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The Diagnosis of Brain Edema by Computed Tomography

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Treatment of Cerebral Edema

Abstract

Axial computed tomography is an X-ray technique which for the first time enables minimal differences in the X-ray absorption of intracranial soft tissue to be measured exactly and their spatial distribution to be represented as a scan [1, 5, 20, 29, 59, 62]. When this method of examination was introduced, it appeared to be possible to detect brain edema in vivo. Computed tomographic phantom measurements have shown that water and fat have lower absorption values than cerebral tissue and are in the zero or negative region of the Hounsfield scale. Because of their absorption properties, water and fat have been regarded as the factors which chiefly influence reductions in density in a computed tomogram. Zones of reduced absorption of radiation in the area surrounding cerebral tumors, metastases, abscesses and hemorrhages have therefore been interpreted as zones of perifocal edema [1, 5, 16, 33, 53, 61]. Biochemical and computed tomographical examinations of perifocal edema in patients with cerebral tumors confirmed this hypothesis [40, 41, 42]. Before removal of a cerebral tumor in our patients, tissue samples were taken from the edema zone close to the tumor and their water and lipid contents were investigated. These laboratory data were compared directly with the corresponding absorption values in the computed tomogram. It was found that the rise in water content in the cerebral parenchyma leads to a significant decrease in the density values in the computed tomogram. Comparable results were obtained by Torack et al. [79, 80] who carried out their investigations on autopsy material (see Table 1).

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  1. W. R. Lanksch
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  1. Neurologische Klinik, Klinikum der Universität Heidelberg, Ruprecht-Karls-Universität Heidelberg, Vosstraße 2, D-6900, Heidelberg 1, Germany

    Alexander Hartmann

  2. Abteilung für Neurochirurgie, Neurochirurgische/Neurologische Klinik und Poliklinik, Universitätsklinikum Steglitz, Freie Universität Berlin, Hindenburgdamm 30, D-1000, Berlin 45, Germany

    Mario Brock

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Lanksch, W.R. (1982). The Diagnosis of Brain Edema by Computed Tomography. In: Hartmann, A., Brock, M. (eds) Treatment of Cerebral Edema. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-68707-5_7

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  • DOI: https://doi.org/10.1007/978-3-642-68707-5_7

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