Child's brain最新文献

29 cases of intracranial aneurysms in children under 16 years of age are reviewed. The prodrome, presentation, location of aneurysm, and outcome are discussed. Evidence is presented to encourage a more aggressive evaluation of suspected subarachnoid hemorrhage in children.

Computed tomography of 8 cases with West's syndrome before, during and after ACTH treatment are reported. The scans, performed at the third week of therapy, showed consistent widening of the sulci, cisterns and ventricles in all the patients. Of these, 2 patients underwent ICP monitoring which showed higher than normal values. A return to the normal ICP values in association with the disappearance of the CT findings was observed in both cases. It is concluded that widening of the sulci, cisterns and ventricles are not findings of atrophy, but a condition of initial communicating hydrocephalus, which is in accordance with the hypotheses of Riikonen and Lyen.

Different degrees of cerebral calcifications together with encephalofacial angiomatosis and seizure disorders characterize the Sturge-Weber syndrome. According to the observations reported in the literature, calcium deposits may be found in the wall of cerebral vessels, in the perivascular tissue and rarely within the neurons. Corresponding to the variety of localizations, the interpretation of the phenomenon remains obscure. Most theories postulate the role of a vascular factory and of a mesenchymal factor. Ultramicroscopic studies of the specimens obtained in 2 children with the Sturge-Weber Syndrome provided the following findings. A mucopolysaccharidic substance constitutes the substratum for the deposition of calcium. Small amounts of this substance and calcium deposits may be detected within the connective tissue of cerebral vessels precociously; later on, while increasing in size and calcium concentration, they obviously migrate to outside the vessels. Successively, the calcium deposits seem to localize around the blood vessels, In our opinion, these observations stress the role of a primitive vascular factor; consequently, anoxia, necrosis of cerebral tissues, and variation in the calcium ion concentration would act only as secondary factors.

The fine structure of a human medulloblastoma cell strain characterized by the emission of two types of cytoplasmic processes was studied with particular regard to the cytoskeleton organization of the cell processes. A particular abundance of intermediate filaments (6-11 nm) was found in the primary processes. This study suggests that this abundance can strongly condition the cell shape of in vitro medulloblastoma cells and can represent a marker of this type of cells.

The adult survivors of the treatment of brain tumours in childhood are often short. Several adverse factors contribute to the impaired growth of these children including growth hormone (GH) deficiency, impaired spinal growth following spinal irradiation, chemotherapy, poor nutritional intake and recurrent tumour. The GH deficiency is due to radiation-induced damage to the hypothalamic-pituitary axis. GH is always the first pituitary hormone to be affected by such radiation damage but panhypopituitarism may occur if the radiation dose is sufficiently great. Preliminary results suggest that GH therapy will improve the growth rate of children with radiation-induced GH deficiency. Additional endocrine complications, which may occur following spinal irradiation, include thyroid dysfunction and ovarian failure due to direct radiation damage to the thyroid and the ovary.

Spinal dysraphism entirely confined to the cervical or dorsal levels is uncommon. In a large series affecting all levels, only 26 such cases that required operation were found. These are described in order to determine their particular features which include a high incidence of expanding lesions (dermoid cyst and neurenteric cyst) and are therefore associated with a much higher risk of morbidity than dysraphism, at lower levels.

Localization of seizure focus if surgical extirpation is contemplated is critical. It is routine to use cortical recording and stimulation for this purpose but the limited time available in the operating room limits what can be learned. We report a flexible electrode array of four 0.05 disc which can be banked to larger sizes, and left in place subdurally as well as epidurally. It can be used for stimulation as well as recording.