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Biomedical subjects

W Lanksch

Publications and source records attributed to W Lanksch.

At least 37 records · Page 2Linked to original sources
PubMed1981

[Diagnosis and treatment of severe craniocerebral injuries. New developments (author's transl)].

Computer tomography of the skull has considerably improved the diagnosis of different neurotraumatological disease entities, since extracerebral and intracerebral hemorrhages, parenchymatous lesions and traumatic cerebral edema can be visualized directly. The coarse morphological changes and the indirect signs of post-traumatic space-occupying complications in the CT permit prognostic statements. A great advantage of computer tomography is that multiple intracranial lesions can be visualized simultaneously.

Brain Concussion↗
PubMed1979

Sensitivity of computed tomography and serial scintigraphy in cerebrovascular disease.

Computed tomography and serial scintigraphy with 99mTc-pertechnetate (radionuclide angiography and early and late static imaging) were compared in 214 patients with cerebrovascular disease. CT correctly identified 151 (95.0%) of 159 patients with completed ischemic stroke but was positive in only 11 (25%) of 44 patients with asymptomatic stenosis, transient ischemic attacks (TIA), or prolonged reversible ischemic neurological deficit (PRIND). Scintigraphy was positive in 93.1% of patients with completed stroke. CT detected 175 territories of vascular supply involved, scintigraphy 164. In patients with asymptomatic stenosis, TIA, or PRIND, scintigraphy was correct in 77.3% of cases. The combined evaluation offered a sensitivity of 97.5% in patients with completed stroke and 86.4% in those with asymptomatic stenosis, TIA, or PRIND. The rate of true-positive scintigraphic findings in patients with completed stroke did not change as the interval between ictus and study increased. In patients with intracerebral hematoma, CT was far more specific than scintigraphy. If cerebrovascular disease is suspected, radionuclide angiography should be performed first.

Adult↗
PubMed1978

Axial transverse computerized tomography in 73 glioblastomas.

Among 2,600 patients, examined by computerized tomography, 404 had brain tumours, which were gliomas in 150 cases. There were 73 glioblastomas. Examination was performed according to Ambrose's method using an intravenous injection of 1 ml 60% contrast medium per kg body weight. Thus 98% of all gliomas could be demonstrated. Glioblastomas are shown in three different forms: an annular type (55%), a nodular type (18%), and a combined type (27%). Perifocal oedema is found in 88% of glioblastomas. The oedema most frequently belongs to grade II or III. Differentialdiagnosis of gliomas, abscess, metastases and other tumours with central necrosis are discussed.

Astrocytoma↗
PubMed1978

Computerized transaxial tomography and cerebral serial scintigraphy in intracranial tumors--rates of detection and tumor-type identification: concise communication.

In 215 cases of intracranial tumors with subsequent histological identification, computerized transaxial tomography (CTT), and cerebral serial scintigraphy (CSS) with [99mTc] pertechnetate were carried out to compare the efficiency of each method in detecting and classifying such tumors. With a tumor detection rate of 99%, CTT turned out to be superior to CSS (91%). On the other hand, CSS findings enhanced the CTT rate of correctly identified tumor types in meningiomas from 85 to 92% and in high-grade gliomas from 82 to 89%. In metastases, low-grade gliomas, and various other tumors, CSS supported CTT by confirming a number of these tumor types. Therefore, the most important use of CSS in intracranial tumors today is its role as a supplement to CTT in order to establish and confirm type-specific diagnoses.

Brain Neoplasms↗
PubMed1978

[Computerized tomography in head injuries (author's transl)].

Computerized tomography permits the registration of minimal density differences of cerebral tissue. The information obtained by this method is comparable to gross neuropathology. Demonstration of intracranial bleeding and other posttraumatic complications does not present any serious problem. Most of all, it permits for the first time to demonstrate directly parenchymatous lesions of cerebral tissue after a head injury. The treatment nowadays can depend largely on the results gained by computerized tomography. So the care of the patient will be influenced largely by the demonstration of lesions affecting the survival of the patient.

Brain Abscess↗
PubMed1977

Computed tomography in the diagnosis and differential diagnosis of glioblastomas. A qualitative study of 295 cases.

The CT patterns of 295 glioblastomas examined with pre- and postcontrast scans using an EMI scanner Mark I (Matrix 160/160) have been reviewed and compared with the CT appearances of other brain tumors, metastases and abscesses. There is a great variety of CT patterns with glioblastomas. However, a garland-shaped CT appearance, representing a subgroup of ring-shaped lesions, seems to be most typical for glioblastomas since it was observed in 19% of ring-shaped glioblastomas but in only one out of 172 metastases and in no case of an astrocytoma grade II or an abscess in our series. The initial CT diagnosis, based on the CT finding, the patient's history and the clinical data, was correct in 69.8% of the glioblastomas, 41 recurrent glioblastomas included. In 12% of the cases the presence of a glioblastoma was within differential diagnosis. These results lead to the conclusion that in many cases additional diagnostic methods, such as serial scintigraphy and/or cerebral angiography, are required for a reliable differential diagnosis.

Astrocytoma↗
PubMed1977

Computed tomography or orbital lesions. A cooperative study of 210 cases.

Computed tomography (CT) has given us a new method for examining the orbit and its contents. The technique of examination is described, and the indications for the application of computed tomography in ophthalmology are considered: suspected orbital tumors, unilateral exophthalmos, pareses of the ocular muscles, traumatic lesions and malformations in the region of the orbit. The findings in 210 cases of orbital lesions examined in this study are reported and the differential diagnosis is discussed. Considerable improvement and greater accuracy in diagnosis have been achieved in the field of ophthalmology by using computed tomography. Early tumor visualization is possible without risk or discomfort to the patient.

Abscess↗
PubMed1977

[The value of serial scintigraphy with 99mTc pertechnetate compared with axial computed tomography in the diagnosis of cerebral tumours (author's transl)].

The increasing use of cranial computed tomography (CT) in the diagnosis of cerebral tumours has suggested that the place of cerebral serial scintigraphy (CSS) with 99mTc pertechnitate needs to be re-assessed. For this purpose 190 patients with 200 intracranial tumours were examined by both methods. Of the 155 histologically confirmed tumours, 87% could be diagnosed by CSS, and 99% with CT. Amongst the total of 190 patients, CSS was correct in 90%, and CT in 99%. Correct tumour diagnosis of meningiomas was 84% for both methods, and for glioblastomas, 83% for both methods. Combining the two methods, however, produced 92% accuracy with meningiomas, and 90% of glioblastomas could be correctly classified. Gliomas of Grade I/II had an accuracy of 39% for CSS (52% for CT), for metastases 50% for CSS (80% for CT) and in the group "various tumours" 19% for CSS (41% for CT). Computed tomography will have to be carried out in future on all patients suspected of having a primary tumour and before any neuro-surgical intervention. The main task of CSS remains as a screening procedure for intracranial space-occupying lesions and to increase the accuracy of diagnosis. CSS is also valuable as an indication for the use of contrast during CT. In some cases this isotope method may increase the type specific diagnosis of CT.

Adolescent↗
PubMed1977

[Computer tomography in intracranial tumors. A cooperative study of 1658 neoplasms (author's transl)].

This paper decribes the results of the CT teams of the University Clinics Berlin, Mainz and Munich. 1658 patients with cerebral tumors have been examined so far (EMI Scanner Mark I, Matrix 160/160) revealing a diagnostic accuracy of 98.4%. The findings of various kinds of tumors (306 glioblastomas, 255 astrocytomas and oligodendrogliomas, 248 meningiomas, 212 metastases, 200 pituitary adenomas and craniopharyngeomas) are discussed and illustrated by typical images. Differential diagnostic problems and the importance of additional neuroradiological procedures are discussed.

Adolescent↗
PubMed1976

[CT findings in chronic subdural hematomas (author's transl)].

CT findings of 46 patients with operatively confirmed chronic subdural hematomas are reviewed. The analysis of the EMI scans resulted in three different types of CT findings. Type 1 is characterized by decreased attenuation of the hematoma contents compared to brain tissue. The hematoma is visualized as a lens-shaped low density area between the skull and the surface of the brain. Type 2 apart from low density areas contains zones of increased attenuation due to recent bleeding into a watery chronic subdural hematoma. In many cases sedimentation causes a well-defined horizontal borderline between the thin fluid parts in the anterior portion and the blood debris in the posterior portion of the hematoma sac. Type 3 shows the same average absorption values as normal brain tissue, a direct visualization is not possible. However , the presence of a midline displacement in combination with ventricular compression and absence of a circumscript lesion even after contrast enhancement, allows the diagnosis of a unilateral chronic subdural hematoma in these cases too. Bilateral chronic subdural hematomas may cause considerable diagnostic difficulties if only one or none of the hematomas is visualized. A relatively small midline displacement points to a second bleeding on the opposite side. Most frequent were hematomas of type 1 (37%), type 2 and 3 could be observed in 30,5% resp. 32,5% of cases respectively.

Adolescent↗
PubMed1976

Cranial computerized tomography in the diagnosis of brain disorders in infants and children.

Cranial computerized tomography (CCT) has opened new dimensions in the diagnosis of neuropediatric disorders. The results of this new method are comparable to gross neuropathology. Thereby it is often possible to avoid further invasive neuroradiological investigations. This is especially true of pneumoencephalography which, according to the present state of CCT, is no longer indicated. Optimal diagnostic results can be achieved only if the patients is cooperative and does not move his head during the scanning procedure. Therefore in infants general anaesthesia is necessary. Sedation alone has proved to be not sufficient. The numerous new findings gained by CCT cover nearly all types of intracranial lesions. First of all the direct visualization of brain tumours in their relations to the surrounding structures, the surprising findings in inflammatory diseases of the brain, and the impressive demonstration of brain anomalies make CCT superior to all conventional neuroradiological investigations. Only for planning a surgical intervention and in vascular disorders angiography remains irreplacable.

Adolescent↗
PubMed1975

[Axial computerized tomography with high resolution matrix (160 x160)].

The evaluation 1250 patients investigated with computerized tomography reveals a very high detection rate with brain tumours and other intracranial space-occupying lesions. From 246 brain tumours 238 = 96,7 per cent could be diagnosed in the plain scan. After contrast enhancement only one false negative case, a tumour of the corpus callosum, remained. With emergency cases and neuropediatric diseases computerized tomography is the most informative investigation at all. The high definition matrix 160 x 160 in connection with the patient's movements correction has led to further improvement of resolution and visibility of details of intracranial anatomy and pathology in CT-scans.

Adolescent↗
PubMed1975

[Computerized axial tomography of the skull - diagnostic possibilities and clinical results (author's transl)].

Computerized axial tomography is a new method of tissue examination with x-rays whereby a picture can be produced which is a representation of a slice of the skull. This is done by irradiating the skull from 180 or 225 incremental angles and measuring the absorption at each of these angles. Then with the aid of a computer a tomogram is produced which can be displayed on a screen. These tomograms are representations of a cross-section of the skull composed of 160 X 160 points showing the various intracranial structures with great detail. The present study demonstrates the diagnostic possibilities of the high definition matrix with reference to brain disorders in a large sample of patients for the first time. Some tumours are shown as areas of decreased absorption compared with normal brain tissue. Others, however, have been found to have higher absorption values. With glioblastomas very contrasting pictures are produced with coexistng areas of decreased, increased and similar values to brain tissue. The most important finding is the visualization of brain oedema which appears as a low density area. A grading system of brain oedemas is proposed. The brain oedema associated with tumours has been found to propagate mainly in the white matter producing finger-like shapes. Out of 209 intracranial tumours 203 were recognized in the plain scan, a further five after contrast enhancement. In patients who have suffered from a stroke the differentiation between haemorrhage and infarction is made simple due to the contrasting appearance between the two types of lesion. Location, size and propagation direction of a haematoma as well as rupture of a haemorrhage into the ventricular system can be defined exactly. With brain infarction the hypoxically damaged tissue is well delineated and readily attributable to a given vascular area. In head injuries, for the first time it is possible to differentiate brain contusion with oedema from intracerebral haematoma. Coup and contre-coup are demonstrated. All types of acute intracranial haematomas may be diagnosed easily. With chronic subdural haematomas the new method fails if the contents of the haematoma shows the same absorption values as brain tissue. Late sequelae of head trauma such as contusion defects and necrosis of tissue after oedema can be seen in the tomogram. With infantile hydrocephalus, subdural effusions and malformations of the brain, computerized axial tomography offers a complete diagnosis so that other invasive, neuroradiological investigations may be avoided. Orbital tumors are picked out with great clarity. The high definition matrix allows the demonstration of the optic nerve, the lense and the suspension of the eyeball. Without doubt in the coming years computerized axial tomography will play a dominant role in the diagnosis of brain disorders.

Absorption↗