Progressive neurological deficits with benign intracerebral cysts

1986 ◽  
Vol 65 (5) ◽  
pp. 706-709 ◽  
Author(s):  
Yoko Nakasu ◽  
Jyoji Handa ◽  
Kazuyoshi Watanabe

✓ 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.

1985 ◽  
Vol 63 (1) ◽  
pp. 128-130 ◽  
Author(s):  
Henk W. Mauser ◽  
Robert A. P. Ravijst ◽  
Arthur Elderson ◽  
Jan van Gijn ◽  
Cees A. F. Tulleken

✓ The nonsurgical treatment of a case of interhemispheric subdural empyema is reported. At the time of diagnosis, the patient had a mild decrease in consciousness and only moderate focal neurological deficits. Computerized tomography (CT) confirmed the limited (interhemispheric) extent of the intracranial infection. After drainage of the nasal sinuses and antibiotic treatment, the patient recovered, although the lesion was initially increased in size on CT scanning.


2000 ◽  
Vol 92 (6) ◽  
pp. 955-960 ◽  
Author(s):  
Joon K. Song ◽  
Joseph M. Eskridge ◽  
Eun-Chul Chung ◽  
Lindsey C. Blake ◽  
J. Paul Elliott ◽  
...  

Object. The aim of this study was to determine the incidence and clinical significance of complications related to preoperative embolization of cerebral arteriovenous malformations (AVMs) with silk sutures as documented on postprocedure computerized tomography (CT) scans.Methods. The CT scans were obtained within 12 to 24 hours after 221 (96%) of 230 consecutive embolizations in 70 patients. These CT scans were evaluated for the presence of ischemia, infarction, hemorrhage, or contrast agent extravasation. Adverse patient outcomes were determined after each embolization and were correlated with CT findings. New abnormalities demonstrated on CT scans were also correlated with the Spetzler—Martin AVM grade, degree of arteriovenous shunting, and location. New abnormalities, the majority of them infarcts, resulted from 29 (13%) of 221 embolization procedures. In 11 (38%) of 29 cases of new CT findings, patients were asymptomatic, including 10 with new infarcts on CT scans. New neurological deficits occurred in 20 (8.7%) of 230 total embolization procedures in 19 patients, including one death. Permanent deficits occurred in nine patients (3.9% per embolization procedure, 12.8% per patient). Of the patients with new neurological deficits, 18 (90%) of 20 embolization procedures resulted in new abnormalities on CT scans. Two patients with new transient neurological deficits had no new findings on CT scans. Spetzler—Martin grade, AVM location, degree of arteriovenous shunting, and higher numbers of procedures were not statistically associated with a higher incidence of abnormalities on CT scans or new permanent neurological deficits.Conclusions. Silk sutures are an effective and relatively safe embolic agent. After brain AVM embolization with silk sutures, new abnormalities were found on CT scans obtained in one of eight procedures. When a new CT finding occurred, the patient had roughly equal chances of having no new symptoms, having new transient neurological deficits, or having new permanent neurological deficits.


1979 ◽  
Vol 50 (3) ◽  
pp. 339-342 ◽  
Author(s):  
Tuncalp Özgen ◽  
Aykut Erbengi ◽  
Vural Bertan ◽  
Süleyman Saǧlam ◽  
Özdemir Gürçay ◽  
...  

✓ 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.


2002 ◽  
Vol 97 (3) ◽  
pp. 607-610 ◽  
Author(s):  
Hiroshi Wanifuchi ◽  
Takashi Shimizu ◽  
Takashi Maruyama

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.


1985 ◽  
Vol 62 (1) ◽  
pp. 153-156 ◽  
Author(s):  
D. Andries Bosch ◽  
Gustaaf N. Beute

✓ 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.


1982 ◽  
Vol 56 (1) ◽  
pp. 131-134 ◽  
Author(s):  
Hiroshi Yuasa ◽  
Sumitaka Tokito ◽  
Kazuo Izumi ◽  
Kazuaki Hirabayashi

✓ A 51-year-old woman became unconscious 19 hours after the onset of a headache. Computerized tomography disclosed an intracerebral hematoma in the left temporal lobe, with ventricular penetration. Angiography demonstrated the characteristic appearance of cerebrovascular moyamoya disease as well as an aneurysm-like shadow in the left temporal lobe, which proved on histological examination to be a pseudoaneurysm.


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.


2003 ◽  
Vol 98 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Cristina Mattioli ◽  
Luigi Beretta ◽  
Simonetta Gerevini ◽  
Fabrizio Veglia ◽  
Giuseppe Citerio ◽  
...  

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.


1990 ◽  
Vol 73 (2) ◽  
pp. 201-205 ◽  
Author(s):  
Nobuhiko Aoki

✓ The cases of 30 infants with chronic subdural hematoma treated surgically between 1978 and 1987 (after the introduction of computerized tomography) were reviewed. This series was limited to infants presenting with increased intracranial pressure, neurological deficits, or developmental retardation. Nineteen patients were male and 11 were female, ranging in age from 1 to 14 months (average 6.1 months). The surgical treatment was initiated with percutaneous subdural tapping which was repeated periodically, if indicated, for 2 weeks. If the patients failed to respond to subdural tapping, subdural-peritoneal shunting was installed. The follow-up periods were from 3 months to 9 years 8 months (average 4 years 10 months). Computerized tomography at that time disclosed disappearance or minimal collection of subdural fluid in 28 cases (93%) and a significant collection (> 5 mm) in two (7%). Neurological examination revealed that the patients were “normal” in 17 cases (57%), “mildly or moderately disabled” in nine (30%), and “severely disabled” in four (13%). The majority of disabled patients had lesions secondary to infantile acute subdural hematoma, child abuse, or hemorrhagic diathesis. These results indicate that the treatment protocol in the present series is acceptable for the elimination of subdural hematoma. Together, early diagnosis and treatment of the etiological conditions causing the lesion are indispensable for obtaining a satisfactory neurological outcome.


1978 ◽  
Vol 48 (3) ◽  
pp. 360-368 ◽  
Author(s):  
M. Judith Donovan Post ◽  
Fredie P. Gargano ◽  
Donald Q. Vining ◽  
Hubert L. Rosomoff

✓ With the advent of computerized tomography (CT), a new method of visualizing the spinal canal in cross-section has been created. Before the introduction of CT scanning, evaluation of the cross-sectional anatomy of the spinal canal was accomplished chiefly by the Toshiba unit. This study compares these two forms of tomography and discusses their relative effectiveness in diagnosing constrictive lesions of the spinal canal.


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