Significance of contrast enhancement in cranial computerized tomography after subarachnoid hemorrhage

1984 ◽  
Vol 60 (2) ◽  
pp. 335-342 ◽  
Author(s):  
Thomas Doczi ◽  
James Ambrose ◽  
Sean O'Laoire
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Contrast Enhancement ◽  
Computerized Tomography ◽  
Contrast Material ◽  
Ct Scanning ◽  
Visual Evaluation ◽  
Content Type ◽  
Before And After ◽  
Subarachnoid Spaces ◽  
Cranial Computerized Tomography

✓ Eighty patients with subarachnoid hemorrhage underwent computerized tomography (CT) scanning before and after administration of Conray contrast medium. Abnormal enhancement was seen in visual evaluation of the CT scans in 26 cases, in the regions bordering the subarachnoid spaces. Abnormal enhancement was associated with a poor clinical condition, angiographic spasm, and a poor outcome. Measurements of absorption values in the thalamus revealed significant increases in density after contrast enhancement in those patients whose scans showed abnormal enhancement in the regions bordering the subarachnoid spaces on visual evaluation. The authors suggest that the abnormal enhancement is parenchymal, in the gyri, and is not “subarachnoid.” They suggest that it is due to gyral hyperemia or extravasation of contrast material into the cortex resulting from breakdown of the blood-brain barrier, or a combination of both factors.

Computerized tomography and prognosis in early aneurysm surgery

1986 ◽  
Vol 65 (2) ◽  
pp. 217-221 ◽  
Author(s):  
Ludwig M. Auer ◽  
Gerhard H. Schneider ◽  
Thomas Auer
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Computerized Tomography ◽  
Cerebral Aneurysms ◽  
Ct Scanning ◽  
Consecutive Series ◽  
Anterior Portion ◽  
Posterior Portion ◽  
Content Type ◽  
Good Outcome ◽  
Preoperative Ct

✓ A study of computerized tomography (CT) scans was performed in a consecutive series of 100 patients with ruptured saccular cerebral aneurysms who were admitted, diagnosed, and operated on within 72 hours after subarachnoid hemorrhage (SAH) and treated with calcium antagonists. The aneurysms were in the anterior portion of the circle of Willis in 95% of patients and in the posterior portion in 5%; 12% had multiple aneurysms. Preoperative neurological grades according to Hunt and Hess were I to III in 74% of patients and IV or V in 26%. Subarachnoid hemorrhage as determined by CT scanning was minor in 20%, moderate in 43%, and severe in 37% of patients. All patients received intraoperative and postoperative administration of the calcium antagonist nimodipine. Three days postoperatively, SAH (as measured by CT) was significantly reduced in the majority of patients but was still moderate in 18%. In the postoperative course, 2% of patients developed delayed ischemic neurological symptoms due to vasospasm. In two additional patients, ischemic symptoms were transient and fully reversible. At the 6-month follow-up interval, a significant prognostic difference was found between two patient groups with different CT scan findings. Among the patients with SAH only, the rate of good outcome (no or minimal deficit) was 93% when the preoperative neurological Grade was I or II; but even with a Grade of III to V, there was a good outcome in 84% of patients. By contrast, in patients with additional intracerebral and/or intraventricular hemorrhage, the good-outcome rate was only 44%. From these data it is concluded that morphological preoperative CT findings are of prognostic value and may even be superior to clinical grading in predicting outcome.

Postoperative CT contrast enhancement following lobectomy for epilepsy

1990 ◽  
Vol 73 (3) ◽  
pp. 392-395 ◽  
Author(s):  
Varun Laohaprasit ◽  
Daniel L. Silbergeld ◽  
George A. Ojemann ◽  
Joseph M. Eskridge ◽  
H. Richard Winn
Keyword(s):  
Contrast Enhancement ◽  
Computerized Tomography ◽  
Contrast Material ◽  
Residual Tumor ◽  
Ct Scans ◽  
Resection Margins ◽  
Normal Brain ◽  
Content Type ◽  
Preoperative Ct ◽  
Ct Contrast

✓ Contrast-enhanced computerized tomography (CT) is frequently utilized immediately after surgery to determine the presence of residual tumor, but the response of nontumor brain tissue is unclear. Consequently, the authors investigated the postoperative CT contrast enhancement in six patients undergoing lobectomy for epilepsy. Preoperative CT scans were obtained in all cases and revealed no enhancing lesions. All patients underwent craniotomy with electrocorticography while awake, followed by lobectomy. Computerized tomography scans with and without administration of contrast material were obtained on postoperative Days 3, 7, and 30. Edema, artifact, and enhancement of the resection margins were seen on postoperative Days 3 and 7, but had resolved in all patients by Day 30. It is concluded that postoperative CT scans for assessment of residual tumor are best obtained at 30 days or thereafter, when normal brain does not enhance and edema and artifact have diminished.

Magnetic resonance imaging of acute subarachnoid hemorrhage

1988 ◽  
Vol 68 (5) ◽  
pp. 731-736 ◽  
Author(s):  
Alistair Jenkins ◽  
Donald M. Hadley ◽  
Graham M. Teasdale ◽  
Barrie Condon ◽  
Peter Macpherson ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Subarachnoid Hemorrhage ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Ct Scanning ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Content Type ◽  
Before And After ◽  
Subarachnoid Blood

✓ The feasibility, safety, and diagnostic value of magnetic resonance (MR) imaging versus computerized tomography (CT) scanning were compared in 30 patients with clinical evidence of subarachnoid hemorrhage. Subarachnoid blood was identified more often and more information was available about the site and source of the hemorrhage on MR imaging than on CT. Magnetic resonance imaging could be used safely both before and after the operation, provided that nonferromagnetic clips were used and that comprehensive monitoring and cardiorespiratory support were available. Postoperative studies showed that artifacts from metallic implants and from patient movement caused less image degradation on MR images than on CT scans.

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.

Successful stereotaxic evacuation of an acute pontomedullary hematoma

1985 ◽  
Vol 62 (1) ◽  
pp. 153-156 ◽  
Author(s):  
D. Andries Bosch ◽  
Gustaaf N. Beute
Keyword(s):  
Arteriovenous Malformation ◽  
Young Woman ◽  
Computerized Tomography ◽  
Ct Scanning ◽  
Vascular Lesion ◽  
Content Type ◽  
Healthy Young Woman ◽  
First Child ◽  
Fine Print

✓ A healthy young woman developed a rapidly progressive pontomedullary lesion 24 hours after delivery of her first child. The lesion was shown on computerized tomography (CT) to be a primary hematoma. Stereotaxic aspiration was carried out, and the patient recovered. Angiography and CT scanning demonstrated a vascular lesion compatible with an arteriovenous malformation.

Cerebral hemodynamics in normal-pressure hydrocephalus

1984 ◽  
Vol 61 (3) ◽  
pp. 510-514 ◽  
Author(s):  
Norihiko Tamaki ◽  
Tadaki Kusunoki ◽  
Toshimitsu Wakabayashi ◽  
Satoshi Matsumoto
Keyword(s):  
Computerized Tomography ◽  
Transit Time ◽  
Normal Pressure Hydrocephalus ◽  
Mean Transit Time ◽  
Contrast Material ◽  
Normal Pressure ◽  
Cerebral Hemodynamics ◽  
Content Type ◽  
Poor Outcome ◽  
Fine Print

✓ Cerebral hemodynamics in 31 patients with suspected normal-pressure hydrocephalus were studied by means of the xenon-133 (133Xe) inhalation method and on dynamic computerized tomography (CT) scanning. Cerebral blood flow (CBF) is reduced in all patients with dementia. Hypoperfusion was noted in a frontal distribution in these patients compared with normal individuals. There was no difference in CBF patterns between patients with good and those with poor outcome. The CBF was increased following cerebrospinal fluid (CSF) shunting in patients who responded to that procedure: increase in flow correlated with clinical improvement, frontal and temporal lobe CBF was most markedly increased, and the CBF pattern became normal. In contrast, CBF was decreased after shunt placement in patients who were considered to have suffered from degenerative dementia, as evidenced by non-response to shunting. Dynamic computerized tomography studies demonstrated that patients with a good outcome showed a postoperative reduction in mean transit time of contrast material, most prominent in the frontal and temporal gray matter, and slight in the deep frontal structures, but not in the major cerebral vessels. Patients with poor outcome after shunting, however, had an increase in transit time in all regions. This corresponded well with the results as determined by the 133Xe inhalation method.

Three-dimensional computerized tomography angiography in patients with hyperacute intracerebral hemorrhage

1999 ◽  
Vol 91 (3) ◽  
pp. 424-431 ◽  
Author(s):  
Yasuo Murai ◽  
Ryo Takagi ◽  
Yukio Ikeda ◽  
Yasuhiro Yamamoto ◽  
Akira Teramoto
Keyword(s):  
Intracerebral Hemorrhage ◽  
Ct Angiography ◽  
Computerized Tomography ◽  
Three Dimensional ◽  
Ct Scanning ◽  
3D Ct ◽  
Content Type ◽  
Hematoma Enlargement ◽  
3D Ct Angiography ◽  
Fine Print

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.

Traumatic subarachnoid hemorrhage on the computerized tomography scan obtained at admission: a multicenter assessment of the accuracy of diagnosis and the potential impact on patient outcome

2003 ◽  
Vol 98 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Cristina Mattioli ◽  
Luigi Beretta ◽  
Simonetta Gerevini ◽  
Fabrizio Veglia ◽  
Giuseppe Citerio ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Subarachnoid Hemorrhage ◽  
Computerized Tomography ◽  
Statistical Significance ◽  
Unfavorable Outcome ◽  
Content Type ◽  
Ct Findings ◽  
Traumatic Subarachnoid Hemorrhage ◽  
Injured Patients ◽  
Fine Print

Object. The goal of this study was fourfold: 1) to determine the incidence of traumatic subarachnoid hemorrhage (tSAH) in patients with traumatic brain injury (TBI); 2) to verify agreement in the diagnosis of tSAH in a multicenter study; 3) to assess the incidence of tSAH on the outcome of the patient; and 4) to establish whether tSAH itself leads to an unfavorable outcome or whether it is a sign of major brain trauma associated with severe posttraumatic lesions. Methods. Computerized tomography (CT) scans obtained in 169 head-injured patients on admission to 12 Italian intensive care units during a 3-month period were examined. The scans were collected for neuroradiological review and were used for the analysis together with data from a multicenter database (Neurolink). A review committee found a high incidence of tSAH (61%) in patients with TBI and a moderate agreement among centers (K = 0.57). Significant associations were observed between the presence and grading of tSAH and patient outcomes, and between the presence of tSAH and the severity of the CT findings. Logistic regression analysis showed that the presence of tSAH and its grading alone do not assume statistical significance in the prediction of unfavorable outcome. Conclusions. Traumatic SAH frequently occurs in patients with TBI, but it is difficult to detect and grade. Traumatic SAH is associated with more severe CT findings and a worse patient outcome.

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