PubMed · 244832
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C Schenkenfelder. 1977. [Nursing care report (brain concussion)].. https://pubmed.ncbi.nlm.nih.gov/244832/
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A series of 6 infants subjected to child abuse is presented in whom contusional tears of subcortical white matter were detected during life by intracranial sonography. The sonographic appearances of this highly pathognomonic marker of shaking injury are described for the first time and their significance discussed. On the basis of our experience we suggest that high resolution cranial sonography is an extremely valuable part of the diagnostic work up in cases of suspected non-accidental injury.
We are proposing a new method for correcting of scattered photons in technetium-99m (99mTc) imaging by means of photopeak dual-energy window acquisition. This method consists of the simultaneous acquisition of two images and estimation of a scatter image included in the symmetric energy window (SW) image by the difference between these images. The scatter corrected image is obtained by subtracting the scatter image from the SW image. In order to evaluate this method, we imaged a planar and a SPECT phantom with cold lesions and calculated the contrast value with and without the scatter correction. In addition, we performed asymmetric energy window (ASW) imaging to compare with this scatter correction method for planar images. In the planar image with the tissue-equivalent material of 10 cm, the scatter correction method removed 32% of the counting rate of the SW image and improved from 0.81 to 0.94 of the contrast value for a 4 cm-diameter cold lesion, while the contrast value with the ASW was 0.87 for such a cold lesion. The scatter corrected SPECT image had a reduction of 18% of the counting rate of the SW SPECT image and improvement of approximately 11% in contrast for cold spot sizes larger than a 3 cm-diameter, compared with the SW SPECT image. In addition, a perfusion defect could be well visualized by this scatter correction method on 99mTc-HMPAO regional cerebral blood flow SPECT of a patient. Our proposed scatter correction method can improve both planar and SPECT images qualitatively and quantitatively.
The sequelae of severe closed head injury have received much attention in the literature, but the effects of mild closed head injury (MHI) are less well established. There is a subgroup of patients who complain of persisting postconcussive symptoms (PCS) beyond the first weeks of recovery. Although the symptoms generally develop in the absence of clear neurological abnormalities, the condition of PCS can be chronic and disabling. It has been assumed that PCS result from an interaction between organic and psychological factors. Differentiating between the effect of primary neurological injury and secondary psychosocial problems is often difficult for clinicians and engenders controversy. Neuropsychological, neurophysiological, and neuroimaging measures can be helpful in selecting patients at risk of developing PCS. Assessment of the level of cognitive functioning, individual susceptibility to stress, and environmental demands may be beneficial in treating symptomatic patients. It is true that the vague and aspecific nature of the postconcussion syndrome may have given rise to the controversy over this entity, but the many methodological inconsistencies in the experimental approaches to the syndrome have certainly enhanced the confusion about this issue. The ensuing controversy surrounding research on the outcome of MHI and the postconcussion syndrome reflects ambiguities in definition, inconsistencies in criteria for patient selection, variation in procedures for neurobehavioral assessment, and difficulty in obtaining follow-up data.