By E.E Payne
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Additional info for An Atlas of Pathology of the Brain
The sensitivity of noncontrast head CT is reported to be 83%, with a specificity of 76%. Traditionally, a shunt series (a series of plain x-rays without contrast following the course of the shunt from head to destination, usually peritoneum) is also performed. Shunt series have low sensitivity (20%) but high specificity (98%). Studies do not suggest high utility of this test in patients with normal noncontrast head CT, but occasionally the shunt series may be positive in these patients (see Figure 1-37).
Figure 1-34 shows CT findings of hydrocephalus. Figure 1-37 shows a disconnected ventriculoperitoneal shunt, which can result in hydrocephalus. Atrophy In cerebral atrophy, loss of brain volume results in relatively symmetrical increase in size of sulci and ventricles. The basilar cisterns should also remain patent (see Figure 1-33). Computed Tomography Findings of Elevated Intracranial Pressure A variety of CT findings may indicate elevated ICP, though none are completely predictive. 59 What CT Findings Are Contraindications to Lumbar Puncture?
What Imaging Studies Are Indicated? 118,120 In addition, some evidence suggests that patients with TIA may be at higher risk for subsequent adverse clinical outcomes than patients with minor ischemic strokes—possibly because of a higher rate of large vessel atherosclerosis as the cause of TIA. In TIA, large artery atherosclerosis (including carotid artery disease) may account for up to 34% of cases. The 3-month risk for stroke, myocardial infarction, and vascular death is higher for TIA patients than for minor stroke patients (15% vs.