Magnetic resonance imaging for surgical consideration of acute head injury.
The authors studied the extravasation of contrast enhancement on magnetic resonance (MR) imaging within 6 hours after head injury in 10 patients with 12 intracranial haemorrhagic lesions. The decision for surgical intervention was made by neurological examination, computed tomographic scan, and contrast extravasation on MR imaging. Nine of 10 patients showed extravasation of contrast agent and one patient showed equivocal findings of contrast extravasation. All intracranial lesions with contrast extrav asation led to enlargement in size. With the exception of 1 patient who showed equivocal findings of contrast extravasation, 9 patients needed surgical evacuation of the haemorrhagic lesions. The results of the current study imply that extravasation of contrast medium indicates persistence of post-traumatic bleeding. MR imaging with gadolinium enhancement in acutely head injured patients may be used to predict the development of haemorrhagic lesions and could be helpful in decision making for surgical intervention.
Takanashi
Y
Y
Division of Neurosurgery, Hiratsuka Kyousai Hospital, Hiratsuka, Kanagawa, Japan. nouge@yellow.med.yokohama-cu.ac.jp
Shinonaga
M
M
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media / Q000493:pharmacokinetics; D006259:Craniocerebral Trauma / Q000473:pathology* / Q000601:surgery*; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D019786:Gadolinium DTPA