Evaluation of head trauma by computed tomography.

A wide spectrum of traumatic abnormalities has been demonstrated by computed tomography. CT findings in acute trauma range from cerebral edema and contusion to intracerebral or extracerebral hematoma, subarachnoid and intraventricular hemorrhage and varying combinations thereof. Late traumatic changes shown by CT include chronic subdural hygroma, post-traumatic infarct, and porencephaly and hydrocephalus. The latter findings are indistinguishable from changes resulting from degenerative or ischemic brain disease. Follow-up CT scanning elucidates the natural course of various traumatic lesions. Occasionally, it may uncover occult, delayed sequelae which can be remedied surgically before irreparable brain damage occurs.

Association of autoantibodies to different nuclear antigens with clinical patterns of rheumatic disease and responsiveness to therapy.

Using a hemagglutination test which can detect antibodies to (a) native and denatured deoxyribonucleic acid (DNA) and (b) an extractable nuclear antigen (ENA), a comparative study of patterns of autoantibody formation has been done in systemic lupus erythematosus (SLE) and related rheumatic diseases. Antibody to native DNA was present in the serum in 96% of patients with active SLE and disappeared during remissions. Antibody to ENA was found in 86% of those patients with SLE nephritis who responded to treatment but in only 8% of those who did not. The highest titers of antibody to ENA were found in patients having a mixed connective tissue disease syndrome with features of SLE, scleroderma, and myositis. The latter syndrome was notable for the absence of renal disease and for a striking responsiveness to corticosteroid therapy. Hemagglutination testing of 277 sera from normal persons and patients with a wide variety of acute diseases other than SLE revealed the presence of antibody to native DNA in only 1.4% and antibody to ENA in only 0.4%. These results yield significant correlations among the pattern of autoimmune reactivity, the clinical form of the rheumatic disease, and responsiveness to treatment. They implicate the qualitative nature of the patient's immune response as a conditioning factor in the type of disease. Together with other correlations they may allow classification of rheumatic diseases into more biologically meaningful groups and lead to more selective methods of therapy.