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Biomedical subjects

C R Fitz

Publications and source records attributed to C R Fitz.

At least 19 recordsLinked to original sources
PubMed1992

The primary empty-sella syndrome and diabetes insipidus in a child.

The empty-sella syndrome is uncommon in pediatric patients. Hypothalamic-pituitary dysfunction is common in these patients but involvement of the posterior pituitary gland is very rare. We report a seven-year-old girl with empty-sella syndrome who first developed arginine-vasopressin deficient diabetes insipidus and then anterior pituitary gland deficiency. The empty-sella syndrome should be included among the causes of arginine-vasopressin deficient diabetes insipidus in pediatric patients.

Child↗
PubMed1991

Brain tumors in children and adolescents--II. The neuroanatomy of deficits in working, associative and serial-order memory.

The neuroanatomy of memory deficits was studied in 46 children and adolescents with brain tumors. CT-scan reconstructions of 88 brain regions were coded with respect to tumor and related damage, and multiple regression procedures established patterns of brain damage predictive of memory deficits. Two forms of memory revealed non-overlapping focal neuroanatomical substrates: memory for the serial order of pictures that corresponded to heard words involved structures in the limbic system and hypothalamic-pituitary axis; whereas working memory, in which each of a succession of heard words is stored in temporary memory long enough to be compared to or contrasted with incoming words, involved the pineal-habenular region and the anterior and medial thalamic nuclei. Memory for semantically-based word-picture associations, in contrast, was unaffected by tumors in several subcortical brain regions. These data bear on current analyses of the neural substrates of associative and representational memory.

Adolescent↗
PubMed1991

Predictors of survival and characteristics of childhood stroke.

To determine predictors of outcome we reviewed 226 medical records of patients admitted to Children's National Medical Center with the diagnosis of cerebrovascular disease from 1978 to 1988. Ninety-five cases of stroke were identified by either neuroimaging techniques (87), autopsy (7), or clinical examination (1). Causal factors implicated in 89% of the patients included infectious (21%), vascular (18%), hematologic (15%), cardiac (13%) problems, minor trauma (8%) or miscellaneous (14%) causes. Patient outcome (n = 88) included residual impairment in 54%, complete resolution of their initial deficit in 23%, and death in 23%. Among patients with abnormal CT findings (n = 60), a logistic regression model revealed that patients with hemorrhage were at a significant risk (p = 0.0469) for death (odds ratio (OR) = 5.5, 95% confidence interval (CI) 1.2-24.5); those with an altered level of consciousness (stupor or coma) on presentation were also at risk (p = 0.0166; OR = 6.94, CI 1.7-28.5). The sensitivity and specificity of this model were 57% and 93%, respectively. No other clinical, laboratory, or demographic variable analyzed was predictive of outcome.

Cerebrovascular Disorders↗
PubMed1991

Neuroradiology.

Explore the source record for details and available documents.

Brain Diseases↗
PubMed1991

Posterior fossa intracranial hemorrhage in infants treated with extracorporeal membrane oxygenation: sonographic findings.

Posterior fossa hemorrhage was documented by autopsy in five infants who had been treated with extracorporeal membrane oxygenation over a 5-year-period. In all five cases, the diagnosis was made prospectively by cranial sonography. Sonographic findings were compared with those in a control group of 15 infants with normal posterior fossae at autopsy. The following sonographic abnormalities were exhibited in neonates with posterior fossae hemorrhage: loss of definition of the cerebellum and fourth ventricle on midline sagittal images, heterogeneous cerebellar parenchyma, focal hypoechoic lesions, ventricular dilatation, and tentorial abnormalities. Bright foci inferior to the third ventricle were seen in four neonates in the normal control group. These foci measured 5-10 mm in diameter. One cranial sonogram was falsely interpreted as showing a posterior fossa hemorrhage because of prominent echoes in the interpeduncular cistern. Infants treated with extracorporeal membrane oxygenation are at risk for developing posterior fossa hemorrhage. Awareness of sonographic signs and potential pitfalls in the interpretation of posterior fossa hemorrhage is important for early and accurate recognition of these unusual and sometimes treatable hemorrhages.

Cerebral Hemorrhage↗
PubMed1979

Neuroradiological findings in a child with primary leptomeningeal melanoma.

A case of primary leptomeningeal melanoma in a child is presented. The patient was studied with multiple neuroradiological methods, however computed tomography (CT) provided the most important information. The CT findings with leptomeningeal tumor, although not completely specific, do suggest the diagnosis, thus providing important information to explain the acute onset of symptoms in a previously healthy child. This case also differs from previously reported cases in terms of the type of hydrocephalus associated with the tumor.

Cerebral Ventriculography↗
PubMed1979

Normal cord in infants and children examined with computed tomographic metrizamide myelography.

Computed tomographic metrizamide myelography (CTMM) was performed on 25 infants and children and 2 adults with normal spinal cords. Both the cord and the cauda equina were precisely outlined. The most detailed information was obtained with a small window setting, with the image subsequently magnified and color-reversed. Hounsfield-unit measurements alone were inaccurate. Advantages of CTMM include: high accuracy in demonstrating the intrathecal contents of the spine; less need for general anesthesia; and the need for a smaller amount of water-soluble contrast material than in conventional myelography. In selected cases of intraspinal abnormality in children, CTMM is recommended.

Adolescent↗
PubMed1979

Computed tomographic metrizamide myelography in syringohydromyelia.

Four patients with surgically verified syringohydromyelia, including 2 with and 2 without a collapsing cord, were examined with computed tomographic metrizamide myelography (CTMM). When the cord is collapsed, or a contrast-containing cyst is observed on the scan, no further examination is necessary. If the cord is not collapsed, it is difficult to differentiate an intramedullary cyst from a tumor. Flattening of the ventral border of the cord in the supine position, coupled with an increased transverse diameter and alteration of the normally smooth, oval shape are suggestive of syringohydromyelia.

Adolescent↗
PubMed1979

Craniosynostosis: correlation of bone scans, radiographs, and surgical findings.

Skull scintigraphy was performed in 68 children with suspected craniosynostosis after injection of technetium-99m methylene diphosphonate. The scans demonstrated four patterns of sutural activity: normal, absent, increased, and wide. When correlated with surgical findings, "absent" indicated fused sutures, "increased" indicated fusing hyperactive sutures or sutures reacting to fusion elsewhere, and "wide" indicated splite sutures. Upon correlation with the radiographs, it was found that when the radiograph was normal, the scan contributed little; when the radiograph was abnormal or equivocal, the scan was often of great assistance in confirming fused sutures and detecting other abnormal sutures.

Child, Preschool↗
PubMed1979

CT metrizamide myelography for intraspinal and paraspinal neoplasms in infants and children.

Computed tomography (CT) metrizamide myelography is an accurate and satisfactory method for examining the spinal cord in infants and children with suspected intraspinal neoplasms. It was performed in 13 infants and children and in one adult with intra- and paraspinal neoplasms. CT metrizamide myelography in paraspinal masses provides the total geography of the mass; that is, possible intraspinal extension, as well as the paraspinal portion itself. As such, it is superior to conventional myelography.

Adolescent↗
PubMed1978

The radiographic features of unilateral megalencephaly.

Unilateral megalencephaly is a rare anomaly of the brain which causes enlargement of a lobe or an entire hemisphere. The radiological features of the disease are a poorly defined unusual mass effect on PEG, angiography and CT scan. Pathologically, the disease is thought to be due to abnormal cell migration in the 3rd month in utero.

Brain↗
PubMed1978

The clival-perpendicular or modified Water's view in compound tomography.

The air gap type of CT scanner with tilting gantry allows the use of head positions other than the standard semi-axial. The modified Water's or clival-perpendicular position is especially useful in the diagnosis of posterior fossa disease. The position offers a view that is approximately coronal to the clivus and tentorium. The clival-perpendicular view easily separates the supra- and infratentorial compartments. It also helps to differentiate extra- and intra-axial lesions and to locate the fourth ventricle, and it gives far better vertical orientation of posterior fossa pathology.

Adult↗
PubMed1978

Neuroradiologic study of hamartomas of the tuber cinereum and hypothalamus.

Five cases, four histologically proven, of hamartoma of the tuber cinereum and hypothalamus in children are reported. The ages of the patients range from 2 to 12 years. Three cases had pubertas praecox, and in all of these the hamartoma was located in the basal cistern between the chiasm and pons and had a collar button shape and size typical of hamartoma of the tuber cinereum. In the third case, a huge calcified mass in the suprasellar region was initially thought to be craniopharyngioma. The fourth case had a hamartoma within the substance of the hypothalamus and presented with hyponatremia and temporal lobe seizures.

Age Factors↗
PubMed1978

Congenital spinal and cord lesions in children and computed tomographic metrizamide myelography.

Computed tomographic metrizamide myelography (CTMM) has developed into a highly sophisticated and accurate neuroradiologic technique in the diagnosis of childhood spinal dysrhaptic states. Of the 84 patients studied by this technique, 31 with the dysrhaphic spine also had lesions such as a tethered and low conus, diastematomyelia, or neuroenteric cysts. We believe that the exquisite pathologic anatomy obtained by CTMM obviates all neuroradiologic techniques other than a preliminary anteroposterior and lateral spinal roentgenograph.

Age Factors↗
PubMed1978

Computed tomography in hydrocephalus.

Computed tomography has changed the direction of the investigation of hydrocephalus. Alone or with ventriculography and radionuclide CSF flow studies the types and causes of hydrocephalus can usually be diagnosed. Atrophy with large ventricles, subdural hygromas and mild hydrocephalus may still be difficult to separate. Many of the complications of treatment, such as subdural hematoma, shunt blocks and ventricular isolation, are now visible with the use of computed tomography.

Adolescent↗
PubMed1978

Computed tomography in the evaluation of encephaloceles in infants and children.

Computed tomography (CT) is an accurate diagnostic modality in the evaluation of encephaloceles. The axial and coronal planes, contrast enhancement attenuation measurement of the contents of the encephalocele, and the use of the standard and reverse modes for viewing the CT images are all valuable in this evaluation.

Child↗