Surg Neurol
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High-resolution computed tomography (CT) was performed on 31 patients clinically suspected of having petrous bone fracture. The location of the fracture was demonstrated accurately in 28 patients (90.3%), whereas it could be diagnosed by plain skull film in only 17 patients (54.8%). ⋯ We have classified petrous bone fracture into five types according to the anatomic levels demonstrated on CT images. The findings indicate that high-resolution CT is extremely useful for diagnosing petrous bone fracture.
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The role of lumbar puncture and computed tomography scanning for initial diagnosis of subarachnoid hemorrhage has been evaluated in a retrospective survey of 283 consecutive cases. The material has been divided into early-and late-diagnosed cases with 72 hours after bleeding as the demarcation line between groups. The early-diagnosed cases have been further subdivided into patients exhibiting contraindications for lumbar puncture, patients with a typical history of apoplectic headache, and patients presenting with a diffuse noncharacteristic history. ⋯ If neck stiffness is not considered, 4.68 computed tomography investigations per 100,000 individuals would be performed yearly in falsely suspected cases, a diminishingly small cost corresponding to less than 1% of all cranial computed tomography scans performed in this region. Early-diagnosed patients with a diffuse atypical history constitute a small, low risk group for lumbar puncture. It may be acceptable in such patients to diagnose subarachnoid hemorrhage either by means of computed tomography or lumbar puncture, depending on the availability of local computed tomography resources.