Computerized transaxial tomography: its role in the post-operative tumor case

Postoperative CT contrast enhancement following lobectomy for epilepsy

Contrast-enhanced computerized tomography (CT) is frequently utilized immediately after surgery to determine the presence of residual tumor, but the response of nontumor brain tissue is unclear. Consequently, the authors investigated the postoperative CT contrast enhancement in six patients undergoing lobectomy for epilepsy. Preoperative CT scans were obtained in all cases and revealed no enhancing lesions. All patients underwent craniotomy with electrocorticography while awake, followed by lobectomy. Computerized tomography scans with and without administration of contrast material were obtained on postoperative Days 3, 7, and 30. Edema, artifact, and enhancement of the resection margins were seen on postoperative Days 3 and 7, but had resolved in all patients by Day 30. It is concluded that postoperative CT scans for assessment of residual tumor are best obtained at 30 days or thereafter, when normal brain does not enhance and edema and artifact have diminished.

Postoperative intracerebral hemorrhages: a survey of computed tomographic findings after 1074 intracranial operations

We surveyed computed tomographic findings after 1074 intracranial operations to determine the incidence and etiology of postoperative intracerebral hemorrhages. Medium or large hemorrhages occurred after 42 operations (3.9%). Larger hemorrhages, hemorrhages in the suprasellar region, and hemorrhages associated with other types often preceded a poor outcome. Major etiologies underlying postoperative intracerebral hemorrhages were uncontrolled bleeding from a blind area, difficult dissection of a tumor from the brain, retraction injury, vessel injury from a needle, bleeding from a residual tumor, local hemodynamic changes after removal of a tumor, premature rupture of an aneurysm, and hypertensive putaminal hemorrhage. Hypertension during recovery from anesthesia was another important factor.

Computed tomography in the postoperative patient

Nine cases of patients in whom intracranial infection was suspected after operation are presented. Lesions with ring enhancement were seen in all of these patients. The differentiation of enhancement, seen as a normal postoperative phenomenon, from residual neoplasia and cerebral abscess can be difficult. This can be resolved by serial and sequential-delayed CT, and thus unnecessary re-exploration may be prevented.

The reliability of computerized axial tomography in the diagnosis of infratentorial mass lesions. A neurosurgical appraisal

The accuracy of CAT in the diagnosis of infratentorial expanding lesions is analysed on the basis of 224 personal cases. The posterior fossa lesions are classified in four groups according to the reliability of CAT as the only pre-operative examination. The present indications for conventional neuroadiological procedures are also outlined. Particular emphasis is laid on the information supplied by CAT in postoperative follow up to detect both immediate and delayed complications.

Role of computed tomography in the postoperative evaluation of infantile hydrocephalus

The value of CT for the diagnosis and followup of infantile hydrocephalus is discussed. The ventricular volume, subependymal periventricular hypodensity, sbudural hygroma or hematoma, position of catheter in the ventricles, ependymal inflammation and other occasional findings are considered.

Computerized cranial tomography and radionuclide imaging in the detection of intracranial mass lesions

Computerized cranial tomography (CCT) and radionuclide imaging (RI) of the brain are both accurate techniques for detecting intracranial mass lesions. CCT is superior in detecting low-grade gliomas, cystic lesions, parasellar tumors, and brain stem lesions. Overall, CCT detection rates are slightly higher than those with RI, but the use of iodinated contrast media with CCT increases the risk of this examination. There is a significant difference in the generally binary (positive/negative) type of information offered by RI and the more specific information offered by CCT about the pathologic nature of a lesion and its precise location. In the evaluation of patients with suspected intracranial mass lesions, CCT is generally the preferable initial diagnostic test. However, RI may still serve as a satisfactory screening examination in certain well-defined clinical situations.