Biomedical subjects

B Fazzi

Publications and source records attributed to B Fazzi.

7 recordsLinked to original sources

PubMed2001

Visual function in children with hemiplegia in the first years of life.

The aim of this study was to evaluate the incidence of visual function abnormalities in children with infantile hemiplegia, and the relation between visual abnormalities and type of lesion, as shown by brain MRI. Visual function was tested (grating acuity, visual field size, binocular optokinetic nystagmus [OKN], and ocular movements) in a group of 47 children with congenital or early acquired hemiplegic cerebral palsy (mean age 25 months, range 8 to 52 months). The cohort was subdivided into four groups according to MRI findings: brain malformations (n=5), abnormalities of the periventricular white matter (n=20), cortical-subcortical lesions (n=16), and non-progressive postnatal brain injuries (n=6). More than 80% of the children showed abnormal results in at least one visual test: acuity was the least impaired function, while visual field and OKN were abnormal in more than 50% of the cohort. No specific correlation could be identified between the type and timing of the lesions and visual function. Unlike adults with stroke, visual field defects were not always related to contralateral damage in the optic radiations or in the visual cortex. These results indicate that visual abnormalities are common in children with hemiplegia, and that they cannot always be predicted by MRI. All children with hemiplegia need a detailed assessment of visual function.

Age Factors↗

PubMed2000

Correlation between visual function, neurodevelopmental outcome, and magnetic resonance imaging findings in infants with periventricular leucomalacia.

AIM: To evaluate the correlation between visual function and neurodevelopmental outcome in children with periventricular leucomalacia at 1 and 3 years. METHOD: Visual acuity, visual field, ocular motility, and optokinetic nystagmus were tested in 29 infants with periventricular leucomalacia by brain magnetic resonance imaging. All infants also had a structured neurological examination and a Griffiths developmental assessment. RESULTS: 21 of the infants showed at least one abnormality of visual function. The degree of visual impairment-that is, the number of visual tests showing abnormal results-correlated well with the results on developmental assessment at both ages. CONCLUSION: Multivariate analysis showed that visual impairment was the most important variable in determining the neurodevelopmental scores of these infants, more than their motor disability and the extent of their lesions on magnetic resonance imaging.

Child, Preschool↗

PubMed1998

Visual information processing in infants with focal brain lesions.

Visual information processing for faces were tested by means of the Fagan test of infant intelligence (FTII) in six infants of approximately 12 months of age affected by congenital unilateral brain lesions. Magnetic resonance imaging (MRI) was used to determine the side and size of the lesions. In addition to the FTII, all infants were submitted to a psychometric evaluation using the Griffiths scales. Visual acuity, visual field, and ocular motility were also assessed. Three infants showed damage in the left hemisphere and three in the right. The severity of the lesions, as revealed by MRI scan, was similar in the two groups. All infants except one had normal or borderline cognitive scores on the Griffiths scales. Conversely, four infants showed abnormal results on the FTII, which were not associated with the severity of the lesions, psychometric scores, or the presence of visual deficits. A preference for stimuli presented on the left side of the screen was found, independent of the side of the lesions. This effect was stronger for novel stimuli. The results of this study confirm the importance of early assessment of neuropsychological functions in infants with focal brain lesions.

Cerebral Hemorrhage↗

PubMed1998

Visual outcome at 5 years of newborn infants at risk of cerebral visual impairment.

Visual development at 5 years of age was tested in a group of 39 children who had shown severe neonatal encephalopathy or perinatal brain lesions, documented by medical history, cranial ultrasound, or MRI. In all children, grating acuity was tested during the first 2 years of life. The assessment protocol at 5 years included various visual functions (grating and resolution acuity, visual field size, depth perception, optokinetic nystagmus, and ocular motility), and neurological and cognitive development. The majority of the children showed visual disorders of different type and degree, which were not due to ophthalmological abnormalities. Visual defects correlated well with the results of early visual assessment and of neuroimaging. Visual outcome could be predicted by grating acuity at 1 to 2 years in 27 of the 39 children, by neonatal cranial ultrasound in 26 of the 32 cases examined by this technique, and by later MRI in 23 out of 27. Moreover, a significant correlation was found between visual, motor, and cognitive impairment.

Brain↗

PubMed1997

Cerebral visual impairment in preterm infants with periventricular leukomalacia.

Neonatal brain lesions are the main cause of cerebral visual impairment in infancy, i.e., of a visual deficit caused by damage to posterior visual pathways. Visual outcome of preterm infants with periventricular leukomalacia (PVL) was investigated in 14 subjects affected by severe cystic PVL, another 34 with moderate PVL (prolonged periventricular echodensities), and 18 control preterm infants. All cases with significant ocular abnormalities (such as retinopathy of prematurity state III or upwards, optic nerve atrophy, or major refraction problems) were excluded. Visual acuity, visual field, eye alignment, fixation and following, optokinetic nystagmus, and visual threat were tested at 1 year of corrected age. A high incidence of cerebral visual impairment, consisting mainly of low visual acuity, severe oculomotor disorders, and reduced visual field, was found in infants with severe PVL. Visual defects were less frequent and less severe in the moderate PVL group, and very rare in the control group. The results of neuroimaging, and especially of magnetic resonance imaging, correlated with the visual outcome and indicate lesions at the level of optic radiations as the main anatomic substrate of the visual impairment. All infants with PVL need a visual follow-up, from the first months of life, the results of which are important both for visual and motor rehabilitation of these cases and for their daily care.

Female↗

PubMed1996

Correlation between cerebral visual impairment and magnetic resonance imaging in children with neonatal encephalopathy.

To identify brain lesions most often associated with cerebral visual i mpairment (CVI) after neonatal encephalopathy and to evaluate the prognostic value of MRI for visual outcome, the authors reviewed visual assessments and brain MRI of 80 infants and young children with documented perinatal hypoxic-ischaemic and/or haemorrhagic insults. MRIs were classified according to the severity of lesions at the optic radiations and at the visual cortex; visual acuity was tested with the acuity card procedure. Among the 48 children found to have a CVI, 42 had moderate to severe lesions of the optic radiations and 19 had lesions of the visual cortex. In both cases visual acuity was statically correlated with MRI grading, but the damage at the optic radiations was the better predictor. Early detection of abnormal MR findings in the visual cortex and especially, at the optic radiations may indicate which infants with neonatal encephalopthy should receive longitudinal visual assessment and specific rehabilitation and educational management.

Birth Injuries↗

PubMedDate not supplied

Acuity card testing in children with cerebral palsy related to magnetic resonance images, mental levels and motor abilities.

Visual acuity testing using Teller Acuity Cards was carried out on 78 infants and children affected by cerebral palsy (CP). Age of testing was between 3 and 109 months. The aim of the study was to investigate the usefulness of acuity cards in patients with CP, and to relate visual outcome with the type of CP, MRI findings, mental levels and motor disabilities. Visual acuity estimates were obtained for 60 children: acuity values were within normal values for age for 17 and below the 5th percentile for 43. Cerebral blindness was diagnosed in 10 patients. Eight infants were not testable, mainly because of behavioural problems. The overall success rate was 88%. Visual impairment in most infants with low acuity and in all blind children was not due to ophthalmological abnormalities. Visual outcome was significantly related to the type of CP, with hemiplegic children showing the best results and tetraplegics the worst. Cerebral blindness was significantly correlated with tetraplegia, the severity of lesions in the optic radiations, and visual cortex areas, as indicated by MRI, and the degree of mental, motor and oculomotor deficit. These correlations were mainly due to the blind subjects, who consistently showed major MRI abnormalities and severe motor, mental and oculomotor impairment. Longitudinal results obtained for 45 children showed visual outcome stable over time in 64.4% of cases, improvement in 6.6% and deterioration in 28.9%.

Blindness↗