ABSTRACT
The authors proposed to evaluate the quantity of anatomical intracranial reserve according to morphometric measurements in axial projection by means of helical computer tomography data of bitemporal distance, width of the tentorial opening, diameter of the foramen magnum and mutual correlation of these parameters in points. This method showed a high accuracy (92%) and predictive value (85%) in determination of terms and volume of complex treatment of 140 victims with craniocerebral injury, 120 patients with primary tumors of the brain and 110 patients with acute disorder of cerebral circulation.
Subject(s)
Brain Diseases/surgery , Brain Injuries/surgery , Brain/diagnostic imaging , Tomography, Spiral Computed/methods , Adult , Brain Diseases/diagnosis , Brain Injuries/diagnosis , Female , Follow-Up Studies , Humans , Male , Middle Aged , Reproducibility of ResultsABSTRACT
The complex clinical and radiation examination was made in 135 victims with craniocerebral trauma and in 120 patients with primary tumors of the brain. All observations evaluated the index of transversal dislocation of the brain. It included derivative of volume parameter of intracranial supratentorial substratum, the value of dislocation of ventricular system and its width relatively to the septum pellucidum and at the same time the state of mind according to Glasgow coma scale. High diagnostic informativity of developed and certified index of transversal dislocation in dif- ferent intracranial pathology allowed using the index for more wide application.
Subject(s)
Brain Neoplasms/diagnosis , Craniocerebral Trauma/diagnosis , Magnetic Resonance Imaging/methods , Neurosurgery/methods , Tomography, Spiral Computed/methods , Brain Neoplasms/surgery , Craniocerebral Trauma/surgery , Humans , Patient Selection , Prognosis , Reproducibility of ResultsABSTRACT
The radiation diagnosis made before and after operation was analyzed in 231 case histories of patients with brain tumors treated in hospitals of St.Petersburg in 2009. Most typical errors of administration and interpretation of radiation diagnostic methods were established. MRI was not performed in 54% of cases, in 32% operative intervention was performed without SCT findings. Contrast enhancement was used but in 68% of observations, angiographic methods--in 8%. Not a single radiation examination was performed in 61% of patients, in 33% SCT was made, in 6%--MRI, only in a third of patients contrast enhancement was used. In 52% of cases control radiation examination was not prescribed in dynamics. The estimation of the data obtained helped to obtain more exact criteria of using radiation methods in patients with tumors of the brain before and after operation.
Subject(s)
Brain Neoplasms/diagnosis , Magnetic Resonance Imaging/methods , Neurosurgical Procedures , Tomography, X-Ray Computed/methods , Brain Neoplasms/surgery , Female , Follow-Up Studies , Humans , Middle Aged , Postoperative Period , Preoperative Period , Reproducibility of Results , Retrospective StudiesABSTRACT
A retrospective analysis of 231 case histories of patients with cerebral tumors treated at different hospitals of St. Petersburg in 2009 and expert assessment of the quality of medical care were made. Most frequent defects of medical care were established which were systematized in 3 main groups depending on their influence on the state and results of treatment of the patient: significant, minimally significant and not significant. They were: different errors in pre- and postoperative examinations, medical and surgical strategy as well as making up medical documentation. Significant defects were revealed in 75%, minimally significant--in 47% and not significant--in 83% of observations. In most cases there was a combination of defects of different groups (79-90%). Assessment of the quality of medical care on the basis of the groups established allows the aimed clinical-organizational liquidation of them.
