SUBDURAL FLUID AS A CONSEQUENCE OF PNEUMOENCEPHALOGRAPHY

PEDIATRICS ◽  
1950 ◽  
Vol 5 (3) ◽  
pp. 375-389
Author(s):  
HONOR V. SMITH ◽  
BRONSON CROTHERS
Keyword(s):  
Cerebral Palsy ◽  
Subdural Hematoma ◽  
Cerebral Atrophy ◽  
Mental Deficiency ◽  
Signs And Symptoms ◽  
Brain Lesions ◽  
Subdural Space ◽  
Suitable Treatment ◽  
Superior Longitudinal Sinus ◽  
The Brain

When lumbar or cisternal pneumoencephalography is carried out on children with nonprogressive brain lesions causing mental deficiency, cerebral palsy or epilepsy, air is seen in the subdural space in at least a third of cases. This proportion is much larger in children 2 years of age or under. The roentgenographic appearances of subdural air are described and the importance of not attributing these appearances to cerebral atrophy or hypoplasia is emphasized. In approximately one third of cases in which air enters the subdural space, that is, in from 10% to 15% of all cases, recovery from pneumoencephalography is delayed by the development of signs and symptoms suggesting a rise in intracranial pressure. In such cases fluid can usually be found by needling the subdural space. Typically this fluid is characteristic of that found in subdural hematoma. There is no evidence that such a collection of fluid was present before pneumoencephalography. It is therefore suggested that as air enters the subdural space and the brain falls away from the dura, vessels may be torn as they cross this space to reach the superior longitudinal sinus, with the formation of what may be termed subdural hematoma artefacta. Although the incidence of this complication is moderately high, its effects are seldom serious, provided the situation is appreciated and suitable treatment given. The length of time the child spends in the hospital is, however, often greatly prolonged and occasionally operation proves necessary for removal of a subdural membrane. Since the subdural hematoma is an artefact occurring in the course of treatment, its removal does not influence the ultimate prognosis.

scholarly journals A Critical Evaluation of Current Concepts in Cerebral Palsy

Physiology ◽  
2019 ◽  
Vol 34 (3) ◽  
pp. 216-229 ◽  
Author(s):  
Joline E. Brandenburg ◽  
Matthew J. Fogarty ◽  
Gary C. Sieck
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Cerebral Palsy ◽  
Animal Models ◽  
Critical Evaluation ◽  
Brain Lesions ◽  
Spastic Cerebral Palsy ◽  
Diagnostic Symptoms ◽  
Brain And Spinal Cord ◽  
The Brain

Spastic cerebral palsy (CP), despite the name, is not consistently identifiable by specific brain lesions. CP animal models focus on risk factors for development of CP, yet few reproduce the diagnostic symptoms. Animal models of CP must advance beyond risk factors to etiologies, including both the brain and spinal cord.

Round Table Discussion

PEDIATRICS ◽  
1953 ◽  
Vol 11 (2) ◽  
pp. 166-173
Author(s):  
MEYER A. PERLSTEIN ◽  
EUGENE T. MCDONALD
Keyword(s):  
Cerebral Palsy ◽  
Motor System ◽  
Mental Deficiency ◽  
Round Table ◽  
Round Table Discussion ◽  
Motor Center ◽  
Generic Term ◽  
The Many ◽  
The Brain

Chairman Perlstein: In neuromuscular disabilities there are many problems to consider. However, about half of these comprise that group of diseases we know as cerebral palsy. We will start by orientating ourselves toward cerebral palsy, and in the discussion taking up the question of differential diagnosis and related subjects. Cerebral palsy is not a single disease but a group of conditions which have in common a disorder of the motor system. It can be paralysis, incoordination, tremors or excessive motions, due to involvement of the motor centers of the brain. In other words, palsy and cerebral are defined. The important thing about cerebral is that the motor centers must be involved. If the problem is lack of development because of mental deficiency, you can exclude it. Likewise, spinal palsy, polio, and other causes of motor defects not due to involvement of the motor center are excluded. In schools for children with physical handicaps of all types, about half the children are cerebral palsied. So, from the viewpoint of frequency, cerebral palsy is the most frequent of the disabling conditions. Much confusion exists in the terminology and classification of cerebral palsy. The term "Little's disease" has often been used as a generic term to cover all forms of cerebral palsy. Actually, Little described only one of the many types. Likewise, the term "spastic" is often used by the doctor and laymen to cover all categories. This tendency is conducive to loose thinking. A logical classification of the types of cerebral palsy would help to clarify this confused subject.

CLINICAL CONFERENCE

PEDIATRICS ◽  
1957 ◽  
Vol 20 (3) ◽  
pp. 561-564
Author(s):  
Joseph Ransohoff
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Subdural Space ◽  
Anterior Fontanelle ◽  
History Of ◽  
Group A ◽  
Therapeutic Problem ◽  
The Brain ◽  
Tentative Diagnosis ◽  
Internal Hydrocephalus

Dr. Ransohoff: I want to draw your attention to a group of infants with chronic subdural hematoma. The distinctive feature of these patients is marked enlargement of the skull. This megalocephaly was of such a degree in eight patients we treated that they were all admitted to the hospital with a tentative diagnosis of internal hydrocephalus. The presence of subdural hematoma was only discovered in these children at the time of tipping the subdural space through the enlarged anterior fontanelle prior to carrying out ventriculography. When air is injected into the subdural space in these patients, roentgenograms reveal fairly normal-sized cerebral hemispheres surrounded by hugely distended subdural spaces. We believe that it is this disproportion between the size of the boney vault and the size of the underlying brain which makes this group a special therapeutic problem (Fig. 1). When a surgeon drains blood and fluid from the subdural space, he expects the underlying compressed brain to re-expand and obliterate the remaining cavity. If the lesion is of long standing, he may find it necessary to remove the inner membrane of the subdural hematoma, which is covering the surface of the brain, before the expected re-expansion can occur. However, when the cranium has been so enlarged by bilateral subdural collections that it is considerably larger than the normal-sized brain, the brain cannot be expected to re-expand sufficiently to fill the entire cavity. We became aware of this therapeutic dilemma after applying the usual techniques of treatment to a 3-month-old infant admitted in 1952 with a definite history of trauma. After the removal of about 350 ml of subdural fluid by daily subdural taps, we made bone flaps, bilateral and frontoparietal, and removed the inner membranes of the subdural hematomas, 1 week apart.

scholarly journals Subdural hematomas in young children: clinical and electrophysiological features

2020 ◽  
Vol 10 (6) ◽  
pp. 93-99
Author(s):  
Tat’yana V. Melashenko ◽  
Maria Yu. Fomina ◽  
Ivan N. Usenko ◽  
Yuriy V. Rodionov
Keyword(s):  
Young Children ◽  
Brain Damage ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Cerebral Atrophy ◽  
Psychomotor Development ◽  
Behavioral Disturbances ◽  
Subdural Hematomas ◽  
Structural Epilepsy ◽  
The Brain

Subdural hematoma is a sufficiently rare, but serious pathology of the brain in infants, which can lead to severe neurological deficit or result in death. Subdural hematomas are detected in 2025 per 100,000 children under 1 year. A retrospective analysis of autopsy material revealed that subdural hematomas were diagnosed in 72% of children who died before the age of 5 months from intracranial hemorrhage. According to localization, subdural hematomas are divided into supra- and subtentorial, mainly associated localization, which are located along the tent of cerebellum and sickle of the brain, mainly. The main mechanism of development of subdural hematomas is associated with the rupture of the bridge veins of the subdural space as a result of their tension, both traumatic etiology and nontraumatic brain damage, accompanied by progressive cerebral atrophy. It is believed that perinatal hypoxic-ischemic brain damage is one of the leading etiological factors of developed subdural hematomas in young children. In addition, the formation of subdural hematomas in young children can be observed with intraamniotic infections, congenital fermentopathies, and above all, in children with aciduria. In some infants, subdural hematomas occur without clinical manifestation, but in most cases are accompanied by the development of neurological disorders, both in acute and in distant periods. In the main, subdural hematomas in the acute period manifest with focal convulsions with secondary generalization of seizures, behavioral disturbances, respiration, and symptoms of intracranial hypertension. During the formation of chronic subdural hematoma, development of structural epilepsy (up to 20%), microcephaly, impaired psychomotor development is observed. In 55% of young children with acute subdural hematomas, the formation of chronic subdural hematomas is observed.

“Where is Dementia?” A Systematic Literature Review Exploring Neuroanatomical Aspects of Dementia

2017 ◽  
Vol 2 (15) ◽  
pp. 9-23 ◽  
Author(s):  
Chorong Oh ◽  
Leonard LaPointe
Keyword(s):  
English Language ◽  
Signs And Symptoms ◽  
Behavioral Symptoms ◽  
Journal Articles ◽  
People With Dementia ◽  
Different Types ◽  
Precise Diagnosis ◽  
Physical Changes ◽  
The Brain ◽  
Language Literature

Dementia is a condition caused by and associated with separate physical changes in the brain. The signs and symptoms of dementia are very similar across the diverse types, and it is difficult to diagnose the category by behavioral symptoms alone. Diagnostic criteria have relied on a constellation of signs and symptoms, but it is critical to understand the neuroanatomical differences among the dementias for a more precise diagnosis and subsequent management. With this regard, this review aims to explore the neuroanatomical aspects of dementia to better understand the nature of distinctive subtypes, signs, and symptoms. This is a review of English language literature published from 1996 to the present day of peer-reviewed academic and medical journal articles that report on older people with dementia. This review examines typical neuroanatomical aspects of dementia and reinforces the importance of a thorough understanding of the neuroanatomical characteristics of the different types of dementia and the differential diagnosis of them.

scholarly journals Risk factors for hip dislocation in dyskinetic cerebral palsy

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110011
Author(s):  
Kyoko Okuno ◽  
Yukihiro Kitai ◽  
Toru Shibata ◽  
Hiroshi Arai
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Birth Weight ◽  
Gestational Age ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Lesion Location ◽  
Hip Displacement ◽  
Gmfcs Level

Purpose: To investigate the risk factors for hip displacement in patients with dyskinetic cerebral palsy (DCP). Methods: We evaluated 81 patients with DCP, 45 males and 36 females, aged 10–22 years, risk factors for hip displacement were evaluated using multivariate logistic regression analysis with primary brain lesions, Gross Motor Function Classification System (GMFCS) level, gestational age, birth weight, Cobb’s angle, and complication of epilepsy as independent factors. Hip displacement was defined as migration percentage >30%. Primary brain lesions were classified into globus pallidus (GP), thalamus and putamen (TP), and others using brain magnetic resonance imaging (MRI). Perinatal and clinical features were compared between patients with GP lesions and those with TP lesions. Results: Hip displacement was observed in 53 patients (67%). Higher GMFCS levels (p = 0.013, odds ratio [OR] 2.6) and the presence of GP lesions (p = 0.04, OR 16.5) were independent risk factors for hip displacement. Patients with GP lesions showed significantly higher GMFCS levels, more frequent hip displacement, and lower gestational age and birth weight than those with TP lesions. Conclusion: Primary brain lesion location may be an important factor in predicting hip displacement among patients with DCP. Appropriate risk assessment using brain MRI may contribute to the early detection and intervention of hip displacement because brain lesion location can be assessed during infancy before GMFCS level is decided.

Rapid correction of severe hyponatremia in the rat: histopathological changes in the brain

1985 ◽  
Vol 248 (5) ◽  
pp. F711-F719 ◽  
Author(s):  
J. C. Ayus ◽  
R. K. Krothapalli ◽  
D. L. Armstrong
Keyword(s):  
Serum Sodium ◽  
Brain Lesions ◽  
The Other ◽  
Histopathological Changes ◽  
Water Restriction ◽  
Severe Hyponatremia ◽  
Group Iii ◽  
Group I ◽  
The Brain ◽  
Rapid Correction

The purpose of the present studies was to examine the effects of rapid correction of severe hyponatremia (serum sodium less than 120 meq/liter) either to mildly hyponatremic levels (serum sodium = 130 meq/liter) or to normonatremic levels (serum sodium = 150 meq/liter) on the brain histology of rats. In group I, 13% of the rats revealed brain lesions following correction to mildly hyponatremic levels by the administration of 855 mM NaCl. All the rats (100%) in group II had brain lesions following correction to normonatremic levels by 24 h of water restriction. Similarly, all the rats in group III showed brain lesions following correction to normonatremic levels by the administration of 855 mM NaCl. Severe hyponatremia by itself did not cause any brain lesions in another group. We conclude that rapid correction of severe hyponatremia to mildly hyponatremic levels by the administration of 855 mM NaCl does not cause significant brain lesions. On the other hand, rapid correction to normonatremic levels either by water restriction or by the administration of 855 mM NaCl results in significant brain lesions.

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