Pneumorrhachis after jejunal entrapment caused by a fracture dislocation of the lumbar spine.
Explore the source record for details and available documents.
Air↗
Biomedical subjects
O Flodmark
Publications and source records attributed to O Flodmark.
Brain swelling in the asphyxiated term newborn: pathogenesis and outcome.
The role of brain swelling following acute hypoxic-ischemic insult in the genesis of brain injury in the term newborn is controversial. Recent experimental animal studies suggest that it may result from prior irreversible cerebral necrosis and therefore represents a consequence as opposed to a cause of major brain injury. In this study, 32 asphyxiated term newborns were studied during the first week of life with serial intracranial pressure measurements. A total of 26 infants had CT scans during the first five days of life. Seven patients had two CT scans within this period. These investigations were correlated with outcome at 18 months of age. Seven infants had increased intracranial pressure (greater than 10 mm Hg) that reached a maximum between 36 and 72 hours of age. Cerebral perfusion pressures remained normal, which makes ongoing ischemic injury unlikely as a cause. The seven patients with increased intracranial pressure had decreased attenuation on CT that was generalized in six infants and patchy in one infant. Of the infants with increased intracranial pressure and severe CT abnormalities, three died and four had severe neurologic sequelae. In seven infants, a second CT scan at three to four days of life demonstrated progression of the decrease in tissue attenuation. Most of the infants with normal intracranial pressure (23/25) had no or had only minor neurologic abnormalities at follow-up. These data suggest that brain swelling is relatively uncommon in the asphyxiated term newborn.(ABSTRACT TRUNCATED AT 250 WORDS)
Asphyxia Neonatorum↗
Visual recovery from hypoxic cortical blindness during childhood. Computed tomographic and magnetic resonance imaging predictors.
We reviewed the clinical courses and computed tomographic (CT) and magnetic resonance imaging (MRI) scans of 30 infants and children with cortical blindness following hypoxic insults. The degree of injury to the striate and parastriate cortices and the area of the optic radiations were graded from 0 to 4 by a neuroradiologist. Only two children had normal scans of the posterior visual pathway and both had favorable visual outcomes. The visual recovery differed significantly with respect to the age at which the hypoxic insult occurred and CT and MRI abnormalities in the area of the optic radiations, but not with abnormalities in the striate or parastriate cortices. Our results suggest that CT and MRI scanning are helpful in prognosticating the visual potential of children with hypoxic cortical blindness.
Age Factors↗
Prospective study of computed tomography in acute bacterial meningitis.
We performed serial CT scans at the time of admission and discharge, and again after 6 to 18 months, in children older than 2 months of age with bacterial meningitis. During the 2-year study period, 60 patients with bacterial meningitis were admitted to British Columbia's Children's Hospital. Forty-one were included in the study, two of whom died soon after admission. The infecting organism was Haemophilus influenzae in 29, Neisseria meningitidis in six, and Streptococcus pneumoniae in six. Abnormalities on the first two CT scans included subdural effusion in eight patients, focal infarction in five, and pus in the basal cisterns in one. All patients with focal infarction or cisternal pus had hemiparesis. Marked cerebral edema was seen in the two patients who died. Transient mild dilation of the subarachnoid space was a common finding; the size of the ventricles or subarachnoid space was increased on the second scan in 29 of 36 patients, and decreased to normal on the third scan in 30 of 33 patients. Clinical management was not influenced by the CT findings, which failed to reveal any clinically significant abnormalities that were not suspected on neurologic examination.
Acute Disease↗
Proptosis and diplopia following traumatic asphyxia.
We describe a previously unreported complication of traumatic asphyxia. An 11-year-old boy developed proptosis and diplopia following a crush injury in an automatic garage door. Computed tomography scan confirmed displacement of the eye. There was no retrobulbar hemorrhage or skull fracture, and the proptosis appeared secondary to traumatic displacement of orbital fat. Proptosis and diplopia resolved completely over six weeks. Visual disorders may be overlooked as a complication of trauma.
Accidents, Home↗
Periventricular leukomalacia: radiologic diagnosis.
Fifteen infants and children with clinical evidence of periventricular leukomalacia (i.e., spastic diplegia or quadriplegia and premature birth) were studied. Computed tomography (CT) scans of the brain demonstrated the following characteristic abnormalities: reduction in quantity of periventricular white matter, particularly at the trigone, deep and prominent sulci that abutted the ventricles without interposed white matter, and ventriculomegaly with irregular outline of the lateral ventricles. The location and severity of abnormalities on CT scans correlated well with the neurologic abnormalities observed at follow-up and the known anatomic location of periventricular leukomalacia. These observations demonstrate the diagnostic value of CT scanning for periventricular leukomalacia during late infancy and childhood. Although serial ultrasonography during the first weeks of life may be diagnostic of periventricular leukomalacia, it is of less value later. In contrast, CT scans obtained beyond 6 months of age can demonstrate a characteristic pattern of abnormalities that may be considered diagnostic of periventricular leukomalacia.
Encephalomalacia↗
Management of simple depressed skull fractures in children.
Surgical elevation is the treatment usually recommended for a simple depressed skull fracture if the depression is more than the full thickness of the adjacent skull, but there is no clinical evidence to support this management. On that basis, a progressively more conservative approach to the treatment of this condition was adopted, especially in young children. Experience with this mode of management over the period 1972 to 1984 is presented. Of 111 patients under 16 years of age with depressed skull fractures, 64 had simple and 47 compound fractures. Simple depressed skull fractures occurred in a younger age group after less significant trauma than compound fractures. In those patients who were treated surgically, there was an 11% incidence of dural laceration in patients with simple depressed fractures versus 67% for the patients with compound depressed fractures. There was no difference in outcome between surgically and nonsurgically treated patients with simple depressed fractures with respect to the occurrence of seizures, neurological dysfunction, or cosmetic appearance. Surgical treatment prolonged hospitalization, and the only case with a fatal outcome was found in the group of patients treated surgically. It is suggested that the standard treatment of simple depressed skull fractures in the pediatric age group should not include surgery. Surgery is indicated when there is definite evidence of dural penetration and in the older child with an unacceptable cosmetic appearance.
Child↗
Urgent and emergent embolization of lesions of the head and neck in children: indications and results.
Indications for and results and complications of embolization of lesions of the head and neck were analyzed retrospectively. The procedures were performed since 1980 on an emergent or urgent basis in 30 infants and children by an experienced interventional neuroradiologist in Bicetre, France. Indications for embolization included hemorrhage, occular occlusion, respiratory obstruction, CNS complications or potential complications, interference with nutrition, and functional impairment related to the effect of the lesion on the developing facial skeleton and teeth. The specific lesions included seven hemangiomas (palpebral, subglottic, and nasal) and 20 vascular malformations (maxillofacial, auricular, dural, cerebral [including three vein of Galen malformations] and spinomedullary). Embolization was efficacious in 28 of 30 patients. Hemangiomas (potentially involutive tumors) responded dramatically with arrest of the proliferative phase and shrinking of the mass. Combined hemovascular lymphatic malformations (hemolymphangiomas) of the tongue demonstrated a variable decrease in size. High-flow evolutive arteriovenous malformations involving the teeth and dura were controlled but required multiple embolizations. One infant with a vein of Galen arteriovenous malformation died. Three local complications occurred in two patients. No cerebral ischemic or femoral artery complications occurred.
Adolescent↗
Primary Ewing's sarcoma of the base of the skull.
The authors report a case of primary Ewing's sarcoma of the petrous bone. The radiological features, including the computed tomographic scan and angiographic findings, are described in detail.
Cerebral Angiography↗
Radiologic diagnosis of periventricular leukomalacia.
Fifteen infants with clinical evidence of periventricular leukomalacia, i.e. spastic diplegia or quadriplegia and premature birth were studied. CT scans of the brain demonstrated: 1) reduction in quantity of periventricular white matter, 2) deep and prominent sulci which abutted the ventricles without interposed white matter and 3) ventriculomegaly with irregular outline of the lateral ventricles. The location and severity of abnormalities on CT scans correlated well with neurologic handicap and the known anatomic location of periventricular leukomalacia, thus demonstrating the diagnostic value of CT scanning for periventricular leukomalacia during later infancy.
Brain↗
Pediatric surgical neuroangiography. A multicentre approach.
Adult patients who require sophisticated embolization procedures are usually referred to centres where such expertise is available. Because of the special circumstances in the pediatric age group, this type of referral is often not feasible. The authors describe a model in which multiple pediatric institutions have access to sophisticated interventional neuroradiologic procedures through the collaboration of a group of neuroradiologists. The preliminary results are encouraging and appear to indicate that embolization in the pediatric age group can be safe and reliable if performed by well trained teams.
Child↗
Permanent cortical visual impairment in children.
Fifty patients with permanent cortical visual impairment were evaluated. They had a characteristic behaviour profile, usually with residual sight but poor visual attention. 30 of the 50 also had damage to the anterior visual pathway. Visual evoked potential mapping was shown to have a clear advantage over visual evoked responses, and using that in conjunction with CT and clinical data enabled several subgroups of cortical visual impairment to be identified. The diagnosis probably is more common than previously recognised, and should be suspected when there is greater delay in visual development in other areas and the degree of visual loss is unexplained by ocular findings. Using traditional criteria for cortical blindness may mean that many children are not diagnosed, which has serious implications for their rehabilitation.
Adolescent↗
Leg length determination by CT digital radiography.
CT digital radiography is a new accurate technique for measuring leg length discrepancy. It is easily performed on commercially available equipment with a radiation dose of 3-6 times less than the conventional technique. Because of the short time required to complete the examination, charges are comparable with those for existing procedures. Good correlation in total limb length measurements between this new technique and spot scanography was noted in 24 patients. CT digital radiography should be the preferred method for evaluation for limb length discrepancy, particularly in children, because of the simple technique and lowering of radiation dose.
Child↗
Acute hemiplegia in Kawasaki disease and infantile polyarteritis nodosa.
Although aseptic meningitis, lethargy and irritability occur frequently in Kawasaki disease and infantile polyarteritis nodosa, other neurological manifestations are rare. The authors report one case of Kawasaki disease and one of infantile polyarteritis nodosa, both associated with acute hemiplegia. Both patients had received courses of oral corticosteroids for their underlying disease prior to the onset of the hemiplegia. Pathological studies, as well as the four previously reported cases, are reviewed.
Cerebral Infarction↗
[Intracranial hemorrhage and ischemic brain injury in the newborn - pathogenesis, diagnosis and prognosis].
Explore the source record for details and available documents.
Brain Ischemia↗
The prognostic value of computed tomography of the brain in asphyxiated premature infants.
Computed tomography brain scans were done during the first two weeks of life in 145 asphyxiated or apneic newborn infants with birth weights less than 1,500 gm. Sixty-two survived and were assessed neurodevelopmentally at 18 months from the term date. Follow-up CT scans were done at six months post term. There were major neurodevelopmental defects in 15 children, minor defects in 10, and no gross abnormalities in 37. The neonatal CT scans showed germinal layer hemorrhage in 45 (73%) of the survivors and was combined with ventricular bleeding in 29 cases (47%). Areas of hypodensity of brain tissue were present in all neonatal CT and were extensive in 84%. Ventricular dilatation occurred in 31%. There was a significant relationship between hydrocephalus and CT findings of IVH and dilated ventricles, but no relationship between outcome at 18 months and any other features of the neonatal CT. Only four of 56 CT scans done at six months post term were normal. Dilatation of the ventricles and subarachnoid spaces was common but was not related to subsequent neurodevelopmental status.
Asphyxia Neonatorum↗
Computed tomographic scanning of the cerebellopontine angle and the internal auditory canal.
CT scanning of the posterior fossa has been available for eight years, with continued and marked improvements in the scanning accuracy and resolution, particularly in the past three years. Newer computer programs combined with thin axial and coronal slices allow discovery of lesions that are millimeters in size. CT scanning has become the method of choice for screening patients with symptoms referrable to the posterior fossa and is also the most accurate radiographic method of detection. By demonstrating lesions less than one cm in size, CT has greatly enhanced the diagnosis and improved the management of patients who suffer from posterior fossa lesions.
Adult↗
The prognostic value of computed tomography as an adjunct to assessment of the term infant with postasphyxial encephalopathy.
Prospective follow-up studies were done on 62 term infants who were treated as neonates for clinical evidence of postasphyxial encephalopathy. Computed tomographic studies were done during the first two weeks of life and repeated at six months of age. All children were followed a minimum of 18 months, at which time they underwent a psychometric and a neurologic evaluation. Major neurodevelopmental sequelae consisted of: hydrocephalus; spastic quadriplegia, hemiplegia, or diplegia; or a mean Bayley score less than 70. Major sequelae were present in 29 (47%) of the children: all were severely handicapped. Five other children scored between 70 and 85 on the Bayley test. Computed tomographic scans were highly predictive of status at 18 months. Eleven of the 15 with intraventricular or parenchymal hemorrhage were severely handicapped. Eighteen of 20 with extensive areas of hypodensity of the white and gray matter (neonatal CT) were abnormal at 18 months. All but two were severely handicapped. The results suggest that CT studies are very useful in the care of the asphyxiated term infant who has clinical signs of encephalopathy.
Asphyxia Neonatorum↗