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Performance of computed tomography indiagnosis and evaluation oftraumatic intracerebral hemorrhage

Author: Haider Q. Hamood حيدر حمود
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2011 Volume: 53 Issue: 2 Pages: 156-159
Publisher: Baghdad University جامعة بغداد

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Abstract

Background:The intracerebral hemorrhage (ICH) can be classified as traumatic and spontaneous. The frontal and temporal lobes are classic sites for traumatic ICH, which are less commonly affected by spontaneous episodes. Computed tomography (CT) scanning is the most accurate radiological method for demonstrating the acute lesion of intracerebral hemorrhage (ICH). Both types are of high density, but traumatic bleeding is more frequently multifocal, in this study we are dealing with traumatic type of intracerebralhematoma. Aim of the study is to identify the accuracy and performance of CT scan in diagnosis and evaluation of intracerebralhemorrhage.
Patients and methods: 60 patients were examined, their agesrange from 30-70 years with means age 48 years old, they were 36males (60%), and 24females (40%).
Results: Our study reveals, the male patients (36 patients) were more affected than femalepatients (24 patients). Most affected age group in our study was 60-70 years old, 18 patients (30%) with no gender difference. Acute ICH was more than other ICH types, patients with acute ICH were 24 patients (40%) 15 male patients and 9 female patients, patients with subacute ICH were 20 patients (33%) and patients with chronic ICH were 16 patients (27%). In our study, the RTA was the most causative mechanism of ICH, 27 patients with RTA were seen in our study (45%), followed by shell injury which were 24 patients (40%) and then the fall from hight (FFH)which were 9 patients (15%). The most common CT feature noted in our study is the brain edema and it is seen in 27 patients (45%). Basal ganglia were most affected brain region (45%) of cases.
Conclusion:CT is available,rapid imaging modality in the diagnosis of ICH, so it is suitable for diagnosis and evaluation of ICH as emergency cases in casualty department and it is valuable in evaluation of traumatic I.C.H. especially in acute stages.


Article
Medico-Legal Comparative Study Between Traumatic and Spontaneous Intracerebral Hemorrhage

Authors: Yasser Salem Selman. Al-Yessary --- Nabeel Ghazi Hashim Al-Khateeb --- Ahmed Samir Al-Naaimi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 2 Pages: 259-267
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

BSTRACT: INTRODUCTION:Intracerebral hemorrhage may be pathological ortraumatic in nature. It may be primary orsecondary BACKGROUND: Traumatic intracerebral hemorrhage (TICH) is a subtype of intracranial hemorrhage that occurswithin the brain tissue itself and lead to displacement or destruction of brain tissue with high rate.Spontaneous intracerebral hemorrhage (SICH) is defined as a blood clot that arises in the brainparenchyma in the absence of trauma or surgery. OBJECTIVE: The aim of this study is to determine the frequency of fatal traumatic and spontaneous intracerebralhemorrhage, and to differentiate between them in postmortem examination. METHODS: This cross-sectional study is performed in the medico-legal institute of Baghdad for (6) monthsduration from (1-10-2011) to (1-4-2012). Complete medico-legal history was obtained, and fullproper autopsy including external and internal examination of all corpuses was performed speciallythe head. RESULTS: The study included (38) cases of intracerebral hemorrhage; (27) of them were (TICH). Their agesranged between (5 –65) years, and (11) of them were (SICH) with an age ranging between (15 –75)years. Traumatic group was associated with male preponderance and younger age, whilespontaneous group were females and older age. The most common cause of head injuries in thetraumatic group was "missiles" followed by road traffic accidents. Comminuted fractures were themost common type of skull fracture. Brain laceration and contusion were the two most frequentlyobserved associated lesions in the traumatic cases. The "intraventricular" Site was the most frequent in traumatic group, while the "Basal ganglia" was the most frequent inthe spontaneous group. The anterior cerebral artery was the most frequently affected artery intraumatic group, while the middle cerebral artery was the most frequently affected artery inspontaneous group. CONCLUSION: we identified seven basic rules that can be used during autopsy examination in all cases ofintracerebral hemorrhage to differentiate easily between traumatic and spontaneous intracerebralhemorrhage

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