ABSTRACT
Background: There are numerous causes of epilepsy. A neuroimaging study should be done to exclude a structural brain abnormality. The present study was undertaken to find the role of Computed Tomography (CT) scan in patients presenting to our hospital with seizure disorders. Methods: Adult patients who presented to our hospital with history of seizures underwent non-contrast CT scan. Assessment of a radiologist were noted. Results: A total of 90 patients were included, 51% had Simple Partial Seizure (SPS), 21% had Complex Partial Seizure and 28% had Generalized Tonic Clonic (GTC) type. No abnormality was found in 37.8% of the patients. Space occupying lesions were diagnosed in 24.4% of the patients, vascular lesions in eight patients, gliosis and encephalitis in seven patients each, tumours and trauma related lesions in six and four patients respectively. Half of all SPS were localised to the frontal lobe. CPS were similarly distributed in the frontal and occipital, had more than one lobe involvement and included bilateral cerebral hemispheres. GTC more commonly involved occipital lobe than frontal or parietal lobe. More than one lobe involvement or bilateral cerebral hemispheres were most common in GTC, as compared to SPS or CPS. Space occupying lesions manifested mainly as SPS or CPS, and none as GTC. Vascular lesions presented as partial seizures only. In those with a normal CT appearance, SPS was most common. Conclusions: CT scan provides an easier and cheaper means to diagnose a number of organic lesions which may cause seizure disorders
ABSTRACT
Solitary fibrous tumour is an uncommon mesenchymal neoplasm diagnosis of which is difficult because of non-specific clinical and radiological features. A 76 year old male presented with complaints of nausea and vomiting. Physical examination revealed firm mass in the right hypochondrium and epigastrium. CT scan revealed a heterogeneous, lobed and some vascularized mass of size 17.6 x 12.8 cm, situated in the right lobe. After surgery the mass was found to measure 19 cm x 13 cm x 10 cm. Histopathological examination found the tumour cells to be strongly positive for vimentin and CD34, confirming our diagnosis. Microscopic examination revealed haphazard arrangement of spindle cells and collagen bundles between the tumour cells with mild nuclear pleomorphism, and the mitotic count was 0-1/10 high power field. The post-operative course was uncomplicated and the patient was discharged home. After 16 months of follow up examinations, there was no recurrence of disease, local or distant metastasis and the patient remained asymptomatic. The clinical presentation and the radiological imaging can be very non-specific. Suggestive features on CT scan are a single, large, well-circumscribed, heterogeneously enhancing hepatic mass.
ABSTRACT
Background: Intra uterine growth restriction (IUGR) is a common clinical sign seen due to chronic foetal hypoxemia and is considered a major contributor of perinatal morbidity and mortality. The aim of the present study was to determine and compare the sensitivity and specificity of umbilical artery pulsatility index (UA PI), middle cerebral artery (MCA) PI and cerebral perfusion ratio (CPR) in predicting adverse and poor perinatal outcomes in fetuses with IUGR.Methods: The study included 100 pregnant women with post 24 weeks of gestation with clinical history of IUGR. Doppler examination parameters, including waveforms and measurements, of the umbilical artery, middle cerebral artery were recorded. The Cerebral Perfusion Ratio (CPR) was calculated from MCA PI and UA PI and a final comparison of accuracy of Doppler indices was done with perinatal outcome.Results: The sensitivity of the UA PI was higher (49.3%) than that of the MCA PI (43.6%) and the CPR (37.7%). The specificity of the CPR was higher (87.1%) than that of the MCA PI (83.9%) and the UA PI (74.2%).Conclusions: From the findings of the study, it can be concluded that UA PI is the most sensitive and CPR is the most specific parameter in predicting adverse perinatal outcomes in IUGR fetuses. Thus, in addition to pulsatility indices, CPR should be used as a tool for surveillance and included in the routine reporting formats of obstetric Doppler studies.