Reliability of left and right indicators in CT scanning of the head

1987 ◽  
Vol 67 (2) ◽  
pp. 291-292 ◽  
Author(s):  
Alfred J. Luessenhop ◽  
Dieter Schellinger
Keyword(s):  
Ct Scan ◽  
Computerized Tomography ◽  
Patient Positioning ◽  
Ct Scanning ◽  
Ct Scanner ◽  
Content Type ◽  
Normal Side ◽  
Present Generation ◽  
Left And Right ◽  
Fine Print

✓ A case is described in which incorrect preliminary programming of a computerized tomography (CT) machine caused transposition of the left- and right-side indicators in a CT scan, which led to craniotomy on the normal side. The possible mechanism for this is incorrect pre-scan programming of the CT scanner with respect to patient positioning in the scanner gantry. This error, although unlikely, is still possible with the present generation of CT scanners.

Preliminary experience with Brown-Roberts-Wells (BRW) computerized tomography stereotaxic guidance system

1983 ◽  
Vol 59 (2) ◽  
pp. 217-222 ◽  
Author(s):  
M. Peter Heilbrun ◽  
Theodore S. Roberts ◽  
Michael L. J. Apuzzo ◽  
Trent H. Wells ◽  
James K. Sabshin
Keyword(s):  
Ct Scan ◽  
Computerized Tomography ◽  
Guidance System ◽  
Production Model ◽  
Ct Scanner ◽  
Content Type ◽  
Ct Scanners ◽  
Guidance Systems ◽  
Fine Print

✓ The production model of the Brown-Roberts-Wells (BRW) computerized tomography (CT) stereotaxic guidance system is described. Hardware and software modifications to the original prototype now allow the system to be used independently of the CT scanner after an initial scan with the localizing components fixed to the skull. The system is simple and efficient, can be used universally with all CT scanners, and includes a phantom simulator system for target verification. Preliminary experience with 74 patients at two institutions is described. It is concluded that CT stereotaxic guidance systems will become important tools in the neurosurgical armamentarium, as they allow accurate approach to any target identifiable on the CT scan.

Intraoperative computerized tomography scanning to assess the adequacy of decompression in anterior cervical spine surgery

2001 ◽  
Vol 94 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Stephen R. Freidberg ◽  
Bernard A. Pfeifer ◽  
Peter K. Dempsey ◽  
Edward C. Tarlov ◽  
Michael A. Dube ◽  
...  
Keyword(s):  
Ct Scan ◽  
Computerized Tomography ◽  
High Speed ◽  
Ct Scanning ◽  
Bone Resection ◽  
Content Type ◽  
Intraoperative Ct ◽  
Bone Removal ◽  
Cervical Surgery ◽  
Fine Print

Object. The purpose of this study was to improve the accuracy of bone removal during anterior spinal surgery. Intraoperative computerized tomography (CT) scanning was used to assess the success of bone resection and permit immediate correction in the event of inadequate bone removal. Methods. The Phillips Tomoscan M was used to obtain preoperative cervical scans before and after cervical bone resection was complete. The completeness of bone removal was assessed by the operating neurosurgeon by reviewing the postresection CT scan. If the bone removal was deemed inadequate, additional bone was removed using a high-speed drill. A CT scan was obtained after each subsequent decompression until adequate bone removal was achieved. In 31 patients undergoing anterior cervical decompression intraoperative CT scanning was performed. Nineteen patients underwent corpectomy and 12 discectomy. Of the 31 patients, assessment of intraoperative CT scans obtained in 17 indicated further bone removal was required. Conclusions. Intraoperative CT scanning to monitor bone removal during anterior cervical surgery is a valuable tool to ensure the adequacy of surgery.

Prognostic value of early computerized tomography scanning following craniotomy for traumatic hematomas

1999 ◽  
Vol 91 (4) ◽  
pp. 581-587 ◽  
Author(s):  
Santiago Lubillo ◽  
José Bolaños ◽  
Luis Carreira ◽  
José Cardeñosa ◽  
Javier Arroyo ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Hospital Stay ◽  
Ct Scan ◽  
Computerized Tomography ◽  
Ct Scanning ◽  
Unfavorable Outcome ◽  
Content Type ◽  
Gcs Score ◽  
Fine Print

Object. Patients with head injuries traditionally were categorized on the basis of whether their lesions appeared to be diffuse, focal, or mass lesions on admission computerized tomography (CT) scanning. In the classification of Marshall, et al., the presence of a hematoma (evacuated or not evacuated) is more significant than any diffuse injury (DI). The CT scan appearance after evacuation of a mass lesion has not been analyzed previously in relation to outcome. The authors have investigated the importance of: 1) neurological assessment at hospital admission; 2) the status of the basal cisterns and associated intracranial lesions on the admission CT scan; and 3) the degree of DI on the early CT scan obtained after craniotomy to identify patients at risk for development of raised intracranial pressure (ICP) and lowered cerebral perfusion pressure (CPP) and to discover the influence of the postoperative CT appearance of the lesion on patient outcome.Methods. The authors prospectively studied 82 patients with isolated, severe closed head injury (Glasgow Coma Scale [GCS] score ≤ 8), all of whom had intracranial hematoma. Both ICP and CPP were continuously monitored, and a CT scan was obtained within 2 to 12 hours after craniotomy. The CT images were categorized according to the classification of Marshall, et al.The mortality rate during the hospital stay was 37%, and 50% of the patients achieved a favorable outcome. Compression of the basal cistern on the admission (preoperative) CT scan was associated with raised ICP and a CPP of less than 70 mm Hg but not with any other features or with poor patient outcome. In 53 patients the postoperative CT scan revealed DIs III or IV and 29 patients had DIs I or II. The percentages of time during the hospital stay in which ICP was higher than 20 mm Hg and CPP was lower than 70 mm Hg as well as unfavorable outcome were higher in the group of patients in whom DI III or IV was present (p < 0.001). Raised ICP, CPP lower than 70 mm Hg, DI III or IV, and unfavorable outcome were more frequently observed in patients who presented with a motor (m)GCS score of 3 or less, bilateral unreactive pupils, associated intracranial injuries, and hypotension (p < 0.001). When logistic regression analysis was performed, an mGCS score of 3 or less (p = 0.0013, odds ratio [OR] 10.8), bilateral unreactive pupils (p = 0.0047, OR 31.8), and DI III or IV observed on CT scanning after surgery (p = 0.015, OR 8.9) were independently associated with poor outcome.Conclusions. Features on CT scans obtained shortly after craniotomy constitute an independent predictor of outcome in patients with traumatic hematoma. Patients in whom DI III or IV appears on postoperative CT scanning, who often present with an mGCS score of 3 or less and nonreactive pupils, are at high risk for the development of raised ICP and lowered CPP.

Investigation and management of suprasellar arachnoid cysts

1982 ◽  
Vol 57 (5) ◽  
pp. 597-602 ◽  
Author(s):  
Harold J. Hoffman ◽  
E. Bruce Hendrick ◽  
Robin P. Humphreys ◽  
Edward A. Armstrong
Keyword(s):  
Cerebrospinal Fluid ◽  
Ct Scan ◽  
Computerized Tomography ◽  
Arachnoid Cysts ◽  
Cerebrospinal Fluid Shunt ◽  
Ct Scanner ◽  
Content Type ◽  
The Past ◽  
Suprasellar Arachnoid Cyst ◽  
Fine Print

✓ Suprasellar arachnoid cysts, although rare, are now being found with increasing frequency with the help of the computerized tomography (CT) scanner. Forty-six cases have been reviewed from the literature, and the authors add eight patients seen at their institution during the past 6 years. This latter group have all been diagnosed by CT scan combined with an injection of metrizamide through an implanted diversionary cerebrospinal fluid shunt. Patients in whom the suprasellar arachnoid cyst had produced hydrocephalus were treated by communicating the cyst with the ventricular system via a transcallosal route, with very satisfactory results.

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.

Incidence of silent hemorrhage and delayed deterioration after stereotactic brain biopsy

1998 ◽  
Vol 89 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Abhaya V. Kulkarni ◽  
Abhijit Guha ◽  
Andres Lozano ◽  
Mark Bernstein
Keyword(s):  
Ct Scan ◽  
Neurological Deficit ◽  
Stereotactic Biopsy ◽  
Brain Biopsy ◽  
Ct Scanning ◽  
Ct Scans ◽  
Stereotactic Brain Biopsy ◽  
Content Type ◽  
Fine Print

Object. Many neurosurgeons routinely obtain computerized tomography (CT) scans to rule out hemorrhage in patients after stereotactic procedures. In the present prospective study, the authors investigated the rate of silent hemorrhage and delayed deterioration after stereotactic biopsy sampling and the role of postbiopsy CT scanning. Methods. A subset of patients (the last 102 of approximately 800 patients) who underwent stereotactic brain biopsies at the Toronto Hospital prospectively underwent routine postoperative CT scanning within hours of the biopsy procedure. Their medical charts and CT scans were then reviewed. A postoperative CT scan was obtained in 102 patients (aged 17–87 years) who underwent stereotactic biopsy between June 1994 and September 1996. Sixty-one patients (59.8%) exhibited hemorrhages, mostly intracerebral (54.9%), on the immediate postoperative scan. Only six of these patients were clinically suspected to have suffered a hemorrhage based on immediate postoperative neurological deficit; in the remaining 55 (53.9%) of 102 patients, the hemorrhage was clinically silent and unsuspected. Among the clinically silent intracerebral hemorrhages, 22 measured less than 5 mm, 20 between 5 and 10 mm, five between 10 and 30 mm, and four between 30 and 40 mm. Of the 55 patients with clinically silent hemorrhages, only three demonstrated a delayed neurological deficit (one case of seizure and two cases of progressive loss of consciousness) and these all occurred within the first 2 postoperative days. Of the neurologically well patients in whom no hemorrhage was demonstrated on initial postoperative CT scan, none experienced delayed deterioration. Conclusions. Clinically silent hemorrhage after stereotactic biopsy is very common. However, the authors did not find that knowledge of its existence ultimately affected individual patient management or outcome. The authors, therefore, suggest that the most important role of postoperative CT scanning is to screen for those neurologically well patients with no hemorrhage. These patients could safely be discharged on the same day they underwent biopsy.

CT infusion scanning for the detection of cerebral aneurysms

1989 ◽  
Vol 71 (2) ◽  
pp. 175-179 ◽  
Author(s):  
David W. Newell ◽  
Peter D. LeRoux ◽  
Ralph G. Dacey ◽  
Gary K. Stimac ◽  
H. Richard Winn
Keyword(s):  
Intracerebral Hemorrhage ◽  
Ct Scan ◽  
Computerized Tomography ◽  
Cerebral Aneurysms ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Content Type ◽  
Spontaneous Hemorrhage ◽  
Fine Print

✓ 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.

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.

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