[Correlation of cranial computer tomography, diaphanoscopy and clinico-neurologic findings in childhood exemplified by chronic subdural effusion].
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Biomedical subjects
Publications and source records attributed to J Planitzer.
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Computer tomography enables for the first time the direct demonstration of the consequences of a craniocerebral trauma. In the computer tomogram, the cerebral oedema is dominating as an area of reduced density (hypodense region). Three different measuring techniques are compared and their application in 43 craniocerebral traumata discussed. Among the measuring methods employed, the area index shows the greatest diagnostic reliability in the computer-tomographic findings of a posttraumatic cerebral oedema. The partial volume analysis without application of a contrast medium is of little use for computer-tomographic clearing of the question of a generalised cerebral oedema after SHT while the density index is only suitable in conjunction with additional parameters.
The following-up of the course of the disease in the first 1,093 patients examined computer-tomographically at the Neurological Clinic of the Charité Berlin showed cerebral tumours in 197 cases. In 106 patients, CT, PEG and/or angiography was carried out; in 38 cases, the tumour could only be demonstrated by CT. Besides the generally known advantages of CT, further advantages as compared to angiography/PEG were found: uncomplicated direct performance of the examination, with demonstration of all parts of the brain in one examination, the possibility of demonstrating processes at several sites. Processes in the vicinity of the calotte and tumours which had not yet led to a displacement of cerebral structures.
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In a short survey, empirical values are presented in a comparative assessment of computer-tomographical and conventional neuroradiological examination programmes. The demand for subtle clinical preliminary examinations and systematic establishment of indications is just as true of computer tomography as it is of other instrumental methods. If possible, however, non-invasive examination methods should be given preference.
The revolutionary nature of the computer tomography requires new strategies in the diagnosis of neurological diseases. Only a differentiated examination plan can promise maximum success. This plan is determined for each indication under consideration of the clinical pictures including its acuity. Non-invasive examination methods including computer tomography are completed by invasive pre-operative examinations.
Today, the extension of the diagnosis of apoplexy by the employment of computer tomography is part of an important field of indications for this examination method. Experience in this respect could be obtained from a total of 1,500 patients with a share of 105 cases presenting cerebral blood supply disturbances. The unproblematic differentiation of mass haemorrhages and cerebral infarctions including the possibility of an exact assessment of the process dynamics proved to be diagnostically just as important as the differential diagnostics of intracranial haemorrhages of other origins, such as occur after a rupture of aneurysms and angiomas as well as tumour haemorrhages.
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PURPOSE: To investigate the efficacy of 0.025, 0.05 and 0.1 mmol/kg gadopentetate dimeglumine in MR imaging of patients with intracranial tumors at mid and high field strength. METHODS: In 88 patients, an open-label phase III multicenter dose-finding study was performed at 0.5, 1.0, and 1.5 T MR units. Before and after (5, 15, 25 minutes) intravenous administration of gadopentetate dimeglumine, imaging was performed with T1-weighted spin-echo sequences. RESULTS: With 0.1 mmol/kg yielding the highest values, tumor enhancement and numerical tumor/brain contrast showed dose-dependent 5-minute postcontrast values (P less than 0.05). Compared to 5-minute postcontrast values, there was no significant change at 15 and 25 minutes. Although the lowest values of enhancement were found at 0.5 T, differences in enhancement among the field strengths were not statistically significant. The numerical data were confirmed by visual assessment of tumor/brain contrast. Eighty to 90% of cases had diagnostically valuable enhancement at 0.1 mmol/kg, 50% at 0.05 mmol/kg, and 10% at 0.025 mmol/kg (P less than 0.05). There were no adverse events. CONCLUSION: Our results confirm that 0.1 mmol/kg gadopentetate dimeglumine is more effective at enhancing intracranial tumors than lower doses at mid and high field MR units.