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Targeted temperature management (TTM) might improve outcome of patients with severe subarachnoid hemorrhage (SAH) in which vasospasm, delayed cerebral ischemia (DCI), and increased intracranial pressure (ICP) are frequent and severe complications. A series of patients ( n  = 3) with severe aneurysmatic SAH were treated by TTM if they developed ICP crisis and/or severe vasospasm diagnosed by angiography. Once these complications were detected, body core temperature (BCT) was rapidly decreased to 35°C or 33°C, if necessary. BCT induced and maintained by surface cooling remained at the desired level for at least 72 hours. Rewarming was performed by 1°C, only if the target parameters ICP and velocities in the serial Doppler sonography indicating macrovascular vasospasm improved to regular levels. In case of increase of ICP or middle cerebral arteries velocities BCT was decreased again to the last effective level. The patients developed vasospasm between days 6 and 12 after SAH. All aneurysms were treated by coiling. BCT was reduced between days 6 and 12 after SAH. Total duration of BCT <36.5°C was between 5.5 and 8 days. It remained <35°C for 4-6 days, and at 33°C for 3 days on average. ICP could be sufficiently controlled in all patients, because no ICP crisis was observed during TTM and after rewarming. Two patients developed minor DCI. Side effects of prolonged ventilation of 7-18 days included pneumonia for two patients that could be treated sufficiently. Other complications were one case of ventriculitis and two temporary deliriums. Outcome of the patients was good because no focal neurological symptoms could be detected after rehabilitation. TTM represents a promising treatment approach for severe SAH in which standard treatment is often limited and experimental. It deserves further clinical investigation in a larger cohort.

58 patients with recent transient or permanent neurologic deficits of with proven carotid stenoses were examined by dynamic CT at the level of the internal capsule. In the presence of cerebral infarcts there was marked delay in the time/density curve with reduced peaks. Abnormal perfusion could be demonstrated by early examinations before definite morphological changes were seen. With transient ischaemic attacks there were no significant changes in perfusion; in the presence of carotid stenoses the results were variable. The perfusion abnormalities in the hemispheres shown by dynamic cranial CT could be confirmed to some extent by 99mTc-HMPAO-SPECT.

A retrospective study was carried out involving 39 patients with malignant tumours of the head and neck in order to differentiate by CT changes due to local tumour or lymph node recurrences and various post-operative or post-irradiation changes. In these patients, two or more CT examinations of the neck were available, derived from a fourth generation scanner. The suspected lesions were classified according to their type and the appearances correlated with the treatment and clinical findings. There was frequent overlap between the appearances of benign and malignant changes, so that in individual cases a definite decision often proved impossible.

Computed tomographic investigation of the brain is frequently accomplished by scanning parallel to the canthomeatal line. In these scans, evaluation of the brain stem and neighboring structures is often compromised by streak artifacts from bone-induced beam hardening. These artifacts may be reduced by introducing a change in gantry angulation. Results from a phantom study as well as from a clinical trial offer evidence that may be helpful in assessing different scanning planes. An inclination of 5 degrees below Reid baseline is suggested to minimize the interpetrous artifact. Variations in slice thickness and exposure parameters do not appear to affect significantly this typical posterior fossa artifact.

We compared the results of CT and conventional tomography examinations of the thorax of 137 patients with each other and with the final results. In the diagnosis of bronchial carcinomas we found no significant differences between the two methods. In all other investigated items CT proved to be superior to conventional tomography, especially of the evaluation of mediastinum (90% vs. 35%). We conclude that CT is the method of choice in the staging of intrathoracic tumours and especially in the evaluation of hilar and mediastinal masses and there is no need for conventional tomography in these cases.