Search PubMed⌕ Search

Biomedical subjects

E B Hendrick

Publications and source records attributed to E B Hendrick.

At least 37 records · Page 2Linked to original sources

Recognition memory of item, associative and serial-order information after temporal lobectomy for seizure disorder.

Children, adolescents, and young adults with temporal lobectomy judged the context of their encounters with a word (by deciding about its prior occurrence or familiarity) and also identified word attributes involving associative content and serial order (by indicating word meanings and reconstructing word sequences). Laterality of temporal lobectomy was important for identifying familiarity: individuals with right-sided temporal lobectomies made better judgements than those with left resections about the prior occurrence of target words, with the more successful performance depending on enhanced sensitivity to the familiarity or non-familiarity of what was heard. Identifying the attributes of an item, as contrasted with its prior occurrence, depended on aspects of temporal lobe disorder in conjunction with laterality: deficits of brain structure involving histopathology and significant tissue loss disrupted content memory; compromised brain function resulting from certain post-infantile seizures impaired memory for serial order. In the young brain after temporal lobectomy, there exists a functional dissociation between judging the familiarity of an event and identifying its attributes, a dissociation that depends, not only on laterality of surgery, but also on the structural and functional intactness of the residual brain.

Adolescent↗

Matson lecture 1988.

Explore the source record for details and available documents.

History, 20th Century↗

A technique for removal of an adherent ventricular catheter.

A method of freeing the attachment of the intraventricular catheter to the ventricular ependyma or chorioid plexus is described. A metal ventricular cannula is inserted into the lumen of the ventricular catheter and a cutting current from a unipolar diathermy is applied to the distal end. The cutting effect at the interventricular end of the metal cannula effectively lyses the adhesions and permits safe removal of the ventricular catheter without subsequent bleeding.

Cerebrospinal Fluid Shunts↗

Language of hydrocephalic children and adolescents.

How adequate a substrate for the development of language is the young hydrocephalic brain? To answer this question, the development of five language domains (word finding, fluency and automaticity, immediate sentence memory, understanding of grammar, and metalinguistic awareness) was studied in children and adolescents, 75 with hydrocephalus in the first year of life, and 50 normal controls. The results revealed a limited resilience of language to the effects of early hydrocephalus. Resilience was indicated by the finding that, for several language skills, hydrocephalics scored at comparable levels to normals and improved their test performances as they matured. The limits to resilience were also apparent. Language development was not uniform after early hydrocephalus, and, within particular language domains, hydrocephalics were either less skilled or less able to maintain age-appropriate skill mastery than normal peers. Early hydrocephalus had diverse effects on language development: Of the variables measuring its forms, manifestations, and treatments, some were indicative of preserved language functioning while others were predictive of language deficit. The young hydrocephalic brain mediates language development in a manner that is adequate, but far from ideal.

Adolescent↗

Transependymal benign dorsally exophytic brain stem gliomas in childhood: diagnosis and treatment recommendations.

Sixteen children with dorsally exophytic transependymal benign brain stem gliomas were treated at the Hospital for Sick Children, Toronto, between 1949 and 1985. The diagnosis of these benign brain stem gliomas was based on neuroradiographic and operative observations. Five children were diagnosed in the pre-computed tomography (CT) era using ventriculography and pneumoencephalography, and 11 children were diagnosed using CT with and without contrast enhancement. Histological diagnosis was obtained in all 16 cases. In 1980, we first described this distinct group of benign brain stem gliomas, which accounted for 8% (total, 121 cases) of all brain stem gliomas diagnosed at our institution. However, with the use of high resolution CT in recent years, earlier and better definition of this particular type of brain stem tumor can be made. During the 10 years (1976 to 1985) in which CT has been used for preoperative evaluation in our institution, we have treated 49 patients with primary brain stem tumors. Eleven of these cases (22%) fell into the category of dorsally exophytic transependymal benign brain stem tumors. These tumors characteristically protrude into and largely fill the 4th ventricle, breaking through the overlying ependyma and frequently extending into the cisterna magna. On CT, they are isodense and enhance brightly with contrast agent. Clinically, these patients have a longer history of symptoms in comparison with patients with the more malignant, intrinsic types of brain stem tumor. All of our patients were treated by subtotal resection. Radiotherapy was utilized in 7 of the 16 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Neoplasms↗

Hydrosyringomyelia and its management in childhood.

Syringomyelia, once regarded as a degenerative disease of adults, is now recognized to be a disorder usually associated with the Chiari malformation and occurring in patients of all ages. We have reviewed 47 patients with syringomyelia treated on the Neurosurgical Service at the Hospital for Sick Children during the years 1977 to 1985. Twelve of these patients had a Chiari I malformation, 30 had a Chiari II malformation, and 5 had an acquired Chiari malformation. Thirty-one of these patients were treated by decompression of the Chiari malformation and plugging of the obex, 5 were treated by a simple posterior fossa decompression, 9 were treated by shunting of the syringomyelic cavity, and 2 were treated by a combined decompression of the posterior fossa and shunting of the syrinx. The Gardner procedure (decompression of the Chiari malformation and plugging of the obex) was the procedure most commonly used in managing our group of patients and resulted in improvement in over 70% of patients.

Adolescent↗

Congenital spinal cord tumors in children.

The paediatric spinal cord may host a wide variety of congenital tumors, the most common of which have been discussed. Although the majority of these lesions are benign their delayed diagnosis, serious infectious complications or associated congenital anomalies may expose the patient to life threatening morbidity or serious permanent disabilities. Prompt surgical management provides a cure in most instances, and the gratification of a neurologically intact child.

Child↗

The value of CSF flow studies in infants with communicating hydrocephalus.

The authors describe their technique of dynamic CSF scanning utilizing the radionuclide material Tc-99m diethylentriamine-pentacetic acid (DTPA). Thirty-four infants with macrocephaly and enlarged intracranial CSF spaces were investigated with this technique. The resulting studies were graded according to severity. The grading scheme was of value in determining which patients would benefit from a CSF diversionary shunt.

Cerebrospinal Fluid Shunts↗

Traumatic infarction of the spinal cord in children.

Infarction of the spinal cord in childhood is rarely due to trauma. During a 15-year period (1971 to 1985), eight children were admitted to The Hospital for Sick Children, Toronto, with a diagnosis of traumatic infarction of the spinal cord. All of these patients had delayed onset of neurological signs varying between 2 hours and 4 days after their initial trauma. No bone abnormalities were seen on plain spine x-ray films. Myelography was carried out in seven of these children and found to be normal in all seven. Six patients who were paraplegic at the time of admission remained permanently paraplegic, but two with incomplete cord signs did show some improvement.

Angiography↗

Diagnosis and management of pediatric brain-stem gliomas.

The authors reviewed the cases of 49 children, ranging in age from 9 months to 15 years, who were diagnosed by computerized tomography (CT) as having brain-stem glioma. Four distinct groups of brain-stem gliomas were identified based on CT scan characteristics: Group I included isodense contrast-enhancing tumors that were dorsally exophytic into the fourth ventricle; Group II(a) included hypodense nonenhancing intrinsic tumors of the brain stem; Group II(b) included intrinsic tumors of the brain stem with hyperdense exophytic components extending ventrally and laterally into the cerebellopontine and prepontine cisterns; Group III included intrinsic cystic tumors with contrast-enhancing capsules; and Group IV included focally intrinsic tumors of the brain stem that were isodense and enhanced brightly on administration of contrast medium. The clinical presentation, efficacy of surgical intervention, pathology, and prognosis of these tumors were correlated within these groupings. Eleven patients had Group I tumors, all of which were surgically resected; 10 of the 11 lesions were proven to be low-grade gliomas. These patients had an excellent prognosis; 10 of the 11 survived, with a mean follow-up period of 4.5 years. There were 18 patients with Group II(a) tumors; although tumor biopsy was attempted on eight of these, pathological diagnosis at the time of surgery was made in only one case. These patients did poorly; the mean survival time was 6.2 months. The seven Group II(b) tumor patients demonstrated a similarly poor prognosis: all of them died within 23 months of diagnosis, with a mean survival time of 12 months. Only two of six patients undergoing biopsy had sufficient tissue for histological verification. Three of the four patients with Group III tumors died; their mean survival time was 11.5 months. Successful histological examination was carried out in all four cases. The nine Group IV tumor patients did reasonably well; seven of these patients remain alive, with a mean follow-up period of 2.3 years. Histological diagnosis was obtained in three of the seven patients who were explored in this group. This classification system has proven to be of value in determining prognosis and efficacy of surgical intervention.

Adolescent↗

Visual loss in pseudotumor cerebri of childhood. A follow-up study.

The occurrence of visual loss in substantial numbers of adult patients with pseudotumor cerebri is well recognized. In children, the disease has been said to spare the visual system. We evaluated the ophthalmologic features of 36 children with pseudotumor cerebri followed up for one to 12 years. Four patients had rapid, severe loss of visual acuity and visual field changes while receiving medical therapy. Six others had less-severe but prominent abnormalities of visual acuity and/or visual fields at some point during the disease process. Only one patient had a permanent, severe visual impairment, but five had moderate permanent visual abnormalities. A severe degree of papilledema was seen only in the group with visual loss, but some patients in this group had only moderate papilledema. More patients with dural sinus thrombosis had serious visual loss than did those with other associated diseases or idiopathic pseudotumor cerebri. Quantitative perimetry of some sort can be performed in most children and is the preferred sequential test for planning treatment.

Adolescent↗

Decreased risk of infection in cerebrospinal fluid shunt surgery using prophylactic antibiotics: a case-control study.

Four randomised controlled trials have focussed on the use of prophylactic antibiotics in the prevention of cerebrospinal fluid (CSF) shunt infection. None of these studies has been able to demonstrate a statistically significant difference in rate of infection. This may be due to the inadequate power of the studies to detect a clinically significant difference, as a result of small sample size. This retrospective case control study was designed using the same basic principles of avoidance of bias which make randomised controlled trials the model studies for generation of scientific evidence. It has found a highly statistically significant difference in the use of antibiotics among infected compared to non-infected patients, suggesting a three times greater risk of infection among patients who did not receive antibiotics. This study provides the strongest evidence to date regarding the usefulness of perioperative antibiotics in CSF shunt surgery.

Adolescent↗

Management of lipomyelomeningoceles. Experience at the Hospital for Sick Children, Toronto.

Ninety-seven children with lipomyelomeningoceles were operated on at the Hospital for Sick Children between January, 1960, and December, 1982. The most common factor that caused these patients to seek help was the cosmetic effect of the mass on their back. However, 22 patients had urinary incontinence and 15 patients had a deformed or weak leg. Sixty of the 97 patients were female and 37 were male. The patients presented for treatment between 6 days and 18 1/2 years of age with a median age of 7 1/2 months. Fifty-six patients presented before the age of 6 months and 35 of these were perfectly normal at the time of presentation. On the other hand, of the 41 patients who were brought for treatment after the age of 6 months, only 12 were normal prior to surgery. When patients were appropriately treated at an early age, with their spinal cords untethered and their dura securely closed with a dural graft, then they remained unchanged neurologically or even improved. However, when treatment was delayed or not done appropriately then they were left with significant neurological sequelae. Lipomyelomeningoceles are serious lesions which without appropriate therapy can result in gross impairment of neurological function.

Adolescent↗

Experience with pineal region tumours in childhood.

Sixty-one children with pineal region tumours were managed at the Hospital for Sick Children during the period 1950-1982. Histologic verification of these tumours was possible in forty-six children. Although germ cell tumours were the commonest form, germinomas only made up one third of the pineal region tumours. Since 1967, an aggressive approach has been adopted in the management of pineal region tumours at the Hospital for Sick Children with thirty-four patients having direct surgery on their pineal region mass out of a total of forty-one patients with such tumours. The operative mortality for pineal tumour surgery has steadily fallen so that the operative mortality between 1975 and 1982 was 4.3% and there have been no operative deaths since 1977 among the thirteen patients with pineal region tumours who have been operatively treated. Pineal tumours are operable lesions which should be removed if they are benign. Histologic confirmation should be obtained if they are malignant in order to provide for rational management of these lesions.

Adolescent↗

Arteriovenous malformations of the brainstem in childhood.

Brainstem vascular malformation are an uncommon but lethal problem in pediatric neurosurgery. 9 children with confirmed vascular malformations in the brainstem are presented, and the treatment options considered. The recent encouraging results concerning the operative management of these lesions, deserves fullest consideration with the hope that an aggressive management plan can be instituted for the child who otherwise will experience repeated hemorrhage and die from the malformation.

Adolescent↗

Myxopapillary ependymoma of the filum terminale and cauda equina in childhood: report of seven cases and review of the literature.

Seven of fourteen children with spinal cord ependymoma had myxopapillary tumors of the filum terminale. These tumors made up 15.9% of all primary spinal neuroectodermal tumors in children (44 cases) seen during a 62-year period (1919 to 1981). Their clinical presentation, radiological features, pathological findings, treatment, and outcome are reported. Six of the seven patients were known to be alive at the time of writing. The seventh patient was lost to follow-up after 3 years without tumor recurrence. Of 5 patients whose primary mode of treatment was operation alone. 3 had intraspinal or intracranial recurrences. Despite tumor recurrences, 2 patients were long term survivors after further operation and irradiation, whereas the third patient recently received craniospinal irradiation for intracranial tumor recurrence. The 2 patients who did not have tumor recurrence after operation alone had been followed for 3 and 7 years, respectively. Two children with subtotal tumor resection and spinal irradiation had no recurrences at 1 and 17 years, respectively. Our data suggest that this unusual subtype of spinal ependymoma is not uncommon during childhood and has a good prognosis. All patients with this tumor require prolonged follow-up for tumor recurrence after operation and irradiation.

Adolescent↗

Primary intracranial choriocarcinoma: a report of two cases and a review of the literature.

Among 848 cases of primary intracranial malignancy seen during a 63-year period at a pediatric hospital, there were 2 cases of primary pineal choriocarcinoma. The clinical and laboratory findings of these 2 cases were similar to those of 33 cases of intracranial choriocarcinoma reported in the literature. In 1 patient with precocious puberty, the diagnosis was confirmed by labeling human chorionic gonadotropin (HCG) within the tumor, which had been stored for 25 years. In the other patient, who is alive and well 18 months after diagnosis, the response to cranial irradiation and intensive chemotherapy was monitored with serial measurements of serum, cerebrospinal fluid, and urinary HCG and with computed tomography. We conclude that intensive chemotherapy, radiation, and tumor resection, if feasible, offer the best chance of curing this otherwise fatal disease.

Adolescent↗