[Tolerance of pneumoencephalography in intracranial tumors; experience with pneumoencephalography at the neurological clinic during 1942-1950].
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Sequelae to pneumoencephalography.
Fifty patients were examined clinically and neurologically for seven days after pneumoencephalography. Headache was present in 78%, neck stiffness in 34%, pyrexia in 38%, vomiting in 34%, tachycardia in 74%, a change in the level of consciousness in 18%, and abnormal neurological signs in 30%. Of the 13 patients with epilepsy, there was an increased frequency of seizures in four, associated with increased EEG epileptiform activity in three. EEG abnormality either appeared or increased in 74% of cases on the second day after the air study. A mechanism for the production of these sequelae is proposed. It is concluded that these findings indicate that in most cases an organic brain syndrome follows pneumoencephalography.
Adolescent↗
Pediatric pneumoencephalography with nitrous oxide.
The recent advances in neurodiagnostic procedures have changed pneumoencephalography. Now we must find the smallest lesions and demonstrate accurately their relationships to the ventricular system cisterns and surrounding structures. Complex blurring motion tomography gives this detail, but the pediatric patients are difficult to examine and immobilization during the long exposure needed for tomography frequently compromises the airway. Hypoventilation from sedation and from the radiographic positioning may lead to increased intracranial pressure. By performing pediatric pneumoencephalography under general anesthesia, with nitrous oxide as both an anesthetic agent and as the contrast material, we are able to control patient motion, preserve the child's airway, and prevent hypoventilation. The nitrous oxide, rapidly diffusible, is a good contrast agent, as large volumes can be used and the gas leaves the ventricular system quickly after the discontinuation of the anesthetic. This rapid reabsorption and elimination of the subarachnoid gas may decrease pneumoencephalographic morbidity.
Adolescent↗
Cerebral blood volume alterations during fractional pneumoencephalography.
Simultaneous and continuous measurements of the cerebral blood volume (CBV), cerebrospinal fluid (CSF) and blood pressure were carried out in six patients during fractional pneumoencephalography in order to examine intracranial volumetric interactions. Three patients (Group A) showed normal encephalographic findings, and in three patients (Group B) communicating hydrocephalus with convexity block was found encephalographically. In all patients the injection of air was followed by an immediate increase of CSF pressure and blood pressure and a concomitant decrease of CBV. The initial CSF pressure was invariably re-established within 3 to 3.5 min. During this time interval the CBV of the patients of Group B decreased significantly and 30 percent more than that of Group A. Furthermore, after restoration of the original CSF pressure, CBV returned to its initial level in all patients of Group A, whereas it remained unchanged or showed a further decrease in the patients of Group B. Removal of an amount of CSF corresponding to half of the amount of injected air was followed by a significant reactive hyperemic response in two normal patients. The intracranial volumetric alterations during fractional pneumoencephalography are discussed in detail with respect to the underlying physiologic mechanisms and are suggested as a model for acute and low pressure hydrocephalus.
Adult↗
Unreliability of combined pneumoencephalography and scinticisternography.
Evidence is presented that the radiopharmaceutical flow in cerebrospinal fluid may be significantly altered by pneumoencephalography. When both pneumoencephalography and scinticisternography are required in the same patient, the studies should be performed separately rather than as a combined procedure.
Child↗
[Pneumoencephalography in the diagnosis and complex treatment of traumatic epilepsy].
Pneumoencephalographic examinations (after endolumbar injection of 60 ml of air) were carried out in 84 patients who developed epileptic seizures after closed brain injuries. In all the patients diffuse cysto-adhesive arachnoiditis, open inner hydrocephalus, and delayed resorption of air from the cerebral ventricles were revealed roentgenologically. A therapeutic effect that manifested itself in a subjective improvement, abatement of the organic signs, cessation, diminution on the frequency, or transformation of the seizures into milder ones was noted in 77% of the patients. Data on vegetative reactions and changes of the brain bioelectrical activity under the influence of the pneumoencephalography are presented. Possible role of those changes in the mechanisms of the pneumoencephalography therapeutic action is discussed.
Arachnoiditis↗
[Changes in the ventricular system of the brain in epilepsy patients (according to the results of echoventriculometry, planimetric pneumoencephalography and clinical examination)].
Examination of 120 epileptics with the use of pneumoencephalography (PEG) and echoventriculometry (EVM) demonstrated that the changes in the cerebral ventricular system could be pinpointed as early as during the first year of the disease and that later on they had a tendency for gradual progression. These changes are hardly dependent on the total duration of epilepsy but the severity of its course exerts a marked influence on them. A comparative analysis of the EVM and PEG readings as well as cerebrospinal fluid pressure values suggests that the results provided by these methods show good correlation and that in some cases it is possible to limit the work-up of patients to echoventriculometry as a sufficiently informative and safe method, without resorting to pneumoencephalography.
Adolescent↗
Ketamine used for anaesthesia in children for pneumoencephalography.
Ketamine was given together with premedication (droperidol + pethidine + atropine) for general anaesthesia in 36 children during pneumoencephalography. Most children (26) had epilepsy. No significant cardiovascular and respiratory disturbances were observed during and after anaesthesia. This proposed method of anaesthesia in children is sufficient for short-lasting diagnostic procedures, particularly for pneumoencephalography.
Adolescent↗
[Hazards and complications of pneumoencephalography in children].
In a series of 1334 consecutive pneumoencephalographies in children 0-15 years, there were 2 deaths, 3 severe apneas and 1 pneumomediastinum. Respiratory insufficiency, due to contention of the patient with resulting impairment of the motion of thoracic muscles was an important mechanism and pneumoencephalography is contra-indicated in children with respiratory difficulties prior to the examination. In 90 consecutive patients submitted to pneymoencephalography CSF changes and fundus oculi abnormalities were studied prospectively. Aseptic meningitis of a mild degree is common following the examination, whereas significant meningeal haemorrhage is rare. Haemorrhages in the fundi were noted in 10% of the patients. The general tolerance of the examination was good.
Adolescent↗
Comparison of the measurements of the cerebral ventricles obtained by CT scanning and pneumoencephalography.
This study was undertaken to compare the accuracy of measurements of the venticular system obtained by the CT scanner and pneumoencephalography (PEG). In it the ventricular system was evaluated in each case by measuring the span of the frontal horns, cellae mediae and third ventricle in relation to the diameter of the inner and outer tables of the skull from the PEG films. The indices of Evans, Schiersmann, and Schaltenbrand and Nürnberger were applied to these measurements. The same indices were obtained using the appropriate CT printouts. A very good measure of agreement was obtained with the indices arrived at from both the CT scan printouts and the pneumoencephalograms.
Adolescent↗
Constancy of convexity air block on pneumoencephalography.
Twenty-two patients with dementia were examined by pneumoencephalography using special technic with the aim of filling the subarachnoid convexity space. Seven had no obvious hydrocephalus. All patients had convexity blocks which were more or less extensive. Ten had bilateral air block in the frontal, parietal and occipital regions. It was concluded that convexity air block is not a technical artifact and consequently seems to have an organic background.
Adult↗
Computed tomography and pneumoencephalography compared to conductance to outflow of CSF in normal pressure hydrocephalus.
The conductance to outflow of CSF (Cout) was measured in 66 patients with normal pressure hydrocephalus (NPH). All patients were investigated with computed tomography (CT); 34 of the patients also had pneumoencephalography (PEG). Periventricular hypodensity on CT indicates a low Cout. Cortical sulci smaller than 1.9 mm on CT indicate a low Cout, while wide cortical sulci do not exclude a low Cout. There was a good correlation between ventricular size on CT and PEG, but the ventricular size is unrelated to Cout. No findings on PEG indicate a low Cout.
Adult↗
Effects of tiapride on homovanillic acid levels in human cerebrospinal fluid drawn at pneumoencephalography.
The effect of tiapride on HVA and 5-HIAA levels in the CSF drawn at pneumoencephalography (PEG) was studied. Five consecutive 5 ml fractions of CSF were drawn from control and tiapride-treated subjects. In both groups, a linear increase in HVA concentrations was found between the first and subsequent fractions. On the contrary, no significant difference in 5-HIAA concentrations was found in sequential CSF samples. Tiapride increased the mean HVA concentrations and caused a steeper caudocranial gradient of this metabolite but failed to modify 5-HIAA concentrations. The results suggest that tiapride blocks dopamine (DA) receptors and increases DA synthesis.
Adult↗
Acquired hydrocephalus. II. Diagnostic and prognostic value of quantitative isotope ventriculography (QIV), lumbar isotope cisternography (LIC), pneumoencephalography, and continuous intraventricular pressure recording (CIP).
The diagnostic and prognostic values of quantitative isotope ventriculography (QIV), lumbar isotope cisternography (LIC), pneumoencephalography (PEG), and continuous intraventricular pressure recording (CIP) were assessed on the basis of the clinical course in 160 patients suspected of having acquired hydrocephalus. The diagnostic value of a given method is defined as its reliability in the diagnosis of hydrocephalus. The reliability in the selection of hydrocephalic patients who will improve on shunt operation is designated as the prognostic value of the method concerned. As the diagnoses are based on isotopic procedures, the diagnostic values of these procedures cannot be assessed. QIV is of greater prognostic value than the other methods of examination. The presence of plateau waves in CIP is a rare, but prognostically valuable sign. The prognostic value of B waves is also good, whereas their diagnostic value is slight. Both from diagnostic and prognostic points of view, PEG is of less value is communicating hydrocephalus on account of the many false findings.
Cerebral Ventricles↗
Cardiac arrhythmia induced by pneumoencephalography.
Cardiovascular collapse associated with pneumoencephalography (PNE) has been reported but there has been no prospective study of its nature and cause. We have recorded prospectively the e.c.g. of 82 unselected patients, with no cardiovascular or metabolic disease, undergoing PNE under general anaesthesia. The frequency of arrhythmia following air injection was 60%; bradycardia 22%; ventricular ectopic beats 26%; nodal rhythm or sinus tachycardia 11%. Cardiovascular collapse occurred in three patients; two with "torsades de pointes" and one with bigeminy and q.r.s. block. Arrhythmia was more frequent in patients with a pituitary tumour and intracranial hypertension (91%). Eight postoperative control PNE examinations were uneventful. Three of four patients with frontal lobe tumours and four of seven with posterior fossa tumours exhibited arrhythmia.
Aged↗
Computer assisted tomography and pneumoencephalography in nonhydrocephalic, nontumorous head enlargement.
Forty children with enlarged heads were studied by pneumoencephalography and/or computer assisted tomography (CAT). Ventricular dimensions from CAT scans of 70 normal children formed a control group. In the group of 40 children with neither hydrocephalus nor brain tumor, CAT more reliably showed ventricular enlargement in patients with neurologic impairment.
Brain↗
Lesions at the foramen of Monro: evaluation by computed tomography, angiography, and pneumoencephalography.
The majority of abnormalities at the foramen of Monro identified by computed tomography (CT) are colloid cysts, but a number of other diseases in this location may produce a similar CT appearance. In a series of 21 patients the radiologic findings included six colloid cysts, two neoplasms, five vascular lesions, three congenital neuroectodermal diseases, four infectious or granulomatous lesions, and one idiopathic calcified mass at the foramen of Monro. The neuroradiologic evaluation included contrast-enhanced and contrast-nonenhanced cranial CT scans and cerebral angiography in the majority of cases. Pneumoencephalography provided useful ancillary diagnostic information in four patients.
Adolescent↗
Cardio-respiratory changes during pneumoencephalography.
Carbon-respiratory changes associated with changes in posture and injection of intrathecal oxygen were studied in fifeen patients undergoing pneumoencephalography in a Phillips isocentric chair, while breathing spontaneously and anaesthetised with halothane in oxygen. Haemodynamic changes associated with changes in posture were of a minor nature. A rise in PaCO2 occurred in the prone position in two obese patients. There were significant rises in blood pressure following injection of more than 5 ml of oxygen as a bolus into the subarachnoid space.
Adult↗