Computerized tomography (CT) has made it easier to distinguish tumoral from nontumoral diseases of the central nervous system. In the presence of mass effect, however, this distinction may be difficult or impossible to make. Primary demyelinating disease may occasionally present as a focal cerebral mass. The authors report three cases of primary demyelinating disease of the brain involving the corpus callosum and periventricular white matter and associated with mass effect, which proved difficult to differentiate from infiltrating "butterfly" gliomas.
Congenital bicuspid aortic valve, one of the most common congenital heart abnormalities, may become infected, may calcify, and may cause progressive stenosis or progressive insufficiency. While no previous reports suggested cerebral emboli in the absence of valvular infection, we studied four such cases. In all, cerebral angiography was normal and no extracardiac source of emboli was demonstrated. Microthrombus formation and valvular thickening with incompetence could eventuate in embolization.
Perfusion temperature is a factor in recovery from cardiopulmonary bypass. Cold has more adverse neurologic sequelae that prompt computed tomographic scanning whereas warm has more activation of fibrinolytic potential. Tepid is the best temperature for optimizing recovery from cardiopulmonary bypass.
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