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Clinical study of acute cerebral infarction with a midline shift on the CT scan

Abstract

Twenty-one cases of acute cerebral infarction with a midline shift on the CT scan were studied with respect to the development of the midline shift, the angiographic findings, the clinical pictures and the outcome of these patients. The CT findings of hemorrhagic infarction were also studied. No cases showed a midline shift on a CT scan taken within 6 hours after the onset. A midline shift was, however, noted as early as 9 hours after the onset, and it reached its peak between the 2nd and 7th day of the onset. It gradually disappeared by the end of the third week. Hemorrhagic infarction was diagnosed in 6 patients by either spinal tap or autopsy. The CT findings of these hemorrhagic infarction were divided into two types, solid hemorrhages with an unequivocal high density within the low-density area, and small, scattered hemorrhagic of almost the same density as normal brain tissue within the low-density area. In 19 of 21 patients, an round-edged occlusion and/or embolus were observed on the initial angiograms. The recanalization of the occluded vessels was proved in 10 of 14 patients by subsequent angiographic studies. Twenty of 21 patients showed a sudden development of neurological symptoms, and 15  More>>
Authors:
Takemae, T; Mizukami, M; Kin, H; Kawase, T; Araki, G [1] 
  1. Mihara Memorial Hospital, Isezaki, Gunma (Japan)
Publication Date:
Dec 01, 1978
Product Type:
Journal Article
Reference Number:
AIX-11-558982; EDB-81-012514
Resource Relation:
Journal Name: CT Kenkyu.; (Japan); Journal Volume: 1:2
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; CAT SCANNING; NERVOUS SYSTEM DISEASES; DIAGNOSIS; EDEMA; PATIENTS; VASCULAR DISEASES; BODY; CENTRAL NERVOUS SYSTEM; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DISEASES; IMAGE PROCESSING; NERVOUS SYSTEM; ORGANS; PATHOLOGICAL CHANGES; PROCESSING; SYMPTOMS; TOMOGRAPHY; 550601* - Medicine- Unsealed Radionuclides in Diagnostics
OSTI ID:
6759533
Country of Origin:
Japan
Language:
Japanese
Submitting Site:
INIS
Size:
Pages: 215-222
Announcement Date:
Dec 01, 1980

Citation Formats

Takemae, T, Mizukami, M, Kin, H, Kawase, T, and Araki, G. Clinical study of acute cerebral infarction with a midline shift on the CT scan. Japan: N. p., 1978. Web.
Takemae, T, Mizukami, M, Kin, H, Kawase, T, & Araki, G. Clinical study of acute cerebral infarction with a midline shift on the CT scan. Japan.
Takemae, T, Mizukami, M, Kin, H, Kawase, T, and Araki, G. 1978. "Clinical study of acute cerebral infarction with a midline shift on the CT scan." Japan.
@misc{etde_6759533,
title = {Clinical study of acute cerebral infarction with a midline shift on the CT scan}
author = {Takemae, T, Mizukami, M, Kin, H, Kawase, T, and Araki, G}
abstractNote = {Twenty-one cases of acute cerebral infarction with a midline shift on the CT scan were studied with respect to the development of the midline shift, the angiographic findings, the clinical pictures and the outcome of these patients. The CT findings of hemorrhagic infarction were also studied. No cases showed a midline shift on a CT scan taken within 6 hours after the onset. A midline shift was, however, noted as early as 9 hours after the onset, and it reached its peak between the 2nd and 7th day of the onset. It gradually disappeared by the end of the third week. Hemorrhagic infarction was diagnosed in 6 patients by either spinal tap or autopsy. The CT findings of these hemorrhagic infarction were divided into two types, solid hemorrhages with an unequivocal high density within the low-density area, and small, scattered hemorrhagic of almost the same density as normal brain tissue within the low-density area. In 19 of 21 patients, an round-edged occlusion and/or embolus were observed on the initial angiograms. The recanalization of the occluded vessels was proved in 10 of 14 patients by subsequent angiographic studies. Twenty of 21 patients showed a sudden development of neurological symptoms, and 15 patients had a history of various kinds of heart disease, such as atrial fibrillation, valvular heart disease and myocardial infarction. The patients had atrial fibrillation on EKG on admission. These angiographic findings and clinical pictures strongly suggest that the infarction with a midline shift on the CT scan may be caused by a cerebral embolism of cardiac origin. Eight patients died of cerebral herniation between the 2nd and 6th day of the onset. Taking these poor outcomes into consideration, surgical as well as medical decompression of the brain would seem to be most important when the CT scan shows a midline shift.}
journal = []
volume = {1:2}
journal type = {AC}
place = {Japan}
year = {1978}
month = {Dec}
}