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Biomedical subjects

K Murphy-Irwin

Publications and source records attributed to K Murphy-Irwin.

6 recordsLinked to original sources

Correlation of echoencephalographic findings and neurodevelopmental outcome: intracranial hemorrhage and ventriculomegaly in infants of birth weight 1,000 grams or less.

Echoencephalograms were obtained for 118 of 121 successive infants who were admitted to the Stanford intensive care nursery, weighed 1,000 g or less at birth, and survived long enough for at least one study to be performed. Eighty-eight of these infants survived and were followed up for 1 to 3 years; psychometric testing (Bayley Scales of Infant Development, Stanford-Binet Intelligence Scale, or both) was performed on 81% of these infants. Subependymal-intraventricular hemorrhages or intraparenchymal hemorrhages were associated with impaired development, but ventriculomegaly was not. The absence of echoencephalographic abnormalities did not exclude the possibility of impaired development in many infants. Periventricular leukomalacia was not observed. These data support independent scoring of subependymal-intraventricular hemorrhages, intraparenchymal hemorrhages, and ventriculomegaly, rather than use of combined scales for prognostic purposes.

Brain Damage, Chronic

The natural history of subependymal germinal matrix hemorrhage.

A prospective study of 377 premature infants (less than or equal to 1500 gm) was undertaken to delineate the natural history of subependymal/intraventricular hemorrhage (S/IVH) and its complications using ultrasound (US) and computed tomography (CT). Low grade (I, II) S/IVH had a low mortality while higher grades (III, IV) still had elevated mortality rates. The addition of intraparenchymal hemorrhage (IPH) to S/IVH incrementally increased the incidence of death and other complications, suggesting IPH hemorrhage should be categorized separately. When a specific day could be identified, S/IVH had its onset in the first 7 days of life with peak incidence occurring on day 3. S/IVH appeared to be an event limited to less than 24 hours in all but 5% of infants in whom progression of hemorrhage was documented over a 24-hour period. The mortality rate of these progressive hemorrhages was high, 50%. The benign phenomenon of late S/IVH was detected in 5% of infants. These hemorrhages were clinically silent and of minor severity. Several complications of S/IVH were detected. Hydrocephalus was a significant complication only for higher grades of S/IVH. When present, severe hydrocephalus had an early onset and reached a maximum at around 3 weeks of age. "Atrophic change" of a cerebral hemisphere was detected in 30% of all S/IVH infants, while this was not seen in nonS/IVH infants. This "atrophic" abnormality had a marked predilection for the left hemisphere, independent of the site of the S/IVH. Periventricular leukomalacia (PVL) was documented by US in 2% of infants and could be detected in the first week of life. PVL presented in the first week of life as an echogenic lesion which developed "cystic" changes at approximately 3-4 weeks of age. This complication should be categorized separately from S/IVH.

Atrophy

Tumors of the central nervous system studied by computed tomography and ultrasound.

Intraoperative ultrasound (US) was compared to computed tomography (CT) in 41 intracranial and 6 spinal cord tumors. The studies correlated closely except for primary gliomas. Eight of the 22 primary intracranial gliomas (37%), including 1 low-grade and 7 anaplastic tumors, were larger and more extensive on US than on CT. Margins of non-enhanced primary astrocytomas were shown by US but not CT. Four anaplastic tumors (19%) exhibited echogenicity extending beyond the enhanced area. In 4 patients an enhanced lesion contained a lucent center which proved to be echogenic. Low-grade astrocytomas were relatively homogeneous on US, while anaplastic astrocytomas were more inhomogeneous. Cysts could be found in both types of astrocytomas and were often small and multiple. The echo pattern was not helpful in differentiating metastases from primary tumors, although all of them had sharp margins. Sonography of the central nervous system can provide valuable information about tumor morphology and margins.

Astrocytoma

Experimental Staphylococcus aureus brain abscess.

The virulent organism Staphylococcus aureus produced brain abscesses that were quantitatively and qualitatively different from those caused by less virulent organisms. S. aureus abscesses created larger lesions, as earlier ependymitis, delayed progress toward healing, and caused areas of inflammatory escape outside the collagen capsule. Imaging tests revealed similar findings: the abscesses were larger, had more extensive central necrosis, and showed earlier evidence of ependymitis. This virulent organism also demonstrated that white matter is more susceptible than overlying gray matter to destruction by infection. The pattern of spread and other histologic findings suggest that collagen capsule formation has less of an infection "containment" function than was previously thought.

Animals