[Ultrasound diagnosis of intracranial hemorrhage in premature infants].
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Biomedical subjects
Publications and source records attributed to D Hörmann.
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47 infants with myelomeningocele were investigated by ultrasound after the surgical closure of the cele and followed up to 12 months. The aim was the early diagnosis of hydrocephalus and the recording of morphological features of the ventricular system in comparison with hydrocephali of other origins, especially of Chiari-Syndrome. 31 infants needed a shunt due to rapid progress of the ventricular dilatation and clinical signs of a raised intracranial pressure: in 25 of this group (81%) the ultrasound investigation demonstrated a Chiari-Syndrome. Of 16 further infants who definitely did not need a shunt, only 5 (31%) had a Chiari-Syndrome. Therefore, the first sonographic examination seems to provide a certain prognostic evidence for the development of a hydrocephalus.
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Thirteen children with intervertebral disc calcifications of the cervical, thoracal and lumbar spine have been diagnosed since 1970. Most of them were observed over a period of several years. Ten children fell ill with acute pains, but only 2 of them suffered from a trauma. In 3 cases the features were discovered accidentally combined with malformations of vertebral bodies and congenital diseases. Our results suggest a primary structural inferiority of the calcified discs. The calcifications arise partially from a birth trauma, partially from an unknown etiology. They can last for a long time without symptoms. An acute event effects the pains due to shifting or herniation of calcified disc-fragments. Secondary findings such as decrease of the height of cervical vertebral bodies or destructions of the endplates of thoracal and lumbar vertebral bodies disappear retarded and often incompletely and demand a control for a long time.
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The cause of premature craniosynostosis after ventricular shunting in hydrocephalic children is until now not completely understood. In 331 children we observed 41 premature synostoses (12,4%) of the satural sagittalis, coronaria, lambdoidea, either singular or in various combinations. These findings are compared with clinical data and X-ray findings of skull and ventricular system of the patients. The results suggest a congenital origin, in all probability caused by primary malformation of the basis of the skull. Most of the cranio-stenoses are attributed to a common origin of hydrocephalus and craniostenosis.
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