Carbon monoxide poisoning: clinical, neurophysiological, and brain imaging observations in acute disease and follow-up.

Five patients (aged 19-52 years) were treated for a midbrain syndrome due to acute carbon monoxide poisoning and had clinical follow-up investigations for up to 18 months. Three patients recovered with minor neurological and neuro-psychological deficits and resumed their premorbid life-style. One patient had normal findings, while the fifth remained in a permanent vegetative state. Initial CT of the brain may fail to detect low-density lesions in the globus pallidus. If present, these lesions may either have disappeared, diminished, or remained unchanged at follow-up. Long-term outcome seems to show a closer link to white matter changes, which are at present best investigated by magnetic resonance imaging. The additional value of determining visual evoked responses at repeated follow-up is suggested by the present investigation.

Diagnosis of hypertrophic cardiomyopathies by non-ECG-gated cardiac computed tomography (CCT).

In order to study the significance of non-ECG-gated cardiac computed tomography (CCT) for the diagnosis of hypertrophic cardiomyopathies, the method was applied in 55 consecutive patients and the data were correlated with the echocardiogram. In a subset of 18 patients left and right heart catheterization was additionally performed, and in a subset of 17 patients, endomyocardial biopsy was performed. The CCT turned out to be an easily applicable, non-time-consuming method for obtaining a sectional visualization of the left and right ventricle. Regarding the septal thickness, there was an unexpectedly high correlation between CCT and echocardiogram (r = 0.9). The left ventricular deformity observed by echocardiogram and angiography in patients with hypertrophic cardiomyopathies corresponded well to that visualized by CCT, leading to a good differentiation between HOCM and HNCM (diagnostic specificity: 92% and 80%, respectively). It is concluded that the non-ECG-gated CCT seems to be a very helpful non-invasive method for diagnosing hypertrophic cardiomyopathies and differentiating between the obstructive and nonobstructive forms. From a clinical point of view, this may be important, mainly in patients in whom no clear-cut diagnosis is possible using previously applied non-invasive methods, including echocardiography. It may also be useful for follow-up studies, providing a sectional insight into the distribution of left ventricular hypertrophy.

[Diagnostic and therapeutic problems in amebic liver abscess]. / Diagnostische und therapeutische Probleme beim Amöbenabscess der Leber.

Abscesses of the liver represent the most common complications of amebiasis. In general they are treated non-surgically by the aid of Metronidazol. Complications, however, such as perforations, development of fistulas or septicemia may occur and necessitate surgical intervention. The role of CT in diagnostic problems and therapeutic management is discussed in three different cases with respect to other diagnostic techniques.