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Anti-Bacterial Agents↗

Developmental process of chronic subdural collections of fluid based on CT scan findings.

One hundred twenty-four follow-up scans were performed on 24 patients who had had posttraumatic subdural collections of low density. Of the 24 patients, 6 developed chronic subdural hematomas. Six other subdural collections showed a temporary increase in attenuation but eventually resolved. The remaining 12 subdural collections resolved without apparent increase in density. Illustrative cases are presented with computed tomographic scans. The identity of these posttraumatic subdural lesions of low density is discussed. They seem to be posttraumatic subdural hygromas.

Adult↗

Magnetic resonance imaging of meningitis and its complications.

Routine and aggressive use of antibiotics in patients with meningitis has considerably lessened the number of complications. However, when they do occur, these complications may be accompanied with a significant increase in morbidity and mortality. Often radiologists are the first to identify these complications. Although the initial diagnosis and follow-up of uncomplicated meningitis is a clinical one, magnetic resonance imaging (MRI) is the ideal method to evaluate those patients in whom complications are suspected.

Adolescent↗

[Intracerebral calcifications. Etiology and symptomatic (author's transl)].

The importance of x-ray-investigations of skull is demonstrated in ten remarkable examples. Mostly intracerebral calcification follows inflammatory, traumatic, neoplastic or metabolic disease. In spite of the simplification of contrast-investigations which have assumed great importance x-ray-films of skull often permit specific diagnostic assessment and therefore should be done first.

Adolescent↗

[Cranial axial computerized tomography in children (author's transl)].

This report on computerized tomography in 400 children confirms the high diagnostic value of the new method in neuropediatrics. 31 brain tumours were diagnosed in children. Tumors present themselves as lesions of latered density compared to that of brain matter. Intravenous injection of contrast media increases the density of various lesions as tumors, angiomas, acute infarctions and abscess. Infarctions are low density lesions whereas hemorrhage is a high density lesion and both are thus safely differentiated. Edema may be visualized in the vicinity of tumours in brain injuries and in encephalitis. The normal ventricular system, hydrocephalus, cerebral malformations and subdural hygroma are easily demonstrated. Diseases of the orbits may also be detected.

Brain Abscess↗

Intracranial Salmonella infections: meningitis, subdural collections and brain abscess. A series of six surgically managed cases with follow-up results.

Focal intracranial infections due to Salmonella are rare. So far, around 80 cases have been reported in the world literature. The authors present their experience of 6 cases of intracranial Salmonella infections, mainly subdural empyema in 5 and effusion in 1. In 1 case, subdural empyema was bilateral, and in another case, there was an associated brain abscess. Positive blood cultures and positive Widal tests were noticed in 2 patients each. Early diagnosis and prompt evacuation of subdural collections and brain abscess and antibiotic therapy lead to satisfactory results. This study suggests that a high index of suspicion, early diagnosis and quick evacuation lead to success; this point is highlighted with the help of a review of the literature.

Adult↗

Schizencephaly: a clinical study and review.

Schizencephaly is a rare malformation in which symmetrical portions of the cerebral mantle fail to develop. It should be differentiated by angiography and pneumography from the porencephalies that follow destructive lesions and from the prognostically more favorable subdural hematomas and effusions. If the diagnosis of this anomaly can be firmly established short of surgical exploration, operation or further treatment of any kind is not, in the authors opinion, warranted.

Brain Diseases↗

CT evaluation of Haemophilus influenzae meningitis with clinical and pathologic correlation.

Ten proven cases of Haemophilus influenzae meningitis have been reviewed, in which all had CT scans during their first 3 weeks of illness. An attempt was made to correlate the neuropathologic basis of the disease with the CT findings. Progression of the CT changes with the course of illness and treatment is emphasized. Usual indications for CT imaging of the brain in patients with meningitis are: detection of subdural empyema or effusion, hydrocephalus, infarct, cerebritis and abscess. Widespread cerebral damage can be more fully evaluated with iodine contrast infusion if clinically indicated. CT scanning has proven to be a valuable indicator of such complications and useful predictor of clinical recovery or residual neurologic sequelae.

Adult↗

Cranial MRI and MR angiography in Menkes' syndrome.

We report two boys with Menkes' syndrome who underwent cranial MRI and MR angiography (MRA). In both, CT and MRI revealed progressive cerebral atrophy with a subdural haematoma or effusion. Delayed myelination or dysmyelination of the white matter was suggested. Tortuosity of the cervical and intracranial vessels was well demonstrated by MRA, obviating more invasive conventional angiography should it be thought necessary to demonstrate the characteristic systemic vascular changes of this syndrome.

Atrophy↗

Unilateral subdural-peritoneal shunting for bilateral chronic subdural hematomas in infancy. Report of three cases.

The authors present the cases of three infants with bilateral chronic subdural hematomas (SDH's) (effusions). Communication between the hematoma cavities was confirmed by an injection of air or metrizamide into one of the cavities. In all three cases, both SDH's (effusions) were successfully treated by placement of a unilateral subdural-peritoneal shunt without any untoward consequences. It is stressed that the cavities of bilateral chronic SDH's (effusions) may communicate, and that in such cases unilateral subdural-peritoneal shunting is sufficient to eradicate the SDH's on both sides. In addition, subdural fluid, even with a high protein concentration, may be successfully eliminated by an internal shunt using a shunt tube with a large internal caliber and a low-pressure valve.

Female↗