A meningioma was incidentally identified with computerized tomography (CT) in 17 patients without relevant clinical signs. The tumor was not removed, but biopsy confirming a meningioma was obtained from one patient. Tumor growth rate was calculated from repeat CT scans or follow-up magnetic resonance imaging. The annual growth rate ranged from less than 1% to 21%. It is concluded that in nonsymptomatic meningiomas with a low growth rate a nonsurgical approach may be warranted.
In 45 out of 103 cases with chronic subdural hematoma a definite membrane was found. Membranectomy was performed in 37 cases, mostly as a secondary procedure after burr-hole evacuation and closed system drainage. The mortality rate was 6.6% and in the survivors a complete recovery was achieved in 90%. CT monitoring of the diameter of the hematoma and midline shift did not reveal any correlation of size of the hematoma with neurological findings. The indication for membranectomy can, therefore, not be based on radiological findings alone, but on the clinical course of events and with due regard to the CT findings.
We present 78 patients with spinal cord injuries. Operation is not indicated in cord contusion, extended bleeding into the spinal canal or severe fracture dislocation. However, it would seem advisable to operate on patients with vertebral fractures, particularly at the lower thoracic and lumbar levels, if intraspinal bone fragments are detected by CT scan.
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