[en] Of radiological examinations, especially CT scan of the head in emergency service was viewed. Cranial simple radiography gave more information than CT, while CT revealed pathologic changes in an acute stage of trauma, rapidly, accurately, and noninvasively. Although gave less information than CT, cerebral angiography is advised to perform preoperatively because it revealed the state of circulation and its changes. In cerebral apoplexy, it was same as in head trauma that CT was of value in diagnosing the acute stage precisely. (Ueda, J.)

[en] In a 13 year-old boy suffering with uncontrollable adversive seizures to the left side, CT before contrast enhancement did not demonstrate any findings, but a slight atrophic area localized in the right frontal lobe. After contrast enhancement, a tiny linear high density area was seen in the subcortex of the right frontal lobe. Right common carotid angiography demonstrated no abnormalities in the arterial and capillary phases. However in the venous phase, a caput medusae like or cone shaped lesion was found in the white matter of the right frontal lobe and it consisted of nemerous small veins. Right frontal craniotomy was performed. Postoperatively, the patient was uneventful and discharged without any neurological deficits. Adversive seizures disappeared and EEG had normalized. Histological examinations of the specimen revealed that these malformations consisted of small numerous veins separated by neural tissue and as a cerebral venous angioma was diagnosed. (J.P.N.)

[en] A case of cerebral cavernous angioma of a 60 year-old man was reported and the lesion was also discussed as an epileptogenic lesion detected by CT and surgically treated. Considerations on CT findings will be much contributory to the preoperative diagnosis rather than cerebral angiography. (author)

[en] The present authors have examined 26 cases of intracranial meningiomas with a 0.1 T resistive and 0.5 T superconductive MR system. 7 of these cases were enhanced with Gd-DTPA. The T₁ and T₂ values of the meningioma were then calculated from the computed T₁ and T₂ images. In this paper, the authors have reported that the T₁ and T₂ values have some relation to the histopathological subtype of the meningioma. In the angiomatous type, the T₁ value was slightly prolonged; however, there was no significant statistical relation between the T value and the subtype. The T₁ value of the parasagittal, sphenoidal ridge, and the convexity type were more prolonged than the corresponding values of the CP-angle type. By enhancement with Gd-DTPA, the T₁ and T₂ values were decreased in all cases. The rate of decrease (T-t/T T=Plain, t=postenhanced) was higher in the angiomatous type (55.3%) and the anaplastic type (42.1%) than in the others. There was no difference between the meningothelial type (27.8%) and the fibrous type (30.1%). In conclusion, the prediction of the subtype of meningiomas from the T value is difficult; however, the rate of decrease upon enhancement with Gd-DTPA was quite reliable. (author)

[en] The authors used high resolution volumetric CT for two-dimensional (2D) and three-dimensional (3D) measurements of skull base structures of 52 normal individuals (26 males and 26 females). Computed tomography was performed with a HITACHI W-3000 volumetric CT scanner, slice width was 2 mm, sliding speed 2 mm/sec and scan time 30 sec. We scanned the subjects in an axial plane, parallel to the orbitomeatal (OM) line from foramen magnum to rostral 60 mm, and reconstructed 59 slices of 2D-CT images every 1 mm pitch. The 3D-CT displays were derived from the 2D-CT imaging data. We measured approximately 80 points for both, 2D-CT and 3D-CT. For example, the distance of the internal acoustic meatus to the outer surface of the skull was 43.7±3.0 mm; sigmoid sinus to posterior semicircular canal, 9.1±2.4 mm; anterior clinoid process to foramen ovale, 24.5±3.1 mm; the bilateral anterior clinoid process was 27.0±3.5 mm, etc. These 2D-CT and 3D-CT measurements are useful adjuncts for surgery on the base of the skull. (author)

[en] Among 129 patients with moderate and severe head injuries, subarachnoid hemorrhages (SAH) were observed in 21 cases on initial CT scans. These 21 cases were classified into 4 groups as follows according to the CT findings: Type 1. SAH were seen diffusely in basal cisterns (8 cases). Type 2. SAH were seen dominantly in the interhemispheric fissure or along the tentorium cerebelli (8 cases). Type 3. SAH were seen in the unilateral Sylvian cistern (4 cases). Type 4. SAH were seen in the parietal sulci (1 case). A clinical analysis was undertaken based on this classification; the following results were obtained: (1) In Type 1, the prognosis was poor, and it was frequently accompanied by other intracranial lesions, such as cerebral contusions and intracerebral hemorrhages. (2) In the other 3 types, the prognosis was relatively good. (3) In Type 1 of traumatic SAH, it should always be kept in mind that cerebral vasospasm and hydrocephalus can occur after a certain period of time. (author)

[en] In this report, the computerized tomography (CT) of chronic subdural hematoma was studied. Our experience was based on 22 patients with chronic subdural hematoma, verified by surgery. The results of the analysis of 16 cases excluded infant cases and post-operative cases. (1) In 8 cases, the locations of the hematoma were bilateral, and in 8 cases, unilateral. (2) The CT findings of the hematomas were classified into 4 types: low density (9 cases), iso-density (2 cases), mixed density (2 cases), and high density (3 cases). (3) Contrast enhancement in the capsule and the content of hematoma was indicated by the Marginal Curve. In infant cases (4), it is difficult to diagnose by the CT scan alone. We concluded, however, that CT was very useful in diagnosing chronic subdural hematoma. (author)

[en] Recently, CT-guided stereotactic surgery has become of major interest, and some authors have discussed its potential in functional neurosurgery. The following is a comparative study of the CT-guided stereotactic technique and the conventional roentogenographic stereotactic technique. The Brown-Roberts-Wells apparatus was used for both types of procedures. 37 stereotactic procedures were performed on 35 patients under local anesthesia; 16 for stereotactic biopsy and 21 for stereotactic functional neurosurgery. Target points for stereotactic biopsy were determined by the CT-guided technique and target points for functional neurosurgery were determined by the conventional roentogenographic technique. The correlation with the position of target point determined by both techniques was investigated in the 21 functional neurosurgical procedures. On these occasions the authors used the reformatted horizontal and sagittal CT through the anterior and posterior commissure to determine the position of target point by the CT-guided technique. Results: It was found that the AC-PC line crossed with Reid's base line at angle of 11 ± 1 deg, and therefore it is important to obtain a CT images including AC-PC line at this angle. When applying the CT guided stereotactic procedure for functional surgery, it should be known that there could be a discrepancy within 2 mm from the conventional target determination. (author)

[en] Cysticercosis is well known as a parasitic infection that commonly affects the central nervous system. A 60-year-old man, who once lived in the mainland of China in the 1940s, was admitted to the hospital complaining of the right motor weakness and speech disturbance. Neurological examinations revealed the right hemiparesis with increase of deep tendon reflexes and motor dysphasia. The skull x-ray films showed no abnormal finding, but many small fusiform calcifications were found in the x-ray films of soft tissues of the limbs. Brain CT demonstrated several small rounded and calcified high density areas and cystic low density areas in the parenchyma with a marked dilatation of the ventricular system. And a large cystic mass of the left fronto-parietal region compressed the body of the left lateral ventricle. After infusion of contrast medium, a small ring-enhanced density area in the frontal region was revealed. By a craniotomy, the large cyst, which had a bluish transparent wall, was totally extirpated. The nature of the cystic content was similar to that of the cerebro-spinal fluid. On histological examination of the cyst wall any scolex was not found, but papillary folds and typical three layers of cysticercosis were observed. The immunological testing for cysticercosis was positive on the serum of the patient. These findings confirmed the diagnosis of human cysticercosis. Wider applications of CT in clinical practice could discover more cases of cysticercosis in the recent situation of world wide communication of population. This report will be the first one of cysticercosis which mainly discussed about the findings of CT in the Japanese literature. (author)

[en] In 80 cases of focal epilepsy, excluding such cases as late onset after the age of 30 and traumatic or expansive lesions, the epileptogenic foci have been studied by comparing the CT findings with the seizure types and the EEG findings. The results were as follows: (1) Abnormal CT findings were observed in 36% of the patients. (2) These findings were classified into 4 large groups: localized cerebral atrophy, localized low density, localized high density with contrast enhancement and diffuse cerebral atrophy. (3) The incidence of CT abnormality was higher in the cases with continuous and localized EEG abnormality than in the cases with other types of EEG abnormality. In 48% of the cases, the location of the abnormal CT findings coincided with their EEG foci. (4) In the cases of temporal lobe epilepsy without abnormal CT images, the print-out data compared with the bilateral promised temporal regions, before and after contrast enhancement. The EMI-No. of the medial temporal focus increased more than that of the contralateral side in 3 cases out of 4 after contrast-media injection. (5) Moreover, for the purpose of comparing the CT findings on general seizures with those in focal seizures, we have studied 80 cases of general seizures. In the cases of the general seizures, abnormal CT findings were observed in only 16%. These abnormal findings were diffuse in 5 cases, localized in 6 cases, and combined in 3 cases. (author)