Mamoru Taneda

Computed tomography for diagnosis and assessment of cerebral fat embolism

SummaryA patient with cerebral fat embolism was followed by computed tomography (CT). For the first few days after injury, CT revealed no abnormality. About a week later, multiple low density areas appeared in the white matter of the frontal region. They disappeared within the subsequent 2 weeks while subdural effusions developed in the fronto-parietotemporal regions. As neurologic recovery progressed, the subdural effusions gradually diminished and cerebral atrophy was seen.

Gd-DTPA-enhanced MR imaging of cryptococcal meningoencephalitis

SummaryThis report describes magnetic resonance (MR) imaging of biopsy-proved cryptococcal central nervous system (CNS) infection in a 31-year-old HIV negative man. Initial MR imaging revealed multi-focal Gd-DTPA enhancement and showed more lesions than contrast enhanced CT. The lesions regressed after antifungal therapy. MR imaging aids in diagnosis as well as helps to monitor the response to the pharmacological therapy of cryptococcal meningoencephalitis and possibly provides valuable insights into the pathophysiology of this condition.

Reversible arterial hypotension after acute aneurysmal subarachnoid hemorrhage

The authors report five patients who developed transient arterial hypotension immediately after the rupture of cerebral aneurysms. They manifested deep coma (three cases), abnormal electrocardiogram (four cases), and remarkable pulmonary edema (two cases). The level of consciousness in all three patients who were in deep coma improved with the normalization of blood pressure. Although two patients died of recurrent hemorrhage, the other three patients were discharged in satisfactory condition. Serious clinical conditions that are not terminal and are caused by arterial hypotension immediately after the rupture of cerebral aneurysms are sometimes reversible with adequate treatment.

The Role of Intracranial Blood Volume in Mechanical and Pharmacological Decompression

The cerebral vascular bed is one of the intracranial comPartments which undergoes rapid change. However, it remains unresolved how it responds to decompression. Some decompressive treatment resulting in an increased vascular bed may adversely affect the vascular system by encouraging engorgement of the vascular bed if vasoparalysis is a major etiological factor in increased intracranial pressure, as reported by Langfitt et al. (1966). The present study was carried out to investigate the response of intracranial blood volume (ICBV) during decompression.