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Computed Tomography in Intracranial Tumors: Differential by Prof. Dr. med. Gianni B. Bradač, Prof. Dr. med. Udalrich

By Prof. Dr. med. Gianni B. Bradač, Prof. Dr. med. Udalrich Büll, Prof. Dr. med. Rudolf Fahlbusch, Prof. Dr. med. Thomas Grumme, Prof. Dr. med. Ekkehard Kazner, Dr. med. Konrad Kretzschmar, Priv. Doz. Dr. med. Wolfgang Lanksch, Dr. med. Wolfang Meese, Priv.

The present publication represents a distillation of the adventure received in prognosis of intracranial tumors with computed X-ray tomography on the collage Hos­ pitals of Berlin, Mainz, and Miinchen. To what function? regular radiological options resembling pneumoencephalography with lumbar puncture and cerebral arteriography with puncture of the typical carotid artery are invasive proce­ dures which entail a specific amount of danger in addition to pain for the sufferer. additionally, diagnoses made with those approaches depend totally on oblique indicators of an intracranial space-occupying lesion - resembling displacement of the air-filled ventricles or of standard cerebral vessels. just a couple of kinds of tumor are proven without delay with those options. by contrast, computed tomography demonstrates the pathology at once in just about all situations, and this with at the least threat and ache. additionally, general intracranial constructions are proven, in order that the tumor's impact on its atmosphere will be evaluated. this present day, nearly a decade after HOUNSFIELD'S innovative invention, diagno­ sis of mind tumors with no computed tomography is sort of unthinkable, if no longer in truth irresponsible.

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Extra info for Computed Tomography in Intracranial Tumors: Differential Diagnosis and Clinical Aspects

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Typical Locations The tumors are most commonly found in the frontal, frontoparietal, temporal, and temporoparietal regions. The lesions have also been 32 Computed Tomography in Brain Tumors demonstrated in the parietal lobe, in the thalamus, and in the pontine region, but they are rarely found in the cerebellum (Fig. 13-27). 1 Characteristic Clinical Findings Clinical features include seizures, localizing neurological deficits, and headache. 1 Additional Diagnostic Procedures Skull films do not reveal specific changes in patients with anaplastic astrocytomas, though displacement of the calcified pineal body may be found in large tumors.

The extent of an increase in density after contrast enhancement is also a significant factor in differential diagnosis, since a very strong increase in X-ray absorption suggests a vascular malformation or a highly vascularized lesion. Our experience in the past 6 years has shown that a large number of tumors exhibits a characteristic appearance in the CT scan, which allows the prediction of the histological diagnosis in many cases. We have included a large number of these CT scans among the illustrations, because certain characteristic patterns recur in many tumors.

In some cases the actual neoplasm may be hypodense, and as a result it is not possible to differentiate between tumor and edema in the precontrast study. Postcontrast Study Contrast enhancement was positive in 83% of the 157 patients in our series, but 17% of anaplastic astrocytomas did not take up contrast medium. The latter were hypodense astrocytomas which contained small areas of anaplasia. This inconsistent response to contrast media suggests that hypodense tumors which do not take up contrast media may represent a transitional stage between astrocytoma and anaplastic astrocytoma.

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