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Biomedical subjects

R A Minns

Publications and source records attributed to R A Minns.

At least 55 records · Page 3Linked to original sources
PubMed1989

Cerebrospinal fluid pressure in pyogenic meningitis.

The pressure of cerebrospinal fluid taken at lumbar puncture was recorded objectively by strain gauge pressure measurement in 35 infants and children with pyogenic meningitis. Raised pressures were found in 33 children. The median pressure was 15 mm Hg (range 4-70 mm Hg) in all age groups. The pressure level varied throughout the infection, but a higher median pressure (19 mm Hg) was found when this was measured on the day of admission. The clinical features of the meningitis in these patients suggest that many of the presenting symptoms and signs are those of pressure. These results show that high pressure is frequently present in childhood meningitis, not just in those who die from cones or who have radiological evidence of hydrocephalus. We conclude that raised cerebrospinal fluid pressure is a frequent accompaniment of childhood meningitis and may need treatment in its own right and is therefore one further important factor influencing the course and outcome of childhood meningitis.

Adolescent↗
PubMed1988

The use of CSF pressure recordings in acute purulent meningitis.

Non-fluid displacing pressure transducers can be applied to a spinal needle at LP and direct CSF pressure recordings obtained routinely. The method is particularly applicable to children with suspected meningitis and is both a safer and a more accurate estimate of CSF pressure. Children with acute purulent meningitis frequently have raised intracranial pressure on presentation and Mannitol infusion during the LP recording is useful in returning the pressure to normal.

Brain Edema↗
PubMed1988

Epilepsy precipitated by bathing.

A case of epilepsy precipitated by bathing is described and previously reported cases are reviewed. The prognosis for this rare form of reflex epilepsy seems to be good, in that the seizures resolve with age and neurodevelopment remains normal.

Baths↗
PubMed1988

Role of a separate subcutaneous cerebro-spinal fluid reservoir in the management of hydrocephalus.

A retrospective survey has been carried out on 56 children with shunted hydrocephalus either with a primary idiopathic cause or as a result of a low spina bifida complex. In all 56 children, a separate reservoir has been inserted at some stage in the management of their hydrocephalus. There was no mortality. Morbidity was not increased from CSF infection or shunt blockage. There was less chance of the initial shunt blocking and there was a lesser incidence of visual and schooling handicap. Double cortical puncture did not result in an increased incidence of hemiplegia or epilepsy. We conclude that a separate reservoir greatly eases the management of these children and does not cause significant increased morbidity.

Adolescent↗
PubMed1987

Specific enlargement of the fourth ventricle after ventriculo-peritoneal shunt for post-haemorrhagic hydrocephalus.

Disproportionate enlargement or isolation of the fourth ventricle are rare complications of ventriculo-peritoneal shunt for post-haemorrhagic hydrocephalus. Obvious features such as ataxia may indicate raised intracranial pressure in the posterior fossa. The child may, however, present with less specific signs of vomiting, anorexia, and lethargy and these symptoms may be misinterpreted as secondary to dilation of the lateral ventricular system due to malfunction of the ventriculo-peritoneal shunt. Two children with disproportionate enlargement of the fourth ventricle and two children with isolation of the fourth ventricle are described to illustrate the wide variations in clinical presentation. These rare complications can be diagnosed by real time ultrasound examination of the brain or computed tomography of the head. They should be considered in the differential diagnosis of a child who deteriorates after lateral ventriculo-peritoneal shunting for post-haemorrhagic hydrocephalus, and dealt with specifically to avoid the risk of upward herniation of the enlarged fourth ventricle.

Cerebral Hemorrhage↗
PubMed1987

CSF production rate: "real time" estimation.

CSF production rate has been measured by a drip detector method in 5 cases of childhood hydrocephalus undergoing closed ventricular drainage. The rate of production of CSF with this "real time" estimation is shown not to be constant but to be discontinuous and may vary by a factor of 10 over a one hour period, although the average rate of CSF production remains within previously established normal limits.

Cerebrospinal Fluid↗
PubMed1986

Sedimentation cytomorphology of the CSF in ventriculitis.

The cytological technique of cytocentrifugation and millipore filter collection of cells allows accurate identification of cells in the CSF. This study reports the changing CSF cell-populations during 26 episodes of ventriculitis in children with shunts to control hjydrocephalus. There was a significant discordance between lymphocytes and macrophages in the CSF. Neurosurgery led to a 20 per cent increase in neutrophils on the first postoperative day, with a progressive decline to a mean of 10 cells on the fourth postoperative day. There was a small decrease in lymphocytes on the first postoperative day, followed by an increase on the second day. Macrophages were reduced by 12 per cent on the first postoperative day and then steadily increased from the second to the fourth day. A mean number of two peaks (of all cells) occurred during the treatment for ventriculitis: there was a greater number of of neutrophils in the first peak, with less lymphocytes and macrophages than in the second peak. This study supports the advantages of this technique in the diagnosis and management of ventriculitis.

Adolescent↗
PubMed1985

Congenital rupture of a neuropathic bladder: report of a case.

A case of intra-uterine rupture of a neurogenic bladder in a female child with spina bifida is reported, together with the unusual histological appearances of detrusor-muscle atrophy at the site of rupture. The literature on ruptured bladder in the neonatal period is reviewed.

Adolescent↗
PubMed1984

Abdominal ultrasound in the diagnosis of cerebrospinal fluid pseudocysts complicating ventriculoperitoneal shunts.

Pseudocysts filled with cerebrospinal fluid caused complications at the distal end of ventriculoperitoneal shunts in five children. Only one of these cysts was infected. The children presented with raised intracranial pressure or abdominal symptoms, or both. We report on the usefulness of abdominal ultrasound examination in the diagnosis and follow up of these patients and suggest that abdominal ultrasound should form part of the initial assessment of children with ventriculoperitoneal shunt dysfunction.

Abdomen↗
PubMed1983

Self-retaining catheters for congenital neuropathic bladder: a continuing evaluation.

Sixty (60) spina bifida children have had their neuropathic bladder managed with a continuous Foley catheter regime for periods up to 14 years. Technetium renogram and renal scan assessments prior to commencement of catheter and again recently have shown no overall significant deterioration in 66 kidneys. There is however significantly less (p less than 0.001) intermittent emptying and significantly more (p less than 0.01) renal scarring in those patients who have had a continuous catheter regime for more than 4 years. Remedial complications were reported in 28% patients and these were predominantly males.

Adolescent↗
PubMed1982

Plasma levels of sodium valproate in childhood epilepsy.

Sodium Valproate levels in plasma have been measured in 207 children with epilepsy, only 21 of whom were in-patients. No significant correlation could be found between plasma levels and dose of Sodium Valproate expressed as mg/day, mg/kg body weight or mg/m2 surface area. This finding could not be attributed to irregular compliance, concomitant administration of other anticonvulsant drugs, time of sampling after last dose, duration of treatment or age of the child. We could find no evidence of a therapeutic range of plasma levels of Sodium Valproate and the ranges associated with poor (17%), moderate (44%) or good control (39%) of fits were not significantly different. The average daily dose producing an improvement in seizure control was calculated to be 30 mg/kg.

Adolescent↗