Brain CT studies of 35 patients with anorexia nervosa confirmed the observations of other authors: cerebral dystrophic changes correlate with weight loss and the reversibility of these changes also correlates with the normalization of body weight. Other corroborated facts are: the most numerous and most pronounced enlargements are of the cortical sulci and the interhemispheric fissure, moderate widening affects the ventricles and the rarest and most insignificant changes are those of the cerebellum. The reversibility of the changes showed a parallel to the extent of the changes themselves and to the duration of improvement of the body weight. The reversibility of the enlargement of the cortical sulci and of the distances between the frontal horns of the lateral ventricles was more often significant than that of the abnormal measurements of the cella media. This difference is based on minimal early acquired brain damage which occurs in 60% of our patients. This high incidence of early acquired minimal brain disease in patients with anorexia nervosa is here discussed as a nonspecific predisposing factor. Although there is no exact explanation of the etiology of the reversible enlargement of cerebrospinal fluid (CSF) spaces in anorexia nervosa, the changes resemble those in alcoholics. The mechanisms of brain changes in alcoholism, as shown experimentally, seem to us to throw light on the probable mechanism of reversible dystrophic brain changes in anorexia nervosa.
Computerized tomographic (CT) scans of 271 patients with histologically proven bronchial carcinoma accomplished for initial tumor staging were retrospectively evaluated for signs of cerebral metastasis. The results for the histologic subtypes were quite different. In 13.8% of patients with small cell carcinoma and limited disease the authors found signs of brain metastasis. However, routine cerebral staging in these patients did not seem to be useful because of lack of therapeutic consequences. On the other hand, no patient with non-small cell carcinoma (N-SCC) and tumor Stage I or I1 had brain metastases. All patients with brain metastasis from N-SCC had been classified as tumor Stage 111 before cerebral imaging. Among these patients, however, the authors found brain metastasis in 17.5% of those without known distant metastatic disease (III/MO), especially in large cell carcinoma and in adenocarcinoma. Stage III/MO patients should undergo routine cerebral imaging if their tumor is surgically resectable and thoracotomy is planned. Cancer 66:2007-2011,1990. RANIAL COMPUTED TOMOGRAPHY (CT) camed Out C as part of routine initial staging procedures in patients with bronchial carcinoma is not unanimously accepted ,'-' particularly when patients do not show neu-rologic symptoms. Varying tendencies toward cerebral metastasis have been found for the different histologic subtypes of lung However, most studies published so far either do not differentiate for tumor histologic type,',3,4,6 or consider only small cell carcinomas (SCC).5,7 The question whether routine cerebral imaging can change the overall assessment of tumor stage usually remains un-discussed. This study was intended to depict results of routine cerebral imaging in patients with bronchogenic carcinoma From the Department for Neuroradiology and Computerized To-mography, Evangelische Krankenanstalten, Duisburg-Nord, Federal
Hemangiopericytoma in the central nervous system is a rare tumor occurring predominantly in supratentorial sites. Classification may be confusing because the tumor may mimic the histological pattern of other vascular neoplasms. The particular feature of hemangiopericytoma are pericytes of blood vessels; they distinguish it as a separate and distinct tumor. The case of a 3 3/4-year-old child with a 3 3/4-year course is reported with a tumor in the middle fossa, the diencephalon, and the brainstem. The cystic tumor was resected twice. The child is presently alive with neurological deficit. The clinical, radiographic and histological findings are presented. The role of aggressive surgical treatment is emphasized.
Objective digital determination of CSF spaces is discussed, with ventricular and subarachnoid spaces handled separately. This method avoids the difficulty of visual definition of ventricular borders in planimetric measurements. The principle is to count automatically all pixels corresponding to CSF in a given region with a Hounsfield unit and to multiply this number by the pixel size. This will give the total surface area of CSF spaces in square millimeters. The calculation of pixel values for CSF spaces and brain tissue is experimentally formulated taking the intersection of the Gaussian curves for ventricular content and brain tissue. In practice, the determination of CSF spaces is done by first calculating a histogram of the total brain in a given slice defining all CSF spaces. Next a histogram of a region including ventricles with adjoining tissue is calculated and the ventricular size is calculated. By subtraction of the ventricle value from the total CSF space value, the subarachnoid space size is obtained. The advantages of this method will be discussed.
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