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.

scholarly journals A Comparison of CT Contrast Enhancement and BUDR Labeling Indices in Moderately and Highly Anaplastic Astrocytomas of the Cerebral Hemispheres

1992 ◽  
Vol 19 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Michael W. McDermott ◽  
Hendrikus G.J. Krouwer ◽  
Akio Asai ◽  
Satoyuki Ito ◽  
Takao Hoshino ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Computerized Tomography ◽  
Cerebral Hemisphere ◽  
Cerebral Hemispheres ◽  
Labeling Index ◽  
Ct Scans ◽  
Proliferative Potential ◽  
Ct Contrast

ABSTRACT:Contrast enhancement on computerized tomography (CT) scans has been used in directing therapy for presumed intracranial gliomas. However, for moderately anaplastic astrocytomas (MOAAS) and highly anaplastic astrocytomas (HAAS), it provides no information about proliferative potential. The bromodeoxyuridine (BUDR) labeling index (LI), however, indicates proliferative potential, correlating with histologic malignancy and survival. An LI < 1% is a favorable indicator; LI > 5% suggests more aggressiveness. To determine the correlation, if any, between BUDR LI and contrast enhancement, CT scans of 71 patients with cerebral hemisphere tumors labeled with BUDR were retrospectively reviewed. Among 36 MOAAS, the BUDR LI was < 1% in 77% of enhanced tumors and 61% of unenhanced tumors. Among 35 HAAS, it was < 5% in 56% of enhanced tumors and 90% of unenhanced tumors. Therefore, contrast enhancement on CT scans does not always correctly predict proliferative potential in these tumors, and biopsy and labeling studies are recommended before therapy.

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.

Benign osteoblastoma of a thoracic vertebra

1980 ◽  
Vol 53 (5) ◽  
pp. 710-713 ◽  
Author(s):  
Nancy Epstein ◽  
Vallo Benjamin ◽  
Richard Pinto ◽  
Gleb Budzilovich
Keyword(s):  
Spinal Cord ◽  
Computerized Tomography ◽  
Residual Tumor ◽  
Cord Compression ◽  
Transthoracic Approach ◽  
Content Type ◽  
Benign Osteoblastoma ◽  
Posterior Laminectomy ◽  
Subtotal Removal ◽  
Fine Print

✓ A patient with osteoblastoma of the T-11 vertebral body presented with symptoms of spinal cord compression. Six weeks after an emergency laminectomy and subtotal removal, spinal computerized tomography disclosed residual tumor, which was totally removed via a combined anterior transthoracic approach and posterior laminectomy.

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.

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.

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.

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.

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.

Clinical stages of human brain abscesses on serial CT scans after contrast infusion

1983 ◽  
Vol 59 (6) ◽  
pp. 972-989 ◽  
Author(s):  
Richard H. Britt ◽  
Dieter R. Enzmann
Keyword(s):  
Human Brain ◽  
Contrast Enhancement ◽  
Brain Abscess ◽  
Ct Scans ◽  
Corticosteroid Administration ◽  
Content Type ◽  
Brain Abscesses ◽  
Serial Ct ◽  
Autopsy Specimens

✓ The authors describe a classification of human brain abscesses into stages of development as demonstrated on computerized tomography (CT) scans. The results of CT staging of 14 human brain abscesses are compared with the previously published findings in an experimental brain abscess model developed by the same authors. The CT criteria for categorizing brain abscesses into cerebritis and capsule stages were based on the pattern of contrast enhancement and the time-density curve of enhancement obtained from sequential CT scans after contrast infusion. Using these CT criteria, it was possible to accurately categorize all 14 brain abscesses into cerebritis and capsule stages. Histological examination of surgical and autopsy specimens provided immediate confirmation of the abscess stage in six patients. Indirect staging, based on surgical findings and/or subsequent autopsy findings, was possible in eight patients. Corticosteroid administration greatly reduced contrast enhancement in the cerebritis stage, but had little effect in the capsule stage. A systematic approach utilizing CT for establishing the diagnosis, staging, and treatment planning of brain abscess is proposed.

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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