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[Echoencephalography in myelomeningocele].
Infants with myelomeningocele very often present cranio-cerebral anomalies such as Arnold Chiari malformation. Cranial ultrasonography allows early evaluation of these malformations and helps to detect complications in surgically treated children.
[Two-dimensional echoencephalography in neurosurgery].
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Echoencephalography. A general survey.
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[Experience of unidimensional echoencephalography in obstetric practice].
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[Echoencephalography in the diagnosis of hydrocephalus in infants and small children].
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[Use of echoencephalography in the diagnosis of the neurological complications after an operation with artificial circulation].
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[Echoencephalography in the diagnosis of rhinogenic inflammatory intracranial complications].
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Nuclear medicine and ultrasound in the evaluation of neurologic diseases.
Echoencephalography and radionuclide brain imaging are used to aid in the diagnosis of a variety of intracranial abnormalities. Because of technical considerations, A-mode rather than B-mode echography must, under most circumstances, be employed for examination of the head. There are technical limitations to echoencephalography, and it tends to be relatively subjective and dependent on the skill of the sonographer. These factors have, to some extent, been responsible for the more limited application of ultrasound to neurologic diagnosis, as compared to the application of radionuclides. The most common use of echoencephalography is in the detection of midline shifts associated with various sequelae of head trauma. Ultrasound has also been used to detect space-occupying lesions, either directly or more usually by determing associated midline displacements. The characterization and follow-up of known lesions with ultrasound has also been described. In the above instances its usefulness is usually as a noninvasive technique complementary to nuclear medicine studies, which under most circumstances are more effective than ultrasound. The evaluation of ventricular enlargement, which is not usually possible per se with radionuclides, is possible with ultrasound. Computerized transverse tomography (CTT) can be applied more efficiently in a routine way in many of the above circumstances, including evaluation of ventricular size. The combination of CTT and nuclear medicine procedures in the brain area is so effective and comprehensive that where these are both available the demand for ultrasound will probably decrease but will not be eliminated.
[State of the cerebral ventricular system in cerebral autonomic vascular paroxysms (clinico-echoencephalographic study)].
For diagnosing hydrocephalus of the third ventricle in cases of affections of the hypothalamic region use was made of echoencephalography. Under examination there were 71 patients with hypothalamic vegetovascular paroxysms, as well as 40 healthy subjects that constituted the control group. It was found that in the healthy subjects the width of the third ventricle varied from 3. to 5.5 mm, being 4.60 +/- 0.65 mm on the average. Of the 71 patients with the hypothalamic affections, hydrocephalus of the ventricle was revealed in 56, and the ventricle width varied within 7 to 12.5 mm, most frequently within 7 to 10 mm. In 19 patients the echoencephalographic findings were compared with pneumoencephalographic ones. On the echoencephalography a dilatation of the third ventricle was revealed in 16 of them, and on the pneumoencephalography in all. Thus, echoencephalography enables one to diagnose hydrocephalus of the third ventricle in most patients with affections of the hypothalamus region.
Antenatal origin of neurologic damage in newborn infants. I. Preterm infants.
Currently, the diagnosis of white matter necrosis may be performed with echoencephalography when cysts are observed in the white matter adjacent to the lateral ventricles. One hundred twenty-seven infants with a gestational age less than 36 weeks (mean [+/- SE] gestational age = 31 +/- 3.2 weeks) were studied in the neonatal period with echoencephalography to determine the incidence of white matter necrosis and the perinatal variables associated with this complication. Twenty-three infants (18.3%) had white matter necrosis. Thirteen (10.3%) had cysts by day 3 (11 on day 1), indicating that the onset of white matter necrosis occurred antenatally. The incidence of antenatal white matter necrosis was inversely related to birth weight and was more frequent in infants weighing less than 1000 gm (19%). Stepwise logistic regression analysis of 31 antenatal variables showed that placental vascular anastomoses in multiple pregnancies, funisitis, and purulent amniotic fluid were the only complications associated with antenatal white matter necrosis. Follow-up neurologic evaluations were abnormal in four of six patients with antenatal white matter necrosis. The findings in this study focus attention on prenatal, rather than intrapartum and postnatal, factors as causative agents of neurologic morbidity and emphasize the importance of early and sequential evaluation of neonatal brain structures.
[The comprehensive diagnosis of patients with the sequelae of a brain concussion].
As many as 140 patients aged 16 to 75 years with a history of brain concussion were under observation. The observation periods were from 1 to 2 months after the acute period elapse up to 25 years. In addition to neurological examinations, the patients were subjected to echoencephalography, computer-aided tomography of the brain (38 patients), ultrasound tomoscopy of the brain (40 patients and 30 healthy subjects). It has been shown that the use of echoencephalography, computer-aided tomography and ultrasound tomoscopy of the brain makes it possible to identify, in some cases, different disorders on the part of the brain. The role of these methods in the diagnosis of brain concussion consequences increases, provided they are used combined or jointly with the data obtained during clinical examination and observation.
[The function of neuromuscular structures and the cerebrospinal dynamics in primary arterial hypotension].
To specify correlations between neuromuscular, vegetative functions and CSF dynamics in patients with primary arterial hypotension, 22 young patients were examined with the aid of stimulation electroneuromyography, registration of evoked sympathetic cutaneous potential, echoencephalography and electrothermometry. The data obtained before and after antiorthostatic test were compared. A group of healthy subjects served as control. It has been shown that in patients with primary arterial hypotension with compensated neurological microsymptomatology, unpronounced under common conditions, there are well-defined signs of disorders in the work of neuromuscular structures, vegetative fibers, and in thermoregulation. These disorders undergo different changes under the influence of the antiorthostatic test and are accompanied in the majority of the patients by the enlargement of the ventricular system of the brain. It is assumed that in view of this fact, potentialities of adaptation are decreased in the disease in question. It is recommended that electroneuromyography and echoencephalography be used in an all-round estimation of the health status of patients suffering from primary arterial hypotension.
[Age-dependent changes of the central part of the lateral ventricle of the brain in children (author's transl)].
In 504 children of different age groups the width of the body region of the lateral ventricles was measured by means of one-dimensional echoencephalography in a cross-sectional study. During the first two months of life, there is in the average a decrease of the width of the body region and afterwards an increase until the age of four. It can be assumed that the phenomenon of the decrease is caused by the rapid growth of brain in this period of life. The one-dimensional echoencephalography can be used as screening test for the diagnosis of neuropaediatric disorders.
[EEG and CAT in astrocytomas grade III-IV (author's transl)].
The relation between C.A.T., EEG, echoencephalography and clinical data was studied in 33 patients with astrocytoma grade III-IV. The diagnostic and localizing possibilities of the EEG were evaluated. The occurrence of EEG signs (focal delta-activity, asymmetry of normal rhythms, frontal intermittent rhythmic delta-activity etc.) was related to the C.A.T.-findings. A prognostic value of the EEG could be established in this group of patients. The results of the A-scan echoencephalography were compared with the midine displacements as shown on the C.A.T. It is pointed out that comparative studies of C.A.T. and EEG are valuable only when clinically homogeneous groups are taken into consideration. The necessity of such studies for a better understanding of the EEG is stressed.
[Clinico-echoencephalographic correlations in the early diagnosis of traumatic intracranial hematomas and foci of brain crushing].
The authors examined 254 patients with closed trauma of the skull and brain. Besides clinical examination all patients were subject to unidimensional multiaxial echoencephalography with a modified ultrasonic probe and method of examination Three degrees of brain affection were distinguished according to the clinical signs and three degrees of compression according to the results of echoencephalography, the combination of which allows correct tactics of examination and treatment to be used in patients with severe closed trauma of the skull and brain within the first hours of hospitalization.
Antenatal steroids, delivery mode, and intraventricular hemorrhage in preterm infants.
OBJECTIVE: The relationship between antenatal steroids, delivery mode, and early-onset intraventricular hemorrhage was examined in very-low-birth-weight infants. STUDY DESIGN: A total of 505 preterm infants (birth weight 600 to 1250 gm) were enrolled in a multicenter, prospectively randomized, controlled trial evaluating the efficacy of postnatal indomethacin to prevent intraventricular hemorrhage. All infants had echoencephalography between 5 and 11 hours of life. RESULTS: Seventy-three infants had intraventricular hemorrhage within the first 5 to 11 hours (mean age at echoencephalography 7.5 hours). Four hundred thirty-two infants did not have early intraventricular hemorrhage. There was less antenatal steroid treatment (19% vs 32%, p = 0.03) and more vaginal deliveries (71% vs 45%, p < 0.0001) in the group with early intraventricular hemorrhage. Of 152 infants who received antenatal steroids, those delivered by cesarean section had significantly less early-onset intraventricular hemorrhage than did those delivered vaginally (4% vs 17%, p = 0.02). Of the 353 not exposed to antenatal steroids, 10% of infants delivered by cesarean section and 22% delivered vaginally had early intraventricular hemorrhage (p = 0.003). CONCLUSION: These data are the first to suggest that both antenatal steroids and cesarean section delivery have an important and independent role in lowering the risk of early-onset intraventricular hemorrhage.
Normal-pressure hydrocephalus: diagnosis and patient selection for shunt surgery.
Currently accepted modes of clinical and radiologic evaluation were analyzed retrospectively in 55 patients with "normal-pressure" hydrocephalus on whom a cerebrospinal fluid shunting procedure was done. When applied alone, each criterion neither reliably differentiated normal-pressure hydrocephalus from cortical atrophy nor indicated in a significant number of cases which patients would benefit from shunting. Therefore, future prospective evaluations should include clinical history, physical and neurologic examination, skull radiography, echoencephalography, psychometric testing, brain scanning, lumbar puncture with cerebrospinal fluid laboratory analysis, isotope cisternography, pneumoencephalography, and constant-infusion manometric testing. Cerebral angiography may add optional support to the diagnosis of cortical atrophy but always should be done before lumbar puncture if there is evidence of intracranial mass and/or increased pressure is revealed on neurologic examination, skull radiographs, echograms, or brain scans. Patients with seizures should undergo electroencephalography. Postoperative improvement should be evaluated using serial neurologic and psychometric examinations. Echoencephalography may confirm postshunt reductions in ventricular size.