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Biomedical subjects

E Kosnik

Publications and source records attributed to E Kosnik.

5 recordsLinked to original sources

Seizures in relation to shunt dysfunction in children with meningomyelocele.

To determine whether seizures are a reliable sign of increased intraventricular pressure in children with shunt-dependent hydrocephalus and meningomyelocele, we performed a retrospective chart review of 346 patients with meningomyelocele and shunt-dependent hydrocephalus. Fifty-one patients had seizures. Seizure episodes were investigated to determine whether they were temporally associated with shunt dysfunction. Episodes of actual or presumed shunt dysfunction were analyzed as to presenting symptoms, ventriculogram, computed tomography scan, and shunt film results. These 51 patients had 129 admissions for possible shunt dysfunction. One hundred one admissions were due to increased intraventricular pressure; nine (9%) of these, had a seizure as one of the presenting symptoms. All of the nine episodes had other common presenting symptoms of shunt dysfunction, such as headache, vomiting, lethargy, or respiratory compromise. We conclude that seizures alone are an inadequate predictor of shunt dysfunction in children with meningomyelocele, but can be seen as one of the presenting symptoms.

Cerebrospinal Fluid Shunts

Intracranial trigeminal nerve rhabdomyoma/choristoma in a child: a case report and discussion of possible histogenesis.

Rhabdomyomas are rare tumors that usually arise within the heart, orocervical, or vulvovaginal regions. The cardiac tumors have a characteristic immature morphology, occur often in association with tuberous sclerosis, and are regarded as hamartomas rather than true neoplasms. The histogenesis of the extracardiac tumors and their true neoplastic nature are matters of controversy. We report the first case of a rhabdomyoma located inside the cranium. The intimate association with the mandibular division of the trigeminal nerve, the normal embryogenesis of the craniofacial muscles, and animal homograft and xenograft experiments provide a framework for considering this tumor, and possibly other rhabdomyomas, as a choristoma/hamartoma rather than a true neoplasm.

Child, Preschool

Interhemispheric subdural empyema: neuroradiological diagnosis.

A case of subdural empyema situated in the interhemispheric subdural space is described. CT scan is useful in the diagnosis and follow-up of intracranial inflammatory pathology. Selective angiography was helpful in the compartmental localization of the abscess in the interhemispheric subdural space, adjacent to the falx and tentorium by virtue of the hypertrophied tentorial meningeal arteries and vascular displacement. CT scans are also useful in follow-up of cerebral abscess after micropaque barium has been injected into the cavity as in this patient.

Brain Abscess

Postictal blindness.

Transient loss of vision occasionally follows an epileptic seizure. This rare phenomenon is seen chiefly in children and may be related to the relative electrical instability of the occipital cerebral cortex. Occipital foci are more common in the juvenile electroencephalogram and, with maturity, tend to be seen more rostrally in the temporal areas. We have seen three cases of postictal blindness in children; all have cleared within 24 hours.

Adolescent