[Cerebral cysticercosis. Diagnostic findings and new therapeutic possibilities].
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Biomedical subjects
Publications and source records attributed to H Grau.
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The authors describe two cases with a carotid thrombosis at the level of the skull base. The clinical course and the pathogenesis are discussed with reference to 15 similar cases in the literature. It is considered that a direct injury to the vessel wall is the cause of the carotid thrombosis. To assist in the diagnosis angiography should be undertaken as early as possible. A good collateral supply is the prerequisite for a favourable result.
In 110 parkinsonian patients (53 men, 57 woman) aged 38--81 years, computer-tomographic follow-up investigations were done to assess the development of brain atrophy. The control examinations were done after an average of 28 months. At that time an increase in brain atrophic changes of different localization could be observed in 23% of the patients. In addition, it could be demonstrated that the increase in pathologic CT findings is to be observed especially in patients with higher age, a more marked impairment in psycho-organic capacity, more pronounced handicaps in the fine-motorial performances at the beginning of the study. From the neuroradiological point of view, patients with more marked pathologic CT findings upon the first examination, be these ventricular enlargement and/or cortical atrophy, more often showed a progression of brain atrophy.
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We observed seven comatose patients after various brain injuries who showed an alpha- or spindle-activity in the EEG. All patients were systematically examined by EEG and Computer-Tomography (CT). In all these cases a brain stem lesion was visible in CT. Three times the CT-findings could be verified by autopsy. The CT-findings agree with the well known localization of the lesion in the phono-mesencephalic region in these patients.
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The clinical and radiographic data provided by CT of 34 patients with cerebral defects acquired in early life were analyzed. Seventeen patients showed porus-like defects due to vascular thrombosis. Volume measurements were made in 26 patients to determine tissue loss and volume shifting by ROI. CT is the most effective means of detecting the cause of the lesion.
The diagnostic information obtained from 35 examinations of the skull base by computed tomography (CT) was compared with the findings furnished by conventional or blurring tomography (BT). Computed tomography yielded diagnostically valuable information not only on the soft tissues but also on the bony structures. Compared with BT, CT was superior in 40%, equivalent in 40%, and inferior in 20% of the cases in assessing pathological findings involving the bony structures of the skull base. Obviously, CT's additional capability of accurate display of soft tissue changes represents a fundamental diagnostic advantage.
It is possible to demonstrate extremely fine calcification by computer tomography which cannot be shown by skull radiographs. A value of + 70 CT units was found to be the limit below which calcification visible on the CT could no longer be demonstrated radiographically. The incidence of calcification of the falx and of the choroid plexus is considerably greater on the CT than on radiographs, although no difference was found for calcification of the pineal body. Since it is possible to demonstrate cerebral substance and CSF pathways simultaneously, it is possible to obtain an exact anatomical localisation of any calcification. CT is the method of choice for the demonstration and investigation of intracranial calcification.
In addition to showing the structures of the brain, it is possible with computed tomography to demonstrate the bone of the skull. For this the window width has to be increased, or one has to use additive photographic manipulation (integral photography). The clinical value of views of the skull base is illustrated. The advantages of computed tomography compared with conventional radiographic technique are stressed.
The authors report a case of sarcoidosis of the pineal gland with no other organ manifestation of the disease. The tumor was successfully removed by a direct surgical approach.
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Two typical cases of nasoethmoidal encephaloceles with liquorrhoea, which were operated on by neurosurgeons, are demonstrated. In one case, polyposis of the nose had been operated on twice in childhood, due to the ignorance of the cause with the result of a liquorrhoea. The second patient showed recurrent meningitis with nasal liquorrhoea and turricephaly. The tentative diagnosis of a nasoethmoidal enceplaocele which was suspected by x-ray-tomography and radio-isotopetest could be certified by the aid of detail-angiography. The neurosurgical technique of intracranial, intradural resection of the encephalocele and closure of the liquor fistual with an acrylic flap is shown.
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