Yamamoto M, Imanaga H, Jimbo M, Kitamura K
No Shinkei Geka. 1977 Apr;5(4):333-41.
Computerized transverse axial tomography (CT) of the brain is a recently developed method which allows non-invasive roentgenologic evaluation of intracranial diseases. The advent of CT represents a great advance in the diagnosis of a very wide variety of intracranial lesions, including cerebrovascular diseases. Especially, CT was found to be extremely informative in evaluating intracerebral, intracerebellar and intraventricular hemorrhage. The purpose of this report is to evaluate the clinical usefulness of CT in the diagnosis of intracranial hemorrhage. From the seven hundreds cases of various intracranial diseases hitherto examined by the EMI-scanner (160 X 160 matrix), twenty-three cases of nontraumatic intracranial hemorrhage were selected for the present study. Fifteen cases of fresh hemorrhage consisted of hypertensive cerebrovascular disease, arterio-venous malformation, aneurysm and unknown etiology, number of cases being six, three, four and two, respectively. All cases were examined within fifteen days after the ictus and the positive findings were obtained in all cases. The characteristic feature of the hematoma is the circumscribed and increased density area surrounded by the decreased density zone probably representing the accompanied brain edema. The sequential CT studies revealed that the hematoma area was gradually decreased in its density and finally transformed into the rather low density one in four weeks or so after the ictus. The smallest hematoma detected by CT was the cerebellar hematoma about five grams in weight, which was failed to be recognized by the angiography. In cases of the old hemorrhage, besides the decreased density area of the hematoma, such findings were obtained as cerebral atrophy, ventricular dilatation and porencephalic change. It would be concluded that CT study is the most useful aid at present available in the diagnosis of intracranial hemorrhage. The precise anatomic extent of the hematoma, associated brain edema, ventricular deformity and displacement and hydrocephalus are all readily assessed by CT.