Study of clinico-radiological and clinico-pathological correlation of intracranial space occupying lesion at rural center

摘要

Objective: To study the clinico-radiological and clinico-pathological correlation of intracranial space occupying lesions at AVBRHMethods: The primary method of case ascertainment was detailed neurological examination and review of all CT with contrast of the head performed on the patients between 1st July 2004 to 31st December 2006 at rural centre after suspecision of intracranial space occupying lesions on clinical presentation.Result: In our study of 52 cases the clinicoradiological and clinicopathological correlation of intracranial space occupying was founded in 61.5% Amongst all the ICSOL the maximum number of cases was of neoplastic tumors i.e. 63% next to this was infective group i.e. 21% & rest of the cases were of traumatic group i.e. 15%.Conclusion: CT scan is the diagnostic and the most accurate investigation in localization of ICSOL. CT guided biopsy is helpful in diagnosing the histopathology of various ICSOLs. X ray skull studies are not of much value as a diagnostic tool in ICSOL. The overall incidence of correct clinical localization of the lesion to the final diagnosis after investigations and surgery was seen to be 61.5% cases. Introduction Space occupying lesions in the cranial cavity is known to mankind since 1774, when Louis first reported fungus tumour of the dura mater. Three decades ago and earlier, medical teachers in India 1 frequently stated that brain tumours were uncommon in Indians. With the development of recent investigative techniques in India during the past 2 decades, it has become obvious that brain tumours are as common in this country as elsewhere.The most of the patients with neoplasm has fairly characteristic presentation However; many patients with intracranial masses present a greater diagnostic challenge because of atypical presentation secondary to intratumoural hemorrhage, arterial occlusion and cerebral infarction or tumour involvement of silent areas. In such cases it is important to utilize modern neuroradiological proce?dures in order to detect the lesion to localize it and thus predict the histological tumour type. To detect the presence of potentially life threatening complications such as cere?bral herniation or ventricular entrapment and to provide appropriate pre-therapeutic neuro-anotomic data to prevent an untoward complications. Methods and Material This study of ICSOL was carried out at Acharya Vinoba Bhave Rural Hospital, Sawangi, Meghe, Wardha during the six academic terms from April 2004 to October 2006. Total 52 cases were studied and the primary method of case ascertain was detailed neurological examination and review of all CT with contrast of the brain performed on the patients after suspicion of intracranial space occupying lesions on clinical presentation. Observations From our study it is observed that the maximum numbers of patients were between age group 20 to 50 years i.e. 33 patients (63%) while 3 patients (6%) were below 10 years of age and 7 patients (13%) were above 60 years of age. The sex distribution of patients was 30 male (58%) and 22 female (42%). The ratio of male to female was 1.3:1. The maximum number of patients of ICSOL belonged to malignant etiology of 19 (37%) while 14 patients (27%) belongs to benign nature, 11 patients (21%) were belonged to infective etiology and 8 patients were of traumatic etiology (15%).The incidence of various ICSOL (Figure 1) out of the 52 patients was 13 astrocytoma, 2 oligodendroglioma, 1 medulloblastomas, 3 secondaries in brain. Out of all malignant ICSOL compromising total 19 cases, 1 colloid cyst, 5 meningioma, 1 acoustic Neuroma, 1 pineal tumor, 2 pituitary adenoma, 2 porencephalic cyst, 2 epidermoid cyst. Among the all benign tumors of 14 the distribution was 9 tuberculoma, 1 hydatid cyst, 1 abscess and 11 infective etiology. The 8 patients were of chronic subdural haematoma with history of traumatic etiology. The patients presented with various symptoms like headache, vomiting, convulsions, neurodeficit, fe