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J. F. Butzer, MD
Blodgett Med Bldg 1900 Wealthy St SE Grand Rapids, MI 49506

Arch Neurol. 1977;34(7):450-451.

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In Reply.—

Dr Aita correctly points out that the typical high density associated with hematoma on computerized tomographic (CT) scanning can diminish without complete resolution of the hematoma pathologically. In the cases reported by Messina and Chernick changes of "liquification and clot resorption" in case 1 and "glial reaction and resorptive changes" in case 2 suggest, indeed, that the diminishing density is associated with the process of resolution of the hematoma. Furthermore, to say as Dr Aita suggests that "before an intracerebral hematoma can be accurately described as disappearing or resolving on cranial CT there should not only be a change in composition of the hematoma but also a reduction of its mass effects as evidenced by decreased edema and shift of anatomic structures, in addition to the development of hydrocephalus ex vacuo" is to ignore the small or peripheral hematoma that may not produce a significant mass effect or clearly . . . [Full Text PDF of this Article]

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