Localization of brain tumors with a simple scalp-mounted fiducial device

1989 ◽  
Vol 70 (2) ◽  
pp. 280-281 ◽  
Author(s):  
Henry Hirschberg
Keyword(s):  
Brain Tumors ◽  
Ct Scan ◽  
Computerized Tomography ◽  
Ct Images ◽  
Ct Scans ◽  
Content Type ◽  
Varying Length ◽  
Fine Print

✓ A method is described for marking the site of a tumor on the scalp based on information from computerized tomography (CT) scans. The technique employs a syrinx-shaped array of radiopaque catheters of varying length taped to the patient's scalp for visualization on the CT scan. Fiducial markings on the CT images allow the transfer of the tumor's location directly onto the scalp. The device can be placed anywhere on the scalp, including in a parasagittal position.

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.

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.

Clinicopathological investigation of gyral high density on computerized tomography following severe head injury in children

1995 ◽  
Vol 82 (6) ◽  
pp. 995-1001 ◽  
Author(s):  
Takehide Onuma ◽  
Yasuko Shimosegawa ◽  
Motonobu Kameyama ◽  
Hiroaki Arai ◽  
Kiyoshi Ishii
Keyword(s):  
Computerized Tomography ◽  
Head Trauma ◽  
Brain Atrophy ◽  
High Density ◽  
Ct Scans ◽  
Severe Head Trauma ◽  
Content Type ◽  
Subacute Stage ◽  
Fine Print ◽  
Diffuse Brain

✓ The authors have treated five cases of severe head trauma in children in which abnormally high density along gyri, “gyral high density,” was seen on plain computerized tomography (CT) scans in the subacute stage of the injury. The prognosis in all cases was poor, with either severe disability or a vegetative state as the outcome due to significant brain atrophy following gyral high density. This pathology was classified into three clinical stages: 1) acute stage, cerebral ischemia in which there is diffuse low density of the cerebrum on CT scans (most marked on the 3rd and 4th days); 2) subacute stage, hemorrhagic infarction showing gyral high density on plain CT scans (between 1 and 4 weeks); and 3) chronic stage, brain atrophy (beginning 4 weeks after the trauma). In their consecutive series of head-injured patients (516 children, 1459 adults), the authors did not find gyral high density on CT scan in adults. This is probably due to the fact that adults who suffer the severe head trauma associated with diffuse brain swelling or diffuse brain edema cannot survive, thus making this gyral high density unique to children.

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.

Progressive hemorrhage after head trauma: predictors and consequences of the evolving injury

2002 ◽  
Vol 96 (1) ◽  
pp. 109-116 ◽  
Author(s):  
Matthias Oertel ◽  
Daniel F. Kelly ◽  
David McArthur ◽  
W. John Boscardin ◽  
Thomas C. Glenn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ct Scan ◽  
Ct Scanning ◽  
Older Age ◽  
Ct Scans ◽  
Female Ratio ◽  
Content Type ◽  
Male Sex ◽  
Time From Injury ◽  
Fine Print

Object. Progressive intracranial hemorrhage after head injury is often observed on serial computerized tomography (CT) scans but its significance is uncertain. In this study, patients in whom two CT scans were obtained within 24 hours of injury were analyzed to determine the incidence, risk factors, and clinical significance of progressive hemorrhagic injury (PHI). Methods. The diagnosis of PHI was determined by comparing the first and second CT scans and was categorized as epidural hematoma (EDH), subdural hematoma (SDH), intraparenchymal contusion or hematoma (IPCH), or subarachnoid hemorrhage (SAH). Potential risk factors, the daily mean intracranial pressure (ICP), and cerebral perfusion pressure were analyzed. In a cohort of 142 patients (mean age 34 ± 14 years; median Glasgow Coma Scale score of 8, range 3–15; male/female ratio 4.3:1), the mean time from injury to first CT scan was 2 ± 1.6 hours and between first and second CT scans was 6.9 ± 3.6 hours. A PHI was found in 42.3% of patients overall and in 48.6% of patients who underwent scanning within 2 hours of injury. Of the 60 patients with PHI, 87% underwent their first CT scan within 2 hours of injury and in only one with PHI was the first CT scan obtained more than 6 hours postinjury. The likelihood of PHI for a given lesion was 51% for IPCH, 22% for EDH, 17% for SAH, and 11% for SDH. Of the 46 patients who underwent craniotomy for hematoma evacuation, 24% did so after the second CT scan because of findings of PHI. Logistic regression was used to identify male sex (p = 0.01), older age (p = 0.01), time from injury to first CT scan (p = 0.02), and initial partial thromboplastin time (PTT) (p = 0.02) as the best predictors of PHI. The percentage of patients with mean daily ICP greater than 20 mm Hg was higher in those with PHI compared with those without PHI. The 6-month postinjury outcome was similar in the two patient groups. Conclusions. Early progressive hemorrhage occurs in almost 50% of head-injured patients who undergo CT scanning within 2 hours of injury, it occurs most frequently in cerebral contusions, and it is associated with ICP elevations. Male sex, older age, time from injury to first CT scan, and PTT appear to be key determinants of PHI. Early repeated CT scanning is indicated in patients with nonsurgically treated hemorrhage revealed on the first CT scan.

Subependymoma presenting as subarachnoid hemorrhage

1981 ◽  
Vol 55 (4) ◽  
pp. 643-645 ◽  
Author(s):  
David G. Changaris ◽  
James M. Powers ◽  
Phanor L. Perot ◽  
G. Douglas Hungerford ◽  
George B. Neal
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Brain Tumors ◽  
Young Patient ◽  
Computerized Tomography ◽  
Content Type ◽  
Fine Print

✓ Symptomatic subarachnoid hemorrhage (SAH) in a young patient originated in a non-obstructive lateral ventricular subependymoma. A brief review of brain tumors known to cause SAH is discussed. The computerized tomography scans are presented.

Intracerebral myiasis from Hypoderma bovis larva in a child

1989 ◽  
Vol 71 (6) ◽  
pp. 929-931 ◽  
Author(s):  
Müfit Kalelioğlu ◽  
Gönül Aktürk ◽  
Fadiil Aktürk ◽  
Sezer Ş. Komsuoğlu ◽  
Kayhan Kuzeyü ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Ct Scans ◽  
Intracerebral Hematoma ◽  
Review Of The Literature ◽  
Content Type ◽  
First Case ◽  
Hypoderma Bovis ◽  
History Of ◽  
Exact Identification ◽  
Fine Print

✓ Cerebral myiasis with a 10-day history of convulsions due to an intracerebral hematoma caused by a Hypoderma bovis larva is reported in an 8-year-old child. Computerized tomography (CT) showed the hematoma in a right parieto-occipital location. The H. bovis larva and the extensive intracerebral hematoma were discovered during surgery. Among human parasitoses, cerebral myiasis is rare: a review of the literature revealed only two reports, one published in 1969 and one in 1980. This is the first case that has been diagnosed as cerebral myiasis with exact identification of the Hypoderma bovis larva both from the CT scans and at surgery in a patient during life.

The angiographically occult cerebrovascular malformation

1978 ◽  
Vol 48 (2) ◽  
pp. 292-296 ◽  
Author(s):  
James B. Golden ◽  
Richard A. Kramer
Keyword(s):  
Intracerebral Hemorrhage ◽  
Ct Scan ◽  
Vascular Malformation ◽  
Ct Scans ◽  
Cerebral Lesions ◽  
Content Type ◽  
Surgical Exploration ◽  
Diagnostic Possibility ◽  
Cerebrovascular Malformation ◽  
Fine Print

✓ Three cases presenting with hemiparesis, headache, or seizures gave no history suggestive of subarachnoid or intracerebral hemorrhage. Carotid arteriograms were performed, and in each case failed to demonstrate a vascular malformation. In all three cases cerebral lesions were shown by either computerized tomographic (CT) scan, radionuclide scan, or both. Surgical exploration and biopsy revealed a vascular malformation in each case. The CT scans in two of the cases showed dense lesions that could suggest vascular malformation as a diagnostic possibility.

Volumetric quantification of Fisher Grade 3 aneurysmal subarachnoid hemorrhage: a novel approach to predict symptomatic vasospasm on admission computerized tomography scans

2002 ◽  
Vol 97 (2) ◽  
pp. 401-407 ◽  
Author(s):  
Jonathan A. Friedman ◽  
Stephan J. Goerss ◽  
Fredric B. Meyer ◽  
David G. Piepgras ◽  
Mark A. Pichelmann ◽  
...  
Keyword(s):  
Ct Scan ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Ct Scans ◽  
Content Type ◽  
Fisher Grade ◽  
Volumetric Quantification ◽  
Hemorrhage Volume ◽  
Grade 3 ◽  
Fine Print ◽  
New Onset

Object. Predicting which patients with aneurysmal subarachnoid hemorrhage (SAH) will develop delayed ischemic neurological deficit (DIND) due to vasospasm remains subjective and unreliable. The authors analyzed the utility of a novel software-based technique to quantify hemorrhage volume in patients with Fisher Grade 3 aneurysmal SAH. Methods. Patients with aneurysmal SAH in whom a computerized tomography (CT) scan was performed within 72 hours of ictus and demonstrated Fisher Grade 3 SAH were analyzed. Severe DIND was defined as new onset complete focal deficit or coma. Moderate DIND was defined as new onset partial focal deficit or impaired consciousness without coma. Fifteen consecutive patients with severe DIND, 13 consecutive patients with moderate DIND, and 12 consecutive patients without DIND were analyzed. Software-based volumetric quantification was performed on digitized admission CT scans by a single examiner blinded to clinical information. There was no significant difference in age, sex, admission Hunt and Hess grade, or time to admission CT scan among the three groups (none, moderate, or severe DIND). Patients with severe DIND had a significantly higher cisternal volume of hemorrhage (median 30.5 cm3) than patients with moderate DIND (median 12.4 cm3) and patients without DIND (median 10.3 cm3; p < 0.001). Intraparenchymal hemorrhage and intraventricular hemorrhage were not associated with DIND. All 13 patients with cisternal volumes greater than 20 cm3 developed DIND, compared with 15 of 27 patients with volumes less than 20 cm3 (p = 0.004). Conclusions. The authors developed a simple and potentially widely applicable method to quantify SAH on CT scans. A greater volume of cisternal hemorrhage on an admission CT scan in patients with Fisher Grade 3 aneurysmal SAH is highly associated with DIND. A threshold of cisternal hemorrhage volume (> 20 cm3) may exist above which patients are very likely to develop DIND. Prospective application of software-based volumetric quantification of cisternal SAH may predict which patients will develop DIND.

Vascular malformation simulating a glioma on computerized tomography

1981 ◽  
Vol 54 (1) ◽  
pp. 125-127 ◽  
Author(s):  
Patrick M. Foy ◽  
Leandro Lozada ◽  
Malcolm D. Shaw
Keyword(s):  
Arteriovenous Malformation ◽  
Computerized Tomography ◽  
Vascular Malformation ◽  
Ct Scans ◽  
Venous Aneurysm ◽  
Content Type ◽  
Fine Print

✓ A patient with an arteriovenous malformation and giant venous aneurysm was erroneously diagnosed as having an oligodendroglioma on computerized tomography (CT). This case highlights some of the problems of interpretation of CT scans and the dangers of misinterpretation, particularly in the surgical context.

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