Use Of Brain Scans Research Articles

Incidence, management, and outcome of incidental meningioma: what has happened in 10 years?

PurposeThe aim of this study was to study the use of brain scanning, and the subsequent findings of presumed incidental meningioma in two time periods, and to study differences in follow-up, treatment, and outcome.MethodsRecords of all performed CT and MRI of the brain during two time periods were retrospectively reviewed in search of patients with presumed incidental meningioma. These patients were further analyzed using medical health records, with the purpose to study clinical handling and outcome during a 3 year follow up.ResultsAn identical number of unique patients underwent brain imaging during the two time periods (n = 22 259 vs. 22 013). In 2018–2019, 25% more incidental meningiomas were diagnosed compared to 2008–2009 (n = 161 vs. 129, p = 0.052). MRI was used more often in 2018–2019 (26.1 vs. 12.4%, p = 0.004), and the use of contrast enhancement, irrespective of modality, also increased (26.8 vs. 12.2%, p < 0.001). In the most recent cohort, patients were older (median 79 years vs. 73 years, p = 0.03). Indications showed a significant increase of cancer without known metastases among scanned patients. 29.5 and 35.4% of patients in the cohorts were deceased 3 years after diagnosis for causes unrelated to their meningioma.ConclusionsDespite the same number of unique patients undergoing brain scans in the time periods, there was a trend towards more patients diagnosed with an incidental asymptomatic meningioma in the more recent years. This difference may be attributed to more contrast enhanced scans and more scans among the elderly but needs to be further studied. Patients in the cohort from 2018 to 2019 more often had non-metastatic cancer, with their cause of scan screening for metastases. There was no significant difference in management decision at diagnosis, but within 3 years of follow up significantly more patients in the latter cohort had been re-scanned. Almost a third of all patients were deceased within 3 years after diagnosis, due to causes other than their meningioma.

P16.06.A INCIDENCE, FOLLOW UP AND OUTCOME IN INCIDENTAL MENINGIOMA IN THE GOTHENBURG REGION - WHAT HAS HAPPENED IN 10 YEARS?

Abstract BACKGROUND Meningiomas constitute a large portion of brain tumors, with an often indolent natural course of disease. There a now more asymptomatic meningiomas diagnosed each year as compared to their symptomatic counterparts. With brain imaging widely available, increased findings of incidental meningiomas have emerged. There are many unique challenges to the management of incidental meningioma, where if no symptoms are present, there is a lack of evidence-based guidelines for follow-up and treatment. The aim of this study was to map the use of brain scanning, and the subsequent findings of presumed incidental meningioma between the years 2008-2009 and 2018-2019, and to study differences in follow-up, treatment, and outcome among these patients. MATERIAL AND METHODS Records of performed CT and MRI of the brain at the radiological departments at three hospital sites were retrospectively reviewed in search for patients with presumed incidental meningioma. Their medical health records were the used to study the natural course and clinical handling of these patients. RESULTS An almost identical number of patients underwent brain scanning at our three hospital sites during the two time periods (n=22 259 vs. 22 013). In 2018-2019, 25% more incidental meningiomas were diagnosed as compared to 2008-2009 (n=161 vs. 129). In the later years, patients had a higher median age (79 years vs. 73 years, p=0.03) and more often underwent brain imaging due to non-metastatic cancer (n=38 vs. 15, p=0.009). There were no differences in the indication for diagnostic scanning, nor management decision at time of diagnosis. CONCLUSION We could not show an increase in patients undergoing scanning of the brain between the two time periods studied, but with passing time it has become more common to frequently scan the brain of elder individuals, and individuals with cancer without metastases, perhaps due to improved treatment options for patients if metastatic disease was found. When an incidental meningioma was subsequently found, no differences could be seen in the clinical handling of the patients in terms of treatment or follow-up.

Testing Whether the Use of Brain Scans Alone Instead of Brain Scans Plus Preventive Brain Radiation Affects Lifespan in Patients With Small Cell Lung Cancer

Testing Whether the Use of Brain Scans Alone Instead of Brain Scans Plus Preventive Brain Radiation Affects Lifespan in Patients With Small Cell Lung Cancer

Neuroscience and everyday life: Facing the translation problem

To enable the impact of neuroscientific insights on our daily lives, careful translation of research findings is required. However, neuroscientific terminology and common-sense concepts are often hard to square. For example, when neuroscientists study lying to allow the use of brain scans for lie-detection purposes, the concept of lying in the scientific case differs considerably from the concept in court. Furthermore, lying and other cognitive concepts are used unsystematically and have an indirect and divergent mapping onto brain activity. Therefore, scientific findings cannot inform our practical concerns in a straightforward way. How then can neuroscience ultimately help determine if a defendant is legally responsible, or help someone understand their addiction better? Since the above-mentioned problems provide serious obstacles to move from science to common-sense, we call this the 'translation problem'. Here, we describe three promising approaches for neuroscience to face this translation problem. First, neuroscience could propose new 'folk-neuroscience' concepts, beyond the traditional folk-psychological array, which might inform and alter our phenomenology. Second, neuroscience can modify our current array of common-sense concepts by refining and validating scientific concepts. Third, neuroscience can change our views on the application criteria of concepts such as responsibility and consciousness. We believe that these strategies to deal with the translation problem should guide the practice of neuroscientific research to be able to contribute to our day-to-day life more effectively.

Management of children with nonfebrile seizures in the emergency department

Background Children with seizures are often referred to the emergency department where they are typically evaluated by a physician with limited knowledge of pediatric epileptology and undergo a costly and extensive work-up that contributes little to the final decision. Aim The aim of this study was to examine the medical management of children with nonfebrile seizures in the emergency department and to define the potential role of the neurology clinic in this context. Materials and methods The files of 85 children who made 104 visits to the emergency department of a pediatric tertiary hospital for nonfebrile seizures were retrospectively reviewed. Results Average age was 7.5 years. Blood tests were performed in almost all visits; a minority also involved the use of brain scans and electroencephalography. A neurologist was consulted in about half the visits. Only electroencephalography and neurologic consultation contributed significantly to the final decision. Hospitalization was recommended in 71% of cases, but it was usually short term and not accompanied by significant changes in the management. Conclusion In children with nonfebrile seizures, a problem-oriented approach including only the necessary work-up (e.g. electroencephalography) with neurologist consultation can potentially decrease the inpatient load and lower health care costs, while sparing patients unnecessary tests.

A Comparison of Acute and Long-Term Management of Stroke Patients in Barbados and South London

Background: To compare health care utilisation between stroke patients living in a middle-income country with similar patients in a high-income country in terms of the type and amount of health care received following a stroke. Methods: Data were collected from the population-based South London Stroke Register (SLSR) and the Barbados Register of Strokes (BROS) from January 2001 to December 2004. Differences in management and diagnostic procedures used in the acute phase were adjusted for age, sex, ethnic group, living conditions pre-stroke and socio-economic status by multivariable logistic regression. Comparison of subsequent management was made for 3 months and 1 year post-stroke. Results: Patients in BROS were less likely to be admitted to a hospital ward (OR 0.22; 95% CI 0.13–0.37), but the difference for the lower use of brain scans in BROS was smaller (OR 0.62; 95% CI 0.25–1.52). Additional adjustment for stroke severity (Glasgow Coma Score) showed that BROS patients were more likely to have a swallow test on admission (OR 2.95; 95% CI 1.17–7.45). BROS patients were less likely to be in nursing care at 3 months (OR 0.37; 95% CI 0.17–0.81), and less likely to be receiving speech and language therapy at 3 months (OR 0.10; 95% CI 0.03–0.33) and 1 year (OR 0.05; 95% CI 0.00–0.55). Conclusions: The lower use of hospital admission and nursing care at 3 months suggests that in Barbados, family and friends take greater responsibility for patient care around the time of the stroke and in the medium term thereafter.

The Law and Neuroscience

Some of the implications for law of recent discoveries in neuroscience are considered in a new program established by the MacArthur Foundation. A group of neuroscientists, lawyers, philosophers, and jurists are examining issues in criminal law and, in particular, problems in responsibility and prediction and problems in legal decision making.

Mindfields: Return to the ducking stool

India's use of brain scanning to convict two people for murder is a travesty of justice, says A. C. Grayling

An observational study of CT scanning in psychiatric patients

AbstractOpinion is divided on the proper use of brain scans in psychiatry. In this study, the authors reviewed CT scanning in common psychiatric conditions in a district hospital.In their study about 64 per cent of brain scans showed some abnormality. CT scanning influenced patient diagnosis, prognosis and treatment. In addition,almost 3 per cent of patient scans identified potential reversible,previously unknown,intracranial pathology. Copyright © 2007 Wiley Interface Ltd

Faces and Brains: The Limitations of Brain Scanning in Cognitive Science

The use of brain scanning now dominates the cognitive sciences, but important questions remain to be answered about what, exactly, scanning can tell us. One corner of cognitive science that has been transformed by the use of neuroimaging, and that a scanning enthusiast might point to as proof of scanning's importance, is the study of face perception. Against this view, we argue that the use of scanning has, in fact, told us rather little about the information processing underlying face perception and that it is not likely to tell us much more.

Brain activity for modulation of allodynia by topical lidocaine in post-herpetic neuropathy

Topical lidocaine is shown to be effective in alleviating post herpetic neuropathy (PHN) type chronic pain. In this study, we examine brain activity related to tactile allodynia (pain due to brushing of the skin) in PHN, using fMRI. We compare effects of acute and longer-term use of lidocaine. All enrolled PHN patients had pain for at least 3 months. They were trained to use a finger-span device for rating their pain. During a given scanning session, patients 1) rated fluctuations of their pain during the application of a random sequence of mechanical stimuli to the body part having PHN, 2) during mechanical stimulation to a corresponding unaffected body part (stimulus control), and 3) during a visual task (motor-cognitive control). Patients were scanned prior, 6 hours, and 2 weeks post continuous use of topical lidocaine (LidoDerm). Fifteen PHN patients were studied, 11 completed all phases. Allodynia pain was significantly lower after 2 weeks of LidoDerm use. Prior to LidoDerm use, brain activity in relation to mechanical stimulation of allodynia site showed activity in primary, secondary, insula, anterior cingulate, cortices and thalamus. This activity pattern was maintained and further enhanced after acute and longer-term therapy. When brain activity was defined in relation to pain scores, prior to LidoDerm use, it was localized mainly in medial prefrontal cortex, and significantly decreased after 6-hours and 2-weeks of LidoDerm use. The results suggest that LidoDerm therapy is associated with decreases in brain activity corresponding to regions we have previously identified for chronic neuropathic pain. Moreover, our data imply that decreased allodynia is accompanied with increased sensitivity to touch. These results remain preliminary. More rigorous analyses, taking into account the control scans, will be reported. The study demonstrates the use of brain scanning to identify brain areas specifically modulated by therapy. Funded by Endo Pharmaceuticals. Topical lidocaine is shown to be effective in alleviating post herpetic neuropathy (PHN) type chronic pain. In this study, we examine brain activity related to tactile allodynia (pain due to brushing of the skin) in PHN, using fMRI. We compare effects of acute and longer-term use of lidocaine. All enrolled PHN patients had pain for at least 3 months. They were trained to use a finger-span device for rating their pain. During a given scanning session, patients 1) rated fluctuations of their pain during the application of a random sequence of mechanical stimuli to the body part having PHN, 2) during mechanical stimulation to a corresponding unaffected body part (stimulus control), and 3) during a visual task (motor-cognitive control). Patients were scanned prior, 6 hours, and 2 weeks post continuous use of topical lidocaine (LidoDerm). Fifteen PHN patients were studied, 11 completed all phases. Allodynia pain was significantly lower after 2 weeks of LidoDerm use. Prior to LidoDerm use, brain activity in relation to mechanical stimulation of allodynia site showed activity in primary, secondary, insula, anterior cingulate, cortices and thalamus. This activity pattern was maintained and further enhanced after acute and longer-term therapy. When brain activity was defined in relation to pain scores, prior to LidoDerm use, it was localized mainly in medial prefrontal cortex, and significantly decreased after 6-hours and 2-weeks of LidoDerm use. The results suggest that LidoDerm therapy is associated with decreases in brain activity corresponding to regions we have previously identified for chronic neuropathic pain. Moreover, our data imply that decreased allodynia is accompanied with increased sensitivity to touch. These results remain preliminary. More rigorous analyses, taking into account the control scans, will be reported. The study demonstrates the use of brain scanning to identify brain areas specifically modulated by therapy. Funded by Endo Pharmaceuticals.

Brain activity for modulation of spontaneous pain by topical lidocaine in post-herpetic neuropathy

Topical lidocaine is shown to be effective in alleviating post herpetic neuropathy (PHN) type chronic pain. In this study, we examine brain activity related to spontaneous fluctuations of ongoing pain in PHN, using fMRI. We compare effects of acute and longer-term use of lidocaine on the ongoing pain. All enrolled PHN patients had pain for at least 3 months. They were trained to use a finger-span device for rating their pain. During a given scanning session, patients 1) rated fluctuations of their spontaneous pain (without any stimulus application) and 2) during a visual task (motor-cognitive control). Patients were scanned prior, 6 hours, and 2 weeks post continuous use of topical lidocaine (LidoDerm). Fifteen PHN patients were studied, 11 completed all phases. Spontaneous PHN pain was significantly lower after 6 hours, and 2 weeks of LidoDerm use. Brain activity in relation to spontaneous PHN pain showed activity in insula, and prefrontal cortex. When brain activity was defined in relation to pain scores, prior to LidoDerm use, it was localized mainly in medial prefrontal cortex, and significantly decreased after 6-hours and 2-weeks of LidoDerm use. The results suggest that LidoDerm therapy is associated with decreases in brain activity corresponding to regions we have previously identified for chronic neuropathic pain. These results remain preliminary. More rigorous analyses, taking into account the control scans, will be reported. The study demonstrates the use of brain scanning to identify brain areas specifically modulated by therapy. Funded by Endo Pharmaceuticals.

The value of brain scanning in the management of strokes.

The usefulness of brain scanning in the diagnosis and management of strokes was evaluated in 313 serial cases. Of 38 patients with transient ischemic attacks (TIAs), only one had a positive test. The optimal time for scanning completed strokes was between seven and 14 days after onset. The pattern of uptake was characteristic of a vascular lesion in 76.8%. When uptake was indistinguishable from tumor, follow-up scans were useful. Patients with negative scans in the second week have a significantly better prognosis than the ones with a positive study. Cerebral angiography and brain scan correlated well in 56 patients who had both tests performed. The postmortem findings in 12 cases again emphasize the importance of the correct timing of the study, and the fact that a brain scan does not usually demonstrate lesions smaller than 2 cm in diameter. It is concluded that the brain scan represents a useful tool in the diagnosis of strokes and helps in predicting the degree of recovery following a vascular insult.

Usefulness of Brain Scanning in Diagnosis of Acousitc Neurinoma

Usefulness of Brain Scanning in Diagnosis of Acousitc Neurinoma

Brain Scanning and Cerebral Radioisotope Angiography (CRA) in Children

The incidence of abnormal brain scans was high in children with symptoms of increased intracranial pressure, focal motor signs or meningitis. In patients with seizure disorders, headache (alone) and mental retardation, abnormal brain scan findings occurred in 1%, 2%, and 4% of the cases, respectively; thus the routine use of brain scanning as a screening procedure of the patients may be questionable. The true-positive rate of brain scans in this series was 83%. Cerebral radioisotope angiography (CRA) increased the true-positive rate by 3% when done selectively. Cerebral radioisotope angiography was frequently abnormal in patients referred for early diagnosis of cerebrovascular accidents, when the brain scan was most frequently normal. The high yield and sensitivity of brain scanning for diagnosis of brain abscess was confirmed in this study. The brain scan was found very useful in localizing brain abscess for surgical drainage and to assess the results of therapy.

BRAIN SCAN USING Tc99m PERTECHNETATE IN PATIENTS WITH INTRACRANIAL TUMORS

In a series of 52 cases with intracranial tumors we performed brain scan using Tc-99m pertechnetate.Positive scans were obtained in 38 out of 52 cases, so our diagnostic accuracy was about 73%. As was presented by others, also in our series brain scan was extremely accurate in the detection of meningioma, glioblastoma and metastatic tumor (about 93% accuracy).In detecting the intracranial tumors, angiography and air study were generally said to be more efficient than brain scan, but both methods were not complete to detect the lesions. Furthermore at times brain scan showed the lesion more accurate than angiography as was presented, therefore combination of brain scan, angiography and air study should be carried out to raise the diagnostic accuracy.The possibilities of predicting tumor pathology and of detecting reccurent tumor by use of brain scan were also discussed.

The use of brain scans in diagnosis of brain tumors in childhood : W. Koos, E. Deisenhammer, G. Pendl, F. Böck, and R. Höfer. Wien. Med. Wschr. 120:866, (November) 1970

The use of brain scans in diagnosis of brain tumors in childhood : W. Koos, E. Deisenhammer, G. Pendl, F. Böck, and R. Höfer. Wien. Med. Wschr. 120:866, (November) 1970

Usefulness and limitations of brain scanning in the diagnosis of head injuries.

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.

Use of brain scans.

To the Editor .—The September 1966, issue of theJournalcarries a report by David et al of the Gelisinger Medical Center on their attempts to determine and localize intracranial disease in childhood by the use of brain scans. A group of 220 children were given 100μc to 500μc of radioactive mercury. The report does not give the indications for using the test, but states that scans were done on 113 of 231 children with a final diagnosis of convulsive disorder; the scan was abnormal in two of them, but it is not mentioned whether these two had a mass lesion. In nine children in whom a tumor was subsequently found, the scan was negative in three, and positive or suspicious in six. This is a 33% rate of false-negative results, and clearly indicates that brain scan alone cannot satisfactorily rule out the presence of a brain tumor. Of the

THE USEFULNESS OF BRAIN SCANNING.

THE SEARCH for improved ways of visualizing structures which lie hidden beneath the skin has been a continuous one since Roentgen's momentous discovery of x-ray in 1895. The contents of the cranial vault have been investigated with much success by arteriography and pneumography. The advancement of nuclear medicine techniques has provided brain scanning as a third major tool for this type of study. This paper relates the results achieved with brain scanning at the Baptist Hospital and explores the diagnostic problems associated with this procedure in a community hospital setting. A number of agents have been available in the past, but wide-spread use of brain scanning, especially at the community hospital level, became not only feasible but useful following the introduction of chlormerodrin tagged with radioactive mercury ( 203 Hg) by Blau and Bender in 1959. 1 Given intravenously, about half of the dose is excreted in eight hours. It accumulates