CT Scan importance in the first eight hours of head injury

Traumatic brain injury following head injury is a major public health problem that can result in significant long-term morbidity and mortality among adults and children worldwide. Emergency brain imaging is necessary for individuals subjected to traumatic brain injury to early detect treatable conditions. Prompt neurosurgical management of treatable conditions can prevent further damage and secondary neurological deficits. This will subsequently improve the outcome and reduce long-term disability. Computed Tomography (CT) of the brain is the investigation of choice for assessment of patients with head injury due to its availability, advantages, and sensitivity for multiple lesions following head trauma. This article will review and discuss the importance of CT imaging in evaluating patients with traumatic brain injury, its advantages, limitations, and prognostic values

Primary malignant rhabdoid tumor of the brain: CT and MR findings

PURPOSE: To describe the CT and MR findings of primary malignant rhabdoid tumor (MRT) of the brain, which is a rare but very aggressive neoplasm in childhood. MATERIALS AND METHODS: Retrospectively, we evaluated the CT and MR findings of 5 patients of primary MRT of the brain with a review of clinical records. RESULTS: The primary MRTs of the brain were large (n = 4) with a tendency to be associated with necrosis, hemorrhage (n = 2) and calcification (n = 2). Solid components of the tumor showed increased attenuation on precontrast CT scan and iso- or slightly hyper-signal intensity on T2-weighted images probably due to hypercellularity. Solid components of the tumor were also well enhanced on contrast-enhanced CT scan (n = 5) and MRI (n = 2). In 1 case with intratumoral bleeding, MR findings were variable on T1-weighted and T2-weighted images. Intracranial and intraspinal metastasis were found in 2 cases on preoperative MR studies. Follow-up CT and MR studies showed recurrence of the tumor and/or leptomeningeal metastasis in 3 cases. CONCLUSIONS: Although CT and MR findings of primary MRT of the brain are nonspecific, a tendency toward large size, calcification and intratumoral bleeding may be attributed to CT and MR findings. The solid components of tumors could present hyperdense on precontrast CT scan and iso- or slightly hyper-signal intensity on T2-weighted MR image. Preoperative and follow-up MR studies are important to detect metastatic foci.

Primary Intracranial Subdural Empyema: Case Report

Two cases of primary intracranial subdural empyema are reported. One is 15 yr-old male and the other is 14 yr-old female. Clinical presentation was high fever, severe headache, impaired consciousness, marked neck stiffness and periorbital swelling in both cases. Since CT brain scan with contract enhancement clearly demonstrated the lesion, angiography was not performed. In one case, craniotomy was done with drainage of pus and thorough irrigation. He died on the 9th postoperative day after generalized covulsive seizure. In the other case, craniectomy was taken. She received additional two craniectomies due to reaccumulation of pus and osteomyelitis, and discharged without major disability on the 64th hospital day. Related reports were briefly reviewed.

Early Prognostic Evaluation with C-T Scan in Cerebral Contusion

The cerebral contusion(necrotic brain tissue infiltrated with blood) is common post-traumatic lesion, In 851 consecutive C-T scan performed by 48 hours from injury, the contusion were present in 193(22.%) of the case. Comparing the midline shift, area, number, size of the lesions and their etiopathogenesis with the clinical course(assessed by Glasgow coma scale), it is possible to evaluate the early prognosis. The patient who showed 1) midline shift over 15mm, 2) the contusional lesion in basal ganglia, brain stem or corpus callosum, 3) multiple or large sized lesion took poor prognosis. Cortical contusion especially in the frontal region had relatively good prognosis. The pathogenetic mechanisms(angular acceleration of the brain) is the same in basal ganglia, brain stem and corpus callosum, but a direct impact of the In conclusion, the etiopathogenetic mechanism and consequent site of the cerebral contusion are the most important factors on the evaluation of the severity of the brain damage and their prognosis.

Clinical Analysis of Intracranial Tuberculomas

We have experienced 10 cases of intracranial tuberculoma which were confirmed by CT scan in National Medical Center from Jan. '79 to Aug. '82. The analysis is based on 10 cases with intracranial tuberculoma on whom operation was performed in 7 cases and conservative treatment was done in 3 cases. Extracranial disease or a past history of tuberculosis are evident in half of patients. The common presenting features are intracranial hypertension and papilledema. These are usually located in the supratentorial region. The use of CT brain scanning can be of great help in diagnosis and follow up more than others. The current treatment consists of medical therapy such as combined antituberculous agents, but surgical exploration may be reserved for intractable seizure, suspected brain tumor and medical failure or severe intracranial hypertension.