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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.41 no.2 São Paulo June 1983

http://dx.doi.org/10.1590/S0004-282X1983000200007 

Computerized axial tomography and diagnosis of multiple sclerosis

 

Tomografia axial computadorizada e diagnóstico de esclerose múltipla

 

 

Paulo R.M. Bittencourt, M.D., Ph.D.I; Brian E. Kendall, F.R.C.P., F.R.C.R.II

INeurologist. Department of Radiology, The National Hospital, Queen Square, London, United Kingdom
IIConsultant radiologist. Department of Radiology, The National Hospital, Queen Square, London, United Kingdom

 

 


SUMMARY

Computed axial tomography (C.T.) findings are illustrated in 3 patients who presented with C.T. changes suggesting respectively chronic M.S., acute M.S., and an appearance simulating a malignant tumour. Review of the literature shows that the chronic form with cerebral atrophy and low density lesions in the hemispheres is common in patients with a long history and is unlikely to cause diagnostic difficulty. The acute presentation is less common and could be confused with a variety of causes of multiple low density enhancing lesions. The C.T. diagnosis of M.S. is more difficult in rare cases in which plaques cause mass effect and show ring enhancement; all 3 such cases in the literature were subjected to cerebral biopsy.


RESUMO

Os achados na tomografia axial computadorizada (C.T.) são descritos em 3 pacientes com esclerose múltipla (M.S.) que tiveram C.T. sugestiva de M.S. crônica, aguda e aguda simulando tumor cerebral. Revisão da literatura mostra que a forma crônica, com atrofia cerebral e lesões de baixa densidade nos hemisférios cerebrais, é comum em pacientes com longa história de M.S., e não deve causar dificuldade diagnostica. A apresentação aguda é menos comum e pode ser confundida com várias causas de lesões de baixa densidade que acumulam contraste intravenoso homogeneamente. O diagnóstico por C.T. é especialmente difícil quando as placas de desmielinização causam efeito de massa com deslocamento de estruturas cranianas mediais, e padrão em anel após injeção intravenosa de contraste. De 3 casos da literatura incluindo um apresentado neste trabalho, todos necessitaram biópsia cerebral para excluir causas tratáveis.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

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From the Lysholm Department of Radiology, The National Hospital, Queen Square, London, United Kingdom.
Acknowledgements - The authors wish to thank Professor J. Marshall and Dr. P. C. Gautier Smith (The National Hospital) and Dr. M. Harrison (The Middlesex Hospital) for allowing presentation of patients under their care.
Departamento de Clínica Médica (Neurologia) - Hospital de Clínicas - Rua General Carneiro 180 - 80000 Curitiba, PR - Brasil.

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