Summary
The AA. discuss the usefulness of brain scans in the diagnosis of head injuries. Brain scans have been carried out on 91 patients, 51 scans with Neohydrin-Hg203 and 40 with Technetium 99m. The method is very useful for head injuries with subacute or chronic brain damage, but the minimal time for the examination (1 hour after the injection of Technetium 99m) is often too long for the diagnosis of acute lesions. 13 subdural haematomas out of 14, one intracerebral haematoma and 12 brain contusions out of 13 were correctly localized. Subdural haematomas are so clearly recognisable, that in a large percentage of cases it is possible to operate on without further neuroradiological investigations.
Zusammenfassung
Die Autoren beschreiben den Wert der Hirnszintigraphie in der Diagnostik von Schädelverletzungen. Bei 91 Patienten wurden 51 Szintigramme mit Neohydrin-Hg203 und 40 mit Technetium 99m ausgeführt. Die Methode erwies sich als nützlich bei Kopfverletzten mit subakuten und chronischen Hirnschäden, während die minimale Untersuchungszeit (1 Stunde nach Injektion von Technetium 99m) oft zu lang für die Diagnose von akuten Schäden ist. Von 14 Fällen wurden 13 subdurale Hämatome und von 13 anderen wurden ein intrazerebrales Hämatom und 12 Hirnkontusionen richtig lokalisiert. Subdurale Hämatome sind so eindeutig erkennbar, daß es in einem großen Prozentsatz der Fälle möglich ist, ohne weitere neuroradiologische Untersuchungen zu operieren.
Résumé
Les auteurs discutent l'utilité des examens scintigraphiques cérébrales dans le diagnostic des traumatismes craniens. Ces examens ont été faits chez 91 malades: 51 ont été effectués avec Neohydrin-Hg203 et 40 avec Technetium 99m.
Cette méthode est très utile pour les traumatismes avec lésions cérébrales subaiguës ou chroniques, mais le temps minimum de l'investigation (1 heure après l'injection de Technetium 99m) est souvent trop long pour permettre le diagnostic des lésions aiguës. 13 hématomes subduraux sur 14, 1 hématome intracérébral et 12 contusions du cerveau sur 13 ont été localisés correctement.
Les hématomes subduraux sont si facilement reconnaissables qu'il est possible, dans un grand pourcentage de cas, une intervention sans artériographie.
Riassunto
Gli AA. riferiscono la propria esperienza con la scintigrafia cerebrale nella diagnostica dei traumi cranici. Sono stati studiati complessivamente 91 pazienti, di oui 51 con Neohydrin-Hg203 e 40 con Tecnezio 99m.
Le lesioni traumatiche suscettibili di diagnosi con la metodica scintigrafica sono quelle a decorso sub-acuto e cronico, in una quanto anche il tempo minimo richiesto (1 h) per un esame con Tecnezio 99m è troppo lungo per la diagnosi di lesioni ad evoluzione acuta.
Tra le lesioni sub-acute e croniche, sono stati correttamente diagnosticati 13 ematomi sottodurali su 14, 1 ematoma intracerebrale e 12 focolai lacerocontusivi su 13.
La lesione che tuttavia trae maggior vantaggio dalla diagnosi seintigrafica è certamente l'ematoma sottodurale cronico, in cui la esatta diagnosi, sia di localizzazione che di natura, è raggiunta nella quasi totalità dei casi, consentendo in tal modo di evitare ulteriori indagini arteriografiche.
Resumen
Los autores discuten la utilidad del examen scintigráfico del cerebro en los traumas craneales. Se han estudiado 91 enfermos: 51 exploraciones han sido realizadas con Neohydrin-Hg203 y 40 con Technetium99m.
Este método es muy ùtil en los traumas craneales con lesiones cerebrales subagudas o crónicas, pero el tiempo mínimo de investigación (1 hora después de la inyección de Technetium99m) es a menudo demasiado largo para el diagnóstico de las lesiones agudas. Se localizaron correctamente 13 casos de hematomas subdurales en un total de 14, 1 hematoma traumático intracerebral y 12 contusiones cerebrales de un total de 13.
Los hematomas subdurales son muy faciles de reconocer en un gran porcentaje de casos, permitiendo la intervención sin examen neuro-radiológico previo.
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The AA. wish to thank Mr.Antonio Ladislao and Mr.Nino Stucchi for the technical assistance.
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Migliore, A., Paoletti, P. & Villani, R. Usefulness and limitations of brain scanning in the diagnosis of head injuries. Acta neurochir 19, 281–296 (1968). https://doi.org/10.1007/BF01405524
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DOI: https://doi.org/10.1007/BF01405524