Computed tomography in the diagnosis of malignant brain tumours: do all patients require biopsy?

A proportion of patients with computed tomographic (CT) scan appearances of malignant brain tumour undergo conservative management, despite the absence of histological confirmation of the diagnosis. Concern that this policy risked misdiagnosing a benign tumour prompted us to examine the accuracy of CT scanning in diagnosing malignant lesions. The study was designed to determine whether within a group of 300 patients with intracerebral mass lesions of known pathology, two sub-groups existed: one with appearances so specific for malignant glioma that biopsy was unnecessary, and the other in which the appearances were characteristic of malignancy, though not specific for glioma.

Operative findings on microsurgical exploration of the cerebello-pontine angle in trigeminal neuralgia.

The anatomical findings in 52 patients undergoing posterior fossa exploration for idiopathic trigeminal neuralgia are described. Anatomical abnormalities in the cerebello-pontine angle were found in 46. The commonest was an arterial loop indenting or distorting the nerve at the root entry zone.

Conservative management of intracranial extradural haematoma presenting late.

Three patients with intracranial extradural haematomas presenting several days after injury have been managed without surgery, with clinical improvement. Spontaneous resolution of the haematomas has been demonstrated by serial computed tomography over periods of six weeks.

Computer tomographic features of giant intracranial aneurysms.

Five cases of giant intracranial aneurysm are reported, all of which presented as intracranial mass lesions. All five aneurysms were visualised by CT scanning as well as angiography. Their CT scan appearances may be sufficiently characteristic to be distinguished from other mass lesions.

Five cases of intracranial tuberculoma followed by serial computerised tomography.

Five cases of intracranial tuberculoma in Asian adults are described, all of whom presented with epilepsy. The computerised tomographic (CAT) scanner displayed the lesions particularly well, and their characteristics are described. Only two cases were explored surgically, but triple antituberculous chemotherapy has the scan abnormalities in all of them to resolve completely.