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November 5, 1982

Nonneoplastic Intracranial Lesions Simulating Neoplasms on Computed Tomographic Scan: Excellent Sensitivity With Limited Specificity

Author Affiliations

From the Departments of Surgery (Dr Kandalaft) and Radiology (Dr Diehl), the University of Texas Health Science Center at Dallas; and the Departments of Surgery and Biochemistry, Oregon Health Sciences University and the Veterans Administration Hospital, Portland (Dr Neuwelt).

JAMA. 1982;248(17):2166-2168. doi:10.1001/jama.1982.03330170070038

CEREBRAL neuroradiological diagnostic tools have improved vastly since the introduction of radiology. Ventriculography was soon followed by angiography and radionuclide scanning. With the advent of computed tomographic (CT) scanning, high hopes were attached to its ability to provide accurate preoperative presumptive histological diagnoses of multiple intracranial lesions. Nonetheless, the combined modalities of radionuclide scanning, cerebral angiography, and CT scanning, even with clinical data, still cannot provide a 100% correct preoperative presumptive histological diagnosis, although a high percentage of correct diagnoses is possible. Initiation of treatment without obtaining a histological diagnosis remains hazardous. In this regard, we wish to present four cases that were encountered on the General Neurosurgical Service at the University of Texas Southwestern Medical School, Dallas, between January 1978 and June 1980. In these cases, neuroradiological findings provided a preoperative or premortem presumptive diagnosis, or both, that was subsequently proved incorrect.

Report of Cases 

Case 1.—  The patient