ABSTRACT
To examine the premise that cognitive impairment in Huntington's disease (HD) is related to striatal degeneration, we determined those cognitive deficits most closely associated with linear CT indices of brain atrophy in HD. We systematically evaluated 60 drug-free HD patients who were judged to be in stages I (n = 34) or II (n = 26) of illness. All subjects underwent comprehensive neuropsychological assessment covering a broad spectrum of cognitive operations and standardized head CT imaging for determination of frontal horn (FH), intercaudate (CC), and outer-table (OT) distances. We grouped the cognitive test results, based on a principal-component factor analysis, to form factors 1 (complex psychomotor), 2 (verbal memory), 3 (visuospatial), and 4 (general knowledge). Factors 1 and 3 sharply discriminated between subjects in stages I and II of illness. Factors 1, 2, and 3 correlated strongly with CC/OT, an index of caudate atrophy, whereas only factor 2 correlated with FH/OT, an index of frontal atrophy. These data demonstrate that cognitive impairment is a clear-cut characteristic of early HD that is linked closely to the extent of caudate atrophy as measured by CT.
Subject(s)
Cognition , Huntington Disease/psychology , Neuropsychological Tests , Tomography, X-Ray Computed , Adult , Aged , Atrophy , Brain/diagnostic imaging , Female , Humans , Huntington Disease/diagnostic imaging , Male , Middle Aged , Psychomotor PerformanceABSTRACT
This review article emphasizes the role of computed tomography in the diagnosis and management of brain tumors. The head CT scan has become one of the most precise noninvasive tests in the neurosciences. It has given clinicians more information than they were able to obtain in the past. The subject is covered by subdividing it into several categories: detection of true tumor extent, radiation treatment planning, the immediate postoperative period, treatment responses, failure patterns, detection of radiation-induced damage, and the potential to predict histopathology. The paper is illustrated with examples that emphasize the advantages and some of the limitations of computed tomography as it exists today.
Subject(s)
Brain Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Brain/radiation effects , Brain Neoplasms/pathology , Brain Neoplasms/therapy , Child , Female , Humans , Radiation Injuries/etiology , Radiotherapy/adverse effectsABSTRACT
Distinctive plain X-ray and computer assisted tomography (CAT) findings led to the diagnosis in a case of teratoma in the pineal region and helped avoid invasive investigations. The demonstration by CAT of the location and size of the tumor as well as the presence of marked hydrocephalus directed the patient's therapy to ventriculoperitoneal shunting and radiation.
Subject(s)
Brain Neoplasms/diagnostic imaging , Pineal Gland/diagnostic imaging , Teratoma/diagnostic imaging , Adolescent , Brain Neoplasms/complications , Female , Humans , Radiography , Rupture, Spontaneous , Teratoma/complicationsABSTRACT
Thirty-two cases of proved pineal tumor were analyzed. Calcification was seen in 75%. The size, character, and position of the calcification were useful indicators of abnormality on plain-film evaluation. Fray's cranioangle method was more sensitive than Oon's method in determining abnormal position of the calcified pineal tumor on the lateral skull film. Most calcifications were displaced postero-inferiorly or inferiorly, which can be explained by obstructive hydrocephalus or direct tumor expansion.