Computed tomography of intracerebral hematomas. I. Transmission CT observations on hematoma resolution

Dolinskas, CA; Bilaniuk, L T; Ra, Zimmerman; Kuhl, D.E.

doi:10.2214/ajr.129.4.681

Cited by 108 publications

(33 citation statements)

References 7 publications

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“…Two patients had no symptoms; two had symptoms but no ate, and moderately severe handicap, corresponding to grades 2, 3, and 4, respectively, on the modified Rankin scale. 89 The mean volume of the original hematoma in these patients was 8.7 cm 3 (range 2-20 cm 3 ). This was significantly smaller than the mean hematoma volume (23.8 cm 3 ) in patients with residual lesions (p=0.007).…”

Section: Resultsmentioning

confidence: 83%

“…89 The mean volume of the original hematoma in these patients was 8.7 cm 3 (range 2-20 cm 3 ). This was significantly smaller than the mean hematoma volume (23.8 cm 3 ) in patients with residual lesions (p=0.007). Focal atrophy (enlargement of cerebral sulci or part of the ventricular system) was found in 11 of the 28 patients with hypodense lesions.…”

Section: Resultsmentioning

confidence: 83%

“…In five other patients, ventricular enlargement was the only finding. In two patients, calcification at the site of the previous hematoma was the only residual lesion; volumes of the original hematomas were 10 cm 3 and 29 cm 3 . Figure 1 illustrates slit-like lesion.…”

Section: Resultsmentioning

confidence: 96%

“…In one follow-up study with CT of 23 patients with cerebral hemorrhage, the residual lesions were radiolucent. 3 Some have found that the volume of the residual hypodensity was equal to that of the original he-matoma, 4 but in other studies the residual lesion was always smaller. The aim of the present study was to investigate residual abnormalities on CT in a large series of 42 patients with CT-proven ICH.…”

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confidence: 93%

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Residual lesions on computed tomography after intracerebral hemorrhage.

Franke

Swieten

Gijn

1991

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Background and Purpose:We investigated the residual abnormalities on computed tomography in a series of patients with proven intracerebral hemorrhage to determine whether the type of lesion is related to the site and size of the initial hematoma.Methods: In a partially prospective follow-up study, we studied computed tomographic scans of 42 patients with spontaneous intracerebral hemorrhage after 2-24 (median 9) months.Results: Lobar hemorrhages had occurred in 20 patients; the other 22 hemorrhages were in the basal ganglia or thalamus. No residual lesions were found on seven scans (17%), despite residual handicap in three of these seven patients (slight, moderate, and moderately severe). In five cases, the scan showed only focal atrophy, and in two there were only focal calcifications. There were six patients with slit-like lesions (only after deep hemorrhages), 12 with rounded and isolated hypodense areas, and 10 with rounded hypodense areas connected to the ventricular system. The connection between the residual lesion and the ventricular system depended to a large extent on the size of the initial hematoma, but very little on whether it had initially ruptured into the ventricular system.

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Section: Resultsmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 96%

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confidence: 93%

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Residual lesions on computed tomography after intracerebral hemorrhage.

Franke

Swieten

Gijn

1991

Stroke

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“…A apoplexia pituitária aguda é evento relativamente raro, ocorrendo em menos de 10% dos adenomas pituitários 1 . Entretanto, a presença de formação cística e hemorragia clinicamente não suspeitada pode ocorrer em mais de 25% dos casos submetidos a revisões patológicas [5][6][7] . Esses eventos silenciosos podem causar sintomas neurológicos atípicos ou podem ser clinicamente assintomáticos; esta entidade tem sido designada de apoplexia pituitária subclínica 8,9 .…”

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Apoplexia subclínica em tumores pituitários

Pinheiro

Cukiert

Salgado

et al. 1999

Arq. Neuro-Psiquiatr.

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RESUMO -Apoplexia pituitária aguda é fenômeno relativamente raro, mesmo em macroadenomas. No entanto, a presença de áreas necro-hemorrágicas intratumorais nestes tumores que não se relacionam a qualquer sintomatologia aguda parece ser bem mais frequente do que se imaginava na era da tomografia. Com o advento da ressonância magnética estas áreas podem ser facilmente diagnosticadas pré-operatoriamente. Dentre os 40 últimos macroadenomas operados e examinados com RMN, 10 possuíam áreas apopléticas subclínicas em seu interior. Sete destes tumores eram não secretores, 2 secretores de GH e um de prolactina. O quadro clínico incluiu, além daqueles correspondentes à eventual secreção endócrina, perda visual progressiva (sem história de piora abrupta ou rápida) (n=8) e cefaléia (n=3). Após a remoção cirúrgica destes tumores e descompressão do aparato óptico, obtivemos melhora visual em 6 pacientes e em 2 a visão permaneceu inalterada. A cefaléia desapareceu em 2 casos. A presença de áreas apopléticas nestes macrotumores bem como sua ausência em séries de microtumores relatadas na literatura sugere que se relacionam mais ao tamanho do tumor do que ao seu caráter secretor ou não, o que é compatível com a provável natureza (insuficiência vascular) da apoplexia subclínica nesses casos.PALAVRAS-CHAVE: apoplexia, tumores, pituitária, assintomáticos. Asymptomatic apoplexy in pituitary tumorsABSTRACT -Acute pituitary apoplexy is a rare event, even in patients with pituitary macroadenomas. On the other hand, the presence of necrotic/hemorrhagic areas, especially in macroadenomas, seems to be more common than earlier reported in the CT period. After the introduction of MR in the presurgical workup of these patients, these apopleptic areas have been more easily diagnosed preoperatively. Forty consecutive patients with pituitary macroadenomas were studied with high-resolution 1.5 T T1 coronal, sagittal and axial slices over the sellar region. Special attention was paid in the detection of necrotic, cystic and hemorrhagic areas within these tumors. Ten patients had hemorrhagic/necrotic areas within their tumors, without any sign or symptom of acute apoplexy. These areas varied from small (2 mm) to very large (30 mm) ones. Seven patients had non-secreting tumors, 2 GH and 1 prolactin secreting tumors, which is the same profile of secretory pattern for the whole series (40 patients). The clinical picture included (other than that caused by endocrine secretion) slowly progressive (but not acute) visual loss (n=8) and headache (n=3). After surgical decompression of the surrounding structures and visual apparatus, which was facilitated by the presence of the necrotic areas, there was visual improvement in 6 patients and headache resolution in 2. The presence of asymptomatic apopleptic areas in these macroadenomas and their absence in microadenomas as can be seen in the literature suggest that they are related more to the size of the tumor than to its endocrine secretion pattern. This is in agreement with a vascular insufficiency hypothesi...

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Computerized Tomography in Intracranial Hemorrhage

Weisberg¹

1979

Archives of Neurology

122

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Computed tomography of intracerebral hematomas. I. Transmission CT observations on hematoma resolution

Cited by 108 publications

References 7 publications

Residual lesions on computed tomography after intracerebral hemorrhage.

Residual lesions on computed tomography after intracerebral hemorrhage.

Apoplexia subclínica em tumores pituitários

Computerized Tomography in Intracranial Hemorrhage

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