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Biomedical subjects

D S Bachman

Publications and source records attributed to D S Bachman.

At least 19 recordsLinked to original sources

Electroencephalographic abnormalities in children with congenital heart disease.

Ninety-eight consecutive patients with clinically suspected congenital heart disease were prospectively studied with electroencephalographic (EEG) recordings before cardiac catheterization. Twenty-five patients had abnormal EEGs. Fifty-five patients had acyanotic heart disease and normal neurologic examination results, of whom 15 had abnormal EEGs. Thirteen had spikes or spike and wave discharges and two had mildly abnormal EEGs. Twenty-seven patients had cyanotic heart disease and normal neurologic examination results, of whom four had abnormal EEGs. Seven patients (8%) had abnormal neurologic examination results, of whom four had abnormal EEGs. There was a higher incidence of seizures with increasing age. Based on their medical history two children with acyanotic heart disease had had seizures without EEG abnormalities. Five children with normal catheterization findings and four children with Down's syndrome (two with abnormal EEGs) were excluded from the total of 98. These findings suggest that subclinical nervous system involvement may occur in congenital heart disease.

Brain

Fatal long-term sequela following radiation "cure" for ependymoma.

There are no previous reports of glioblastoma occurring following central nervous system irradiation. This report describes a young girl with an ependymoma at age 13 months who was treated by radiotherapy following surgical removal. At age 6 years she presented with a new lesion in the same location. Histologically there was no evidence of recurrent ependymoma. Instead, the pathological picture suggested glioblastoma or a severe radiation-induced encephalopathy. In either case, it seems likely that the changes were radiation induced.

Brain

Long-term treatment of juvenile Huntington's chorea with dipropylacetic acid.

Since the proposed mode of action of dipropylacetic acid, an anticonvulsant, is to increase central nervous system gamma-aminobutyric acid levels, we used this agent to treat identical twins with juvenile Huntington's chorea. Their clinical status did not improve immediately after they received dipropylacetic acid. Furthermore, long-term administration (over a year) of high doses of the agent (up to 2,400 mg per day; 92 mg per kilogram per day) did not seem to alter the slow progression of their disease. Prior to treatment with dipropylacetic acid, the twins had normal cerebrospinal fluid gamma-aminobutyric acid levels. In addition, cerebrospinal fluid 5-hydroxyindoleacetic acid and homovanillic acid were determined before and after 18 hours of high-dose probenecid. The former showed a normal threefold to fourfold increase after probenecid administration, but homovanillic acid had a distinctly subnormal turnover after probenecid, with only a threefold rather than the normal tenfold increase.

Child

Computerized axial tomography in neurologic disorders of children.

Computerized axial tomography offers major advantages over air encephalography and angiography for studies of neurologic disorders in children. The low morbidity and the ease of the procedure permit the accurate diagnosis of intracranial pathology in situations where more invasive procedures would not be undertaken. The techniques of the procedure and its uses and limitations are emphasized in a number of neurologic problems of children.

Anesthesia

Spontaneous improvement in "normal" pressure hydrocephalus.

A patient is presented with "normal" pressure hydrocephalus including dementia, incontinence, and apraxic gait. He had a normal lumbar CSF pressure, hydrocephalus with lack of air over the convexities on pneumoencephalography, and ventricular filling with prolonged retention on cisternography. He did not receive a shunt and, nevertheless, showed spontaneous improvement in his mental function over the next few years. This cases emphasizes the necessity for a controlled study of shunting for "normal" pressure hydrocephalus.

Aged