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[Two-dimensional echoencephalography in focal brain pathology].

Two-dimentional echoencephalographic examinations were conducted in 35 patients with focal lesions of the brain of different etiology. Normal tomoechoencephalogramme and ultrasonic semiotics of transverse sections of the brain in different pathology is described with reference to its nature and interrelationships with the meninges and brain matter (tumours, abscesses, emningeal and intracerebral haematomas, hydroma, brain confusion, intracranial foreign bodies). The authors believe that two-dimentional echoencephalography is a promising method of diagnosis, free of contraindications, combinding safety and promptness of the examination. direct visualization of focal pathology of the brain through an intact skull.

Brain

Two-dimensional echoencephalography in paediatric neurology.

Two-dimensional echoencephalography is a useful procedure in screening young infants for hydrocephalus and cerebral malformation. The procedure is noninvasive and easily repeated. The procedure is less reliable in detecting mass lesions except insofar as they disturb the anatomy of the ventricular system. The procedure can be considered as complementary to computerised axial tomography in the investigation of cerebral anatomy in paediatric neurology.

Brain

B-mode echoencephalography in the normal and high risk infant.

Commercially available high resolution, contact, gray scale imaging systems can now dependably visualize the normal and abnormal ventricular system as well as some other intracranial structures in all newborns. On 25 normal infants and 41 high risk infants, 135 B-mode echoencephalograms were performed. The technique for obtaining these scans is described. The normal lateral ventricle at the midbody in term infants is 0.9--1.3 cm wide (mean, 1.1 cm). Normal ratio of lateral ventricle to hemisphere is 28% (range, 24%--30%). High risk premature infants have a ratio of 31% (range, 24%--34%). The demonstration of hydrocephalus and cystic intracranial masses is reliable and the correlation with computed tomography is excellent. Postoperative or high risk infants can be repeatedly evaluated without radiation, at a lower cost, and more rapidly with ultrasound than with computed tomography. Ventricular size can be closely monitored and shunt failure detected at any early stage.

Cerebral Hemorrhage

[Two-dimensional echoencephalography through a trepan defect in the skull].

With the aid of a non-adapted equipment echoencephalotomogrammes were obtained that revealed fine details of intracranial structures in normals and in patients with space-occupying lesions, these tomogrammes being comparable to those obtained after anatomic sections of the skull in the same planes. This becomes possible thanks to the absence of the bone as a limiting factor. Interpreting the conducted examinations as a model of intraoperative scanning, and considering the results of experimental craniotomies, a conclusion is made as the importance of such investigations especially in cases of bilateral space-occupying lesions.

Brain Injuries

[Neurologic, electro- and echoencephalography studies of former high-risk children and control children].

First results of neurological, electro-encephalographic and echo-encephalographic examinations obtained from three different groups consisting of former high-risk babies (about two thirds) and control children (about one third) are presented. As was to be expected, the control group showed remarkably fewer findings which differed from the physiological variation width. The comparatively high proportion of individual results without pathological findings obtained from high-risk children indicates that reliable diagnostic conclusions can be drawn only if the results of various examination techniques are summarized. The analysis of a neurological longitudinal study of former high-risk infants reveals a trend toward recession of the neurological peculiarities over the observation period which lasted until the sixth year of age. This particularly applies to light phenomena of a neurological character which do not have syndrome character and are pathologically irrelevant. As a result of different interpretations of what "high risks" are, considerable problems can arise when the results of examinations performed on groups of high-risk children by various workers are to be compared.

Brain Damage, Chronic

Determination of brain death via pulsatile echoencephalography.

For cerebral death to occur there must be many levels of cerebral function destroyed. Cortical and subcortical irreversible damage is evident by unresponsiveness to any stimuli. Brain stem and basal ganglia damage is indicated by absence of spontaneous respirations, cephalic reflexes, and thus cerebral circulation. All elements of the criteria for cerebral death must be met. The decision should be made by the attending physician in consultation with his peers. The life support mechanisms should be discontinued after the diagnosis of cerebral death has been made. Absence of pulsatile echoes means absence of cerebral circulation and cerebral function, or a definitive diagnosis of cerebral death. It is a final parameter in the criteria and allows definite measures to be taken. But it behooves one to remember that this phenomenon of cerebral death makes organ donation and transplantation possible. It has not been created in order to supply the needs for organ transplant!

Adult

[Vertical echoencephalography in the diagnosis of space-occupying brain lesions].

Vertical probing used in addition to horizontal probing in echoencephalographic examination of patients allows more exact localization of the volumetric process, especially one situated parasagittaly. Transducers of three frequencies, 0.88, 1,76, and 2.64 m. c. s., are used in the examination of patients. It is shown that transducers with higher frequencies, 1.76 and 2.64 m. c. s., have advantages over a transducer with a frequency of 0.88 m. c. s.

Adult

[Pulsation echoencephalography--a bloodless method of measuring intracranial pressure].

By means of a special procedure an echo encephalograph can be modified in such a manner that changes in the amplitude of an echo peak can be detected and prepared for registration. In this iaay it is possible to single out the medium echo pulsations of the one-dimensional echo encephalography which have been known for a long time and prepare them for recording. In a number of zna persons without an indication of an increase in the intracranial pressure, medium echo pulkmon and ECG were simultaneously recorded. The quotient of the time T1 and R--T of the ECG was calculated 120 times and the respective mean value determined. The same measurements and calculations were then carried out for a total of 100 patients in whom clinical signs suggested an increase in the intracranial pressure (42 patients with extending processes in the supratentorial space, 16 patients with extending processes in the region of the posterior cranial fossa, 10 patients with hypophyseal adenomas, 10 patients with conditions after craniocerebral traumas, 5 patients with occlusions of the aqueductus, 7 patients with disturbances of the cerebrospinal fluid absorption and circulation and 10 patients with aneurysms). In all cases of clinically relevant signs of an increase in the intracranial presure the quotient of T1 and R--T was significantly higher than the calculated mean value. Variations of the pressure were rapidly detected. The results obtained were compared with those of other authors. Advantages and disadvantages of this method were discussed. The task was derived to compare the quotients found with the actual pressure values obtained by invasive methods in order to find out whether there are true correlations which might set the way for a non-bloody quantitative method.

Brain Diseases