[Acute and chronic cerebrovascular insufficiency. Diagnosis of cerebrovascular insufficiency by means of apparatus].
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Angiography↗
Biomedical subjects
W D Sager
Publications and source records attributed to W D Sager.
[Classification and course of cerebral infarcts on computer tomography (author's transl)].
The typical computer tomographic signs of ischaemic cerebral infarct are discussed on the basis of 631 cases. Infarcts have three typical stages. Stage I, one week, fresh infarct with signs of oedema (space-occupying lesion with an unsharp margin, slightly reduced density, lack of contrast uptake). Stage II, second to fourth week, reduction in the oedema. Frequently very marked contrast enhancement of the cortex and basal nuclei. Stage III, later than four weeks. Development of malacic cysts, with further reduction in density and size. Development of homolateral atrophy. The computer tomographic diagnosis of cerebral infarcts during Stage I is often very difficult. Distinction from infiltrating tumour is often possible only after further observation. The diagnosis of cerebral infarcts in stages II and III is possible in most cases. Haemorrhagic cerebral infarcts do not follow a temporal pattern as accurately as anaemic infarcts. They show circular increase in contrast of slowly diminishing size. The increased contrast persists considerably longer and is clearly distinguished from that in an anaemic cerebral infarct.
Adolescent↗
[CT of the pelvis and abdomen during childhood (author's transl)].
The use of CT in the abdomen and pelvis in 25 children is described. Certain problems which reduce the value of the technique are discussed; these include the lack of intra- and retro-peritoneal fat, movement artefacts, the importance of exact indications and the problems of radiation dosage.
Adolescent↗
A correlation of clinical findings and CT in ischaemic cerebrovascular disease.
248 patients with an ischaemic stroke were investigated with computer tomography. A hypodense lesion was observed in 18% of TIAs, 76% of PRINDS and 95% of completed stroke patients. In the patients with TIA the hypodense lesions were mainly single ones, whereas completed stroke patients also had a significantly higher proportion of more bilateral lesions. Atrophy was present in 44% of TIA patients, 68% of PRIND patients and 82% of completed stroke patients. Atrophy was generalised in 60% of the patients and homolateral in only 16%. Contrast medium enhancement in a hypodense area occurred only in patients with PRIND and completed stroke and never in TIA aptients. Multiple lesions and atrophy were significantly more common in patients with dementia. The time course showed oedema initially in 47% of patients which fell to 25% after the 1st week. Contrast medium enhancement was present initially in 42% of the patients, rose to 70% until the 3rd week and then fell continuously until the 6th week. The change from an indistinct to a distinct outline of a lesion coincided with this.
Atrophy↗
Measurement of regional cerebral blood volume using the EMI 1010 scanner.
Regional cerebral blood volume (rCBV) was measured in 14 patients with normal CT scans. An EMI CT 1010 scanner was used in combination with a computer subtraction technique. The mean CBV in the cortex was 5.0 ml/100 ml of tissue and 2.2 in the white matter. Regional differences were not significant and no difference was found between the right and left hemispheres.
Adolescent↗
[The value of EEG and computertomography in ischemic stroke (author's transl)].
35 patients with ischaemic cerebrovascular disease were investigated using EEG and computertomography on the same day and the results from both investigations were compared. The EEG was pathological in 27 cases of which 26 showed focal changes and one case generalised changes. In 8 patients the EEG was normal. The CT-results showed a hypodense lesion in 17 patients and multiple hypodense lesions in 3 patients. 13 cases had atrophy and a normal CT was present in 2 cases. In 26 patients the EEG and CT results were both pathological and in one case both normal. In the diagnosis of ischaemic cerebrovascular disease both of these noninvasive investigative techniques complement each other; CT demonstrating the morphology of a lesion whilst EEG shows more functional changes in the brain.
Adult↗
[The importance of computer tomography in the diagnosis of epilepsy (author's transl)].
208 patients with epilepsy were investigated by computertomography (Emi Scanner CT 1010 and CT 5005). In 173 patients with generalised epilepsy 87 had a normal scan, 51 revealed a definitive diagnosis and 37 showed generalised atrophy. Of the 35 patients with partial seizures a definitive diagnosis was possible in 22; representing a higher proportion than the group with generalised seizures. A definitive diagnosis from the CT Scan was significantly more common in both patients with generalised and partial seizures when pathological neurological findings were also present. Symptomatic epilepsy was only significantly commoner in Dementia patients with generalised seizures. A significantly higher proportion of patients over 30 years old demonstrated a symptomatic epilepsy than those under 30 years of age.
Adolescent↗
[Computerized tomography in hydrocephalus of infancy (author's transl)].
Prior to invention of computerized tomography, the coincidence of hydrocephalus and brain tumors in early infancy resulted in diagnostic problems, frequently. Two cases with primarily insufficient diagnosis are reported. In spite of the necessity of deep sedation or general anesthesia at the present, computerized tomography has turned out to be highly perferable to other common methods.
Brain Neoplasms↗
Calculation of cerebral tissue and cerebrospinal fluid space volumes from computer tomograms.
The volumes of the cerebral tissue, and internal and external cerebrospinal fluid spaces were calculated from the computer tomograms of 28 patients. On the basis of their different absorption coefficients, cerebral tissue and CSF space were outlines and their volumes calculated by computer. The ratio of cerebral tissue volume to CSF space volume was expressed as an index. This correlated well with an objective grading of severity of hydrocephalus. The index in patients without pathology was between 10.5 and 18.4. In cerebral atrophy the index was between 2.1 and 6.7 depending upon the severity. In occlusive hydrocephalus it was between 1.0 and 5.6. The changes in the volume of the CSF space after treatment can easily by demonstrated by appropriate changes in the index.
Adult↗
Stereophotogrammetry: an additional method for three-dimensional x-ray examination.
A comparison of stereophotogrammetry and computer tomography is made. Advantages of both methods are shown in some examples from neurosurgical practice.
Brain↗
[Frontal and half axial projection for cranial computer tomography (author's transl)].
The introduction of second generation computer tomographic apparatus has made it possible to obtain frontal and half axial projections. This is particularly important for lesions at the skull base, the ventricular system, the tentorium, the scalp and the epicranium. The appropriate positions are described in detail.
Humans↗
[Radiation to the orbits during computer tomography with the emi scanner ct 1010 (author's transl)].
Radiation dose to the lens during examinations with the EMI scanner CT 1010 depends on the region examined, on the angle of swing, duration of scan and the plane of the examination. In the most common position (horizontal, 180 degrees and 60 seconds) lens dose during examination of the orbit is about 900 mR., and for examination of the skull about 300 mR. Longer durations of scan and greater swings may increase the dose to the lens to 9 R. Even in the most unfavourable cases, the dose to the lens is less than would be obtained from skull tomography and skull angiography in two planes. Nevertheless, axial computer tomography used under certain conditions, and particularly when repeated, will have to be considered as a possible cause of damage to the lens.
Humans↗
[Modified biological behaviour of 99mTc-pertechnetate in man as a result of a preceeding administration of tin (tin effect) (author's transl)].
An increased image of blood-filled spaces (Plexus choriodeus, Sinus transversus) was observed in 99mTc-pertechnetate scintigraphy when it had been preceded by the administration of tin (e.g. of 99mTc-Sn-diphosphonate). We have called this behaviour the "tin effect". In vitro studies demonstrated binding of about 80% of the administered activity in the blood with a biological half-life of about 44 hr and an effective half-life of about 5.3 hr. 95% of the blood activity was bound to red cells and 5% to plasma. This resulted in an increased radiation dose to the bone marrow of about 530 mrad/mCi 99mTc-pertechnetate (following tin). The extent of the tin effect decreased with the length of the interval between tin and 99mTc-pertechnetate administration. Because of the tin effect 99mTc-DTPA or 99mTc-citrate should be used for brain scintigraphy if this has to be performed within the first 5 or 7 days following a bone scintigraphy with a tin-containing radiopharmaceutical. The "tin effect" might be taken advantages of when labelling red cells and imaging vascular spaces.
Brain↗
[Index of brain volume and space occupied by the CSF--A parameter for the diagnosis of hydrocephalus via computerised tomography (author's transl)].
Cranial computerised tomography allows to calculate, from the volume elements of all layers, the volume of the brain and of the outer and inner spaces occupied by the cerebrospinal fluid. The ratio between the volume of the brain and of the spaces occupied by the CSF is represented by an index figure known as brain--liquor space index. Success of therapy is objectivated by a change of the index as determined by control examinations.
Adolescent↗
[Aneurysm of commune carotid artery as late sequelae of a gunshot injury].
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Adult↗
[Comparison of brain scintigraphy with 99mTc-pertechnate and 99mTc-citrate].
20 patients with ultimately proven cerebral lesion were studied consecutively with 99mTc-pertechnetate and 99mTc-citrate. A comparison of the brain scans showed neoplastic lesions to be visualized more clearly with 99mTc-citrate, and vascular lesions to be demonstrated better with 99mTc-pertechnetate. Comparative brain scanning utilizing 99mTc-citrate and 99mTc-pertechnetate facilitates the differentiation between acute brain infarcts and neoplastic lesions which is difficult or may be impossible by cerebral computer tomography. The reduced radiation exposure from 99mTc-citrate and its superior usefulness in the visualization of neoplastic lesions suggest its use as the primary brain scanning agent.
Brain Diseases↗
[Relative uptake of 99mTc-diphosphate and its temporal change in bone diseases].
Quantitative regional measurements of the distribution of a bone seeking radiopharmaceutical is performed easily together with a bone scan using a scintillation camera. Comparative measurements of regional radioactivities yield a ratio of relative uptake. The time change of such a relative uptake ratio is obtained by repeating the regional comparison measurements after a 4--8 weeks interval. The time change of the relative uptake ratio was found to be a clinically useful parameter in the follow-up of skeletal diseases. A decrease in the relative uptake ratio was found with healing fractures, with receding osteomyelitis and during radiation therapy of bone metastases; an increase was observed with spreading metastases, developing osteomyelitis, developing pseudathrosis, and in the beginning of normal fracture healing.
Bone Diseases↗
[Optimized cross-section determination for treatment planning in radiation therapy (author's transl)].
A true scale cross-section of the body is an indispensable condition for the accuracy of treatment planning in radiation therapy. To this end, ultrasonic or computed tomography may be used. Advantages and disadvantages of these methods are discussed. By summarization of cross-sections from all positions appropriate for treatment the most authentic body contours are obtained as an optimal basis for irradiation.
Anthropometry↗