies might have both diagnostic and prognostic value.

Documentation of fourth ventricle entrapment by metrizamide ventriculography with CT scanning

1981 ◽  
Vol 55 (5) ◽  
pp. 838-840 ◽  
Author(s):  
Mauricio Collada ◽  
Joseph Kott ◽  
David G. Kline
Keyword(s):  
Cerebrospinal Fluid ◽  
Computerized Tomography ◽  
Fourth Ventricle ◽  
Ct Scanning ◽  
Ct Scans ◽  
Communicating Hydrocephalus ◽  
Content Type ◽  
Ventriculoperitoneal Shunts ◽  
Fine Print

✓ Documentation by metrizamide ventriculography with computerized tomography (CT) of fourth ventricle entrapment is presented. Reevaluation of the cerebrospinal fluid pathways is suggested whenever fourth ventricle enlargment is seen on CT scans of patients with ventriculoperitoneal shunts for communicating hydrocephalus.

Progressive neurological deficits with benign intracerebral cysts

1986 ◽  
Vol 65 (5) ◽  
pp. 706-709 ◽  
Author(s):  
Yoko Nakasu ◽  
Jyoji Handa ◽  
Kazuyoshi Watanabe
Keyword(s):  
Histological Examination ◽  
Computerized Tomography ◽  
Cyst Wall ◽  
Benign Lesion ◽  
Ct Scanning ◽  
Neurological Deficits ◽  
Review Of The Literature ◽  
Content Type ◽  
Ct Findings ◽  
Fine Print

✓ Two patients with benign intracerebral cysts are reported and a brief review of the literature is given. Although computerized tomography (CT) scanning is useful in detecting a variety of intracerebral cysts, the CT findings are not specific for any lesion. An exploratory operation with establishment of an adequate route of drainage and a histological examination of the cyst wall are mandatory in the management of patients with a progressive but benign lesion.

The use of computerized tomography in the diagnosis of cerebral hydatid cysts

1979 ◽  
Vol 50 (3) ◽  
pp. 339-342 ◽  
Author(s):  
Tuncalp Özgen ◽  
Aykut Erbengi ◽  
Vural Bertan ◽  
Süleyman Saǧlam ◽  
Özdemir Gürçay ◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Computerized Tomography ◽  
Ct Scanning ◽  
Hydatid Cysts ◽  
Content Type ◽  
Cerebral Hydatid Cyst ◽  
Cyst Membrane ◽  
Fine Print

✓ Eleven cases of cerebral hydatid cyst, diagnosed by computerized tomography (CT), are presented. The importance of CT in minimizing the possibility of accidentally tapping or tearing the cyst membrane is stressed. Repeat CT scanning after removal of the cyst revealed atrophy in the affected hemisphere.

Age-related changes in the proportion of intracranial cerebrospinal fluid space measured using volumetric computerized tomography scanning

2002 ◽  
Vol 97 (3) ◽  
pp. 607-610 ◽  
Author(s):  
Hiroshi Wanifuchi ◽  
Takashi Shimizu ◽  
Takashi Maruyama
Keyword(s):  
Cerebrospinal Fluid ◽  
Computerized Tomography ◽  
Ct Scanning ◽  
Volume Measurement ◽  
Intracranial Volume ◽  
Content Type ◽  
Standard Curve ◽  
Age Related ◽  
Fine Print ◽  
Age Related Changes

Object. The purpose of this study was to establish a standard curve to demonstrate normal age-related changes in the proportion of intracranial cerebrospinal fluid (CSF) space in intracranial volume (ICV) during each decade of life. Methods. Using volumetric computerized tomography (CT) scanning and computer-guided volume measurement software, ICV and cerebral parenchymal volume (CPV) for each decade of life were measured and the intracranial CSF ratio was calculated by the following formula: percentage of CSF = (ICV − CPV)/ICV × 100%. The standard curve for age-related changes in normal percentages of intracranial CSF was obtained. Conclusions. Based on this standard curve, the percentage of intracranial CSF rapidly increased after the sixth decade, seeming to reflect the brain atrophy that accompanies increased age.

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