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Biomedical subjects

O Flodmark

Publications and source records attributed to O Flodmark.

At least 37 records · Page 2Linked to original sources
PubMed1992

Magnetic resonance imaging in pseudotumor cerebri.

The pathophysiology of pseudotumor cerebri is unclear, but may relate to an abnormality in water transport in the brain. The authors performed MR imaging in seven children with pseudotumor cerebri; the signal intensity in the white matter was normal in all patients. These data suggest that periventricular brain water content is not increased markedly in children with pseudotumor cerebri. The authors speculate that this may relate to the establishment of an equilibrium between increased resistance to cerebrospinal fluid outflow and increased brain stiffness, occurring as a consequence of increased cerebral blood-volume and/or interstitial pressure.

Adolescent↗
PubMed1991

Aicardi syndrome: early neuroradiological manifestations and results of DNA studies in one patient.

A patient with Aicardi syndrome is presented. We report results of DNA analysis from the patient and her parents with probes mapped to Xp21.3-22.3 in an attempt to localize a deletion in this region. No signs of a microdeletion could be detected, using 5 different DNA markers. Further, it is suggested that a specific combination of cerebral abnormalities may be characteristic of the syndrome and that antenatal ultrasonographic diagnosis may be feasible.

Agenesis of Corpus Callosum↗
PubMed1991

Acquired mural (dural) arteriovenous shunts of the vein of Galen. Report of 4 cases.

4 patients with acquired arteriovenous shunts located in the wall of an ectatic vein of Galen (VG) are reported. They represent so-called VG dural arterio-venous malformations (DAVM). These shunts involve the vasa vasorum normally present in the VG wall. Physiopathology, clinical signs and age groups are usually the same as those encountered in other DAVMs; conversely they are totally different from the other mural shunts of the VG, detected in the pediatric population (true VG arteriovenous malformations), and leading to different clinical symptoms. Venous approach in these VG DAVMs is almost always contraindicated unless secondary occlusion of VG afferent has spontaneously excluded the pouch from the cerebral venous circulation.

Adult↗
PubMed1991

Computed tomography as an adjunct in etiological analysis of hemiplegic cerebral palsy. I: Children born preterm.

Computed tomography (CT) of the brain has been used to evaluate potential etiologies of hemiplegic cerebral palsy in a population-based group of 28 children born preterm, in whom an obvious postnatal cause of hemiplegia could be excluded. The CT findings were classified according to a system so constructed to reflect the phase of brain maturation during which the insult causing hemiplegia likely had occurred. We found that 50% had evidence of periventricular leukomalacia the lesion typical of hypoxic-ischemic injury to the immature brain. However, it was not possible, neither from the CT scans nor from retrospective review of available clinical data, to date the injury more precisely to the pre- or perinatal period. Analysis of CT findings further showed that 18% of the children had cerebral maldevelopment, indicating an injury during early fetal life as the cause of hemiplegia, earlier than clinically suspected. The CT scans were normal in 25% of the children. It is concluded that the objective information obtained by studying the morphology of brain lesions using CT provides important information in addition to clinical data, and should be integrated with clinical assessment when attempts are being made to evaluate the etiology of cerebral palsy in children.

Adolescent↗
PubMed1991

Computed tomography as an adjunct in etiological analysis of hemiplegic cerebral palsy; II: Children born at term.

CT brain scans were used to evaluate the most likely etiology of hemiplegic cerebral palsy in a group of children born at term. The population based study group comprised 83 children. The CT findings were classified to reflect the phase of brain maturation during which the injury causing hemiplegia most likely had occurred. The most common finding (37%) was periventricular atrophy considered to represent periventricular leukomalacia (PVL). PVL is a form of hypoxic-ischemic damage typical of the immature brain and most commonly seen as a complication of preterm birth. As this lesion was found in children born at term it was considered to reflect a cerebral injury that had occurred in utero. Cerebral maldevelopment, due to a very early intrauterine lesion, was detected in 17%, while cortical-/subcortical lesions, previously considered to be of major importance in hemiplegia, were seen in just 16% of the children. Altogether the CT findings indicated a prenatal origin of hemiplegia in 57%. Assessing the time of injury based on clinical records concurred with prenatal origin in 32% of the children thought to have prenatal origin of hemiplegia by CT. The objective information available from careful review of imaging information such as CT brain scans, is an important adjunct to clinical data. We propose that assessment of brain morphology, by means of imaging, should be integrated with clinical assessment when evaluating the etiology of brain lesions in children with congenital motor impairment.

Adolescent↗
PubMed1990

Familial renal hypophosphatemia, minor facial anomalies, intracerebral calcifications, and non-rachitic bone changes: apparently new syndrome?

We report on two brothers with renal hypophosphatemia, intracerebral calcifications, minor facial anomalies, and short distal phalanges. The children presented with recurrent dental abscesses; one had premature closure of the anterior fontanelle. Biochemical findings included hypophosphatemia and elevated serum alkaline phosphatase with normocalcemia. Blood levels of parathyroid hormone, 1,25(OH)2 and 25(OH) vitamin D levels were normal; TRP (the fractional tubular reabsorption of PO4) and TmP/GFR (the tubular maximum rate of PO4 reabsorption in relation to GFR) were low. Both parents had a normal serum phosphate and brain CT scan without evidence of calcifications. This apparently new syndrome of renal hypophosphatemia associated with intracerebral calcifications appears to be inherited as either an autosomal recessive or an X-linked trait.

Brain↗
PubMed1990

Morphology of cerebral lesions in children with congenital hemiplegia. A study with computed tomography.

This study has analysed the results of CT scans of the brains in children with congenital hemiplegia. The material consists of 111 out of a total of 151 children with this cerebral palsy syndrome in a population-based series. We have classified the morphological findings in five groups. The groups are designed to reflect the phase of maturation of the brain when the insult happened. The groups are: 1. Maldevelopment, 2. Periventricular atrophy, 3. Cortical-/subcortical atrophy, 4. Miscellaneous, 5. Normal. In contrast to previous reports we found a high proportion (17%) with maldevelopment. However the dominating morphological pattern was periventricular atrophy, consistent with a hypoxic-ischemic insult to the immature brain, seen in 42%. Cortical and/or subcortical atrophy was found in 12%. Three children (3%) presented with morphological patterns not possible to classify. The group with no pathology according to CT was 26%.

Atrophy↗
PubMed1990

Electrophysiologic studies, computed tomography, and neurologic outcome in acute bacterial meningitis.

To determine the value of computed tomography and electrophysiologic studies in predicting neurologic outcome, we prospectively studied 41 children with acute bacterial meningitis, using clinical examination, computed tomography of the head, electroencephalography, brain-stem auditory evoked response, and visual evoked potential mapping during the acute illness. Two children died; 32 of the remaining 39 children were reviewed clinically, electrophysiologically, and with computed tomography between 5 and 38 months after the illness. The electrophysiologic data obtained during the illness were not found to alter the acute-stage management. Focal or generalized suppression, demonstrated on the electroencephalogram, was associated with a poor outcome. Cerebral infarction and edema, demonstrated by computed tomography of the head, were predictive of a poor outcome, but enlarged ventricular and subarachnoid spaces and increased subdural effusions were of no predictive value. Neither computed tomographic scans nor electrophysiologic data were better indicators of neurologic prognosis than the clinical examination.

Acute Disease↗
PubMed1990

Thalamic hemorrhage with intraventricular hemorrhage in the full-term newborn.

Intraventricular hemorrhage is an uncommon problem in the full-term newborn. In a review of 19 full-term infants with intraventricular hemorrhage diagnosed on computed tomography prior to 1 month of age, thalamic hemorrhage associated with the intraventricular hemorrhage was documented in 12 infants. Thus, thalamic hemorrhage appears to the most common source of intraventricular hemorrhage in this age group, particularly in infants who had uneventful birth histories and in whom clinical abnormalities (signs of increased intracranial pressure, seizures, altered level of consciousness) developed after the first week of life. The majority of these infants had predisposing factors for cerebral venous infarction such as sepsis, cyanotic congenital heart disease, and coagulopathy. The clinical appearance and outcome for infants with thalamic hemorrhage/intraventricular hemorrhage were similar to those in infants with intraventricular hemorrhage originating from other sites, except for an increased incidence of cerebral palsy in infants with thalamic hemorrhage/intraventricular hemorrhage. Definitive diagnosis was made on the basis of characteristic radiologic abnormalities.

Cerebral Hemorrhage↗
PubMed1990

Computed tomography of the brains of children with cortical visual impairment.

Computed tomography (CT) of the brains of 70 children with permanent cortical visual impairment (CVI) and of 25 children who recovered from their cortical visual loss were analysed and the findings were correlated with clinical signs and symptoms. The 70 children with CVI were divided into groups depending on the known or suspected pathophysiology of CVI. Asphyxia caused permanent CVI in 34 children, of whom 16 were preterm, 17 were term and one lost vision later in life. Congenital brain malformations were the second largest group, followed by trauma, infections and shunt failure. 25 children recovered their visual acuities, but six of them were left with homonymous hemianopia. The results identified various clinical characteristics of the groups. CT scanning was helpful in understanding the pathophysiology of CVI, and provided useful information for the prognosis of visual recovery.

Adolescent↗
PubMed1989

The trans-cerebral veins: normal and non-pathologic angiographic aspects.

The trans-cerebral v. have long been described, but there is little or no knowledge of their function and dysfunction. They are the site of fundamental interchange across the blood-brain barrier, a unique process within the organism. Two systems can be structurally distinguished: the venous system draining the white matter and the trans-cerebral anastomotic system. The former seems to be associated with the nutrition and drainage of the parenchyma, and is rendered visible at angiography by anatomic variations based on developmental venous anomalies. The anastomotic trans-cerebral ventriculo-cortical system seems concerned with the regulation of reabsorption of the cerebrospinal fluid. It is visualized only in exceptional situations where an increased flow (arteriovenous shunt) is combined with obstruction of the normal routes of venous drainage and collateral circulation. It usually functions in the ventriculo-cortical direction. No specific dysfunction of this system is currently recognized.

Cerebral Angiography↗
PubMed1989

Neurosonographic features of Aicardi's syndrome.

Aicardi's syndrome occurs in females and is associated with profound mental retardation, agenesis of the corpus callosum, chorioretinal lacunae, and infantile spasms. We report a distinctive combination of abnormalities which was observed on real-time cranial ultrasound scans of two infants with Aicardi's syndrome. These abnormalities include bilateral prominent cysts in the choroid plexus in conjunction with agenesis of the corpus callosum. Recognition of these radiologic findings may suggest the diagnosis of Aicardi's syndrome in early infancy even prior to the onset of seizures or visualization of chorioretinal lacunae.

Agenesis of Corpus Callosum↗
PubMed1989

MR imaging of periventricular leukomalacia in childhood.

Eight children with clinical and radiologic abnormalities consistent with periventricular leukomalacia were investigated with MR imaging of the brain that employed both inversion-recovery and T2-weighted spin-echo imaging sequences. The more precise delineation of white and gray matter on inversion-recovery images as compared with CT allows a detailed demonstration of the anatomic features of periventricular leukomalacia; specifically, a reduced quantity of white matter in the periventricular region and centrum semiovale and, in more severe cases, cavitated infarcts that replace the immediate periventricular white matter. The T2-weighted spin-echo and short inversion time inversion-recovery images demonstrated abnormally increased signal in white matter that appeared normal on CT scans and only minimally abnormal on conventional inversion-recovery images. These abnormalities most probably represent white matter gliosis that extends beyond the immediate periventricular regions. MR recognition of cerebral white matter abnormalities associated with periventricular leukomalacia may confirm the clinical suspicion of this diagnosis in children with spastic diplegia or quadriplegia.

Adolescent↗
PubMed1989

Hydrocephalus in achondroplasia: the possible role of intracranial venous hypertension.

The significance and cause of ventriculomegaly in achondroplasia was investigated in five achondroplastic children. The intraventricular pressure (IVP) was monitored over 24 hours, followed by intraventricular injection of radionuclide alone or in combination with water-soluble contrast material. The IVP was elevated and the reabsorption of cerebrospinal fluid (CSF) into the sagittal sinus was slow in all cases, but there was no obstruction to CSF flow. The spinal subarachnoid space was well seen in all patients. Jugular venograms with pressure monitoring were obtained in four patients (bilaterally in one). These studies confirmed a narrow jugular foramen in all patients with a significant venous pressure gradient (3 to 10 mm Hg) obtained while the catheter was being pulled back from the sigmoid sinus through the foramen. A second gradient was found in the jugular vein in two patients at the level of the upper thoracic aperture. This gradient was 6 and 14 mm Hg, respectively. Identical venograms and monitoring of the venous pressure in a control group showed no pressure gradients across the jugular foramen and smaller gradients (2 to 5 mm Hg) across the thoracic inlet. It is concluded from these studies that ventriculomegaly in achondroplastic children represents hydrocephalus, which is likely secondary to raised intracranial venous pressure due to hemodynamically significant stenosis of the jugular foramen and, in some cases, the jugular vein in the thoracic aperture.

Achondroplasia↗
PubMed1988

Selective brainstem injury in an asphyxiated newborn.

We report the clinical, radiological, and neuropathological features of selective brainstem injury in an asphyxiated term infant. Disproportionate injury to thalamus, basal ganglia, and brainstem with relative sparing of cortex and subcortical white matter is observed occasionally after acute total asphyxia. Although this entity has been well documented neuropathologically, the specific computed tomographic findings have not been reported previously to our knowledge, and the clinical correlation is recognized rarely.

Asphyxia Neonatorum↗
PubMed1988

Neuronal migration abnormalities can still be diagnosed by computed tomography!

Magnetic resonance imaging is presently the best modality for evaluating gray/white matter anatomy. However, this modality is expensive and not yet readily available in all countries. Most neuronal migration abnormalities can be accurately diagnosed by computed tomography (CT) provided excellent scanning technique is used. Abnormalities of neuronal migration were identified with CT brain scans in 68 children and were categorized as focal heterotopias (11 patients), multifocal heterotopias (19 patients) of diffuse migration disorders (38 patients). The principal indications for imaging were correlated to the radiological features. Neuropathological confirmation of the migration abnormality was obtained in 8 patients. An increased awareness by both clinicians and radiologists together with optimal CT technique are essential for the accurate diagnosis of migration disorders in children.

Brain↗