Moorthy Ranjith K, Rajshekhar Vedantam
Department of Neurological Sciences, Christian Medical College Hospital, Vellore, India.
Surg Neurol. 2004 Feb;61(2):180-4; discussion 184. doi: 10.1016/s0090-3019(03)00423-3.
Diagnostic criteria for posttraumatic brain tumors were formulated in the pre-CT (computerized tomography) era. We propose that radiologic criteria incorporating imaging data be added to the existing criteria.
We report a case of a 56-year-old man who presented with history of raised intracranial pressure of 20 days' duration. Imaging showed a large left frontal intra-axial mass lesion. He had history of head injury 5 years prior with CT evidence of bilateral basifrontal contusions. There was no contrast enhancement at the site of the contusions in an intervening CT scan done 18 months after the trauma. He underwent radical excision of the mass, and the histopathology was reported as glioblastoma multiforme. We formulated additional radiologic criteria for tumors that may present following trauma. A review of the literature of posttraumatic gliomas is also presented.
Fulfillment of the additional radiologic criteria proposed by us will help distinguish a tumor that developed following trauma from that which was present before the occurrence of the injury.
创伤后脑肿瘤的诊断标准是在计算机断层扫描(CT)时代之前制定的。我们建议将纳入影像数据的放射学标准添加到现有标准中。
我们报告一例56岁男性患者,其有持续20天的颅内压升高病史。影像学检查显示左额叶轴内有一个大的肿块病变。他5年前有头部受伤史,CT显示双侧额底挫伤。在创伤后18个月进行的一次CT扫描中,挫伤部位无强化。他接受了肿块根治性切除,组织病理学报告为多形性胶质母细胞瘤。我们为创伤后可能出现的肿瘤制定了额外的放射学标准。同时还对创伤后胶质瘤的文献进行了综述。
满足我们提出的额外放射学标准将有助于区分创伤后发生的肿瘤与损伤发生前就已存在的肿瘤。