Search PubMed⌕ Search

Biomedical subjects

F Kotlarek

Publications and source records attributed to F Kotlarek.

At least 37 records · Page 2Linked to original sources

[Early prognosis of cerebral haemorrhage in premature infants with birth weights less than 1500 g. A clinical and computed tomographic study (author's transl)].

22 premature infants with a birth weight less than 1500 g were studied by computed tomography. All of them needed intensive care therapy and had symptoms, which may have been caused by cerebral haemorrhage. In 15 cases (= 68%) we found subependymal and intraventricular bleeding. Clinical data showed that ventilated premature infants with subependymal and intraventricular haemorrhage needed respiratory support in the first hours p.p. because of hyaline membrane and aspiration syndroms. Premature infants without cerebral haemorrhage were ventilated much later (mean 96 h. p.p.). All patients with intraventricular haemorrhage and ventricular enlargement with and without parenchymal haemorrhage (grade III and IV) died. Prematures with subependymal haemorrhage (grad I) and intraventricular haemorrhage without ventricular dilation (grade II) may survive, depending on eventually present pulmonary complications. The introduction of computed tomography in the examination of the CNS on prematures can therefore help to give an early prognosis.

Birth Weight↗

[Cranial computerized tomography of neonatal encephalopathies. Initial and follow-up studies (author's transl)].

60 premature and newborn infants with clinical evidence of hypoxia or traumatic encephalopathy were examined by cranial computerized tomography (CCT) during the first fortnight of life and their findings compared with those of a "control group", consisting of 7 infants with malformations. 48 patients showed pathologic findings in the initial CCT. With regard to type, topography and extension, two groups with two subgroups could be outlined: 1. lesions with low density due to hypoxic-necrotizing alterations. a) Bilateral in the white matter around the frontal and occipital horns of the lateral ventricles in both, premature and fullterm newborn infants. b) Corresponding to vascular distribution, focal or global, involving both gray and white matter in both, premature and newborn infants. 2. lesions with high density due to hemorrhages. a) Subependymal and intraventricular, mainly in asphyxiated premature infants. b) Subdural and intracerebral, probably of traumatic origin, involving premature and fullterm newborn infants. The morphological findings in the initial CCT were compared with the outcome in each case. Thus, it was possible to distinguish certain morphological patterns significantly associated with prognosis. 14 patients (23.3%) died in the newborn period. The surviving 46 children (76.7%) were at least once re-examined by CCT and followed up during 6-24 months. 16 patients (26.7%) had a normal development. 12 (20%) showed developmental retardation. 18 (30%) suffered from neurological sequela. Frequently the early follow-up CCT showed characteristic patterns. We believe, that the great number of pathologic findings with essential information warrant the application of CCT in premature and fullterm newborn infants with persistent neurological signs. Perhaps our CCT observations will lead to the consequence of a more controlled high care regimen.

Brain Diseases↗

[Computertomographical details of neurological syndromes in the newborn period (author's transl)].

57 premature and full-term newborn infants suffering from a perinatal asphyxia were neurologically and computertomographically examined during their first two weeks of life. No pathognomonical morphological patterns were found comparing the neurological syndromes with the computertomographic results. However, characteristical morphologic findings were obtained related to gestational age and typical neurological syndromes of the newborn period. The cranial computerized tomography permits in many cases a localized topical diagnosis and early prognosis. These morphological findings can have therapeutical consequences.

Asphyxia Neonatorum↗

[Computerized tomography in neurodegenerative diseases in childhood (author's transl)].

The early diagnosis of neurodegenerative diseases in childhood is of great interest for genetic counseling. The development of cranial computerized tomography (CCT) has led to an improvement in the recognition of progressive neurological disorders. On one hand CCT is of importance in distinguishing the neurodegenerative diseases from perinatally acquired cerebral lesions. On the other hand CCT permits the differentiation from degenerations of cerebral gray and white matter. In this connection repeated controls with CCT are of great significance. 4 characteristic case studies are described.

Brain Diseases↗

[The significance of cranial computerized tomography for diagnosis and therapy of inflammatory diseases of the brain and meninges in children (author's transl)].

The significance of cranial computerized tomography (CCT) for the diagnosis and therapy of inflammatory diseases of the central nervous system in children is discussed in connection with five characteristic case studies. CCT is shown to be superior to classical neuroradiological approaches, and to allow important diagnostic insights: 1. the early recognition of diffuse brain edema and the resulting possibility of an early begin of therapy--2. the pathological expansions of the cerebral ventricles of various etiology before a pathological enlargement of the head can be detected, and the size of the ventricles after neurosurgical therapy can be measured--3. the early recognition of space-occupying inflammatory complications.

Brain Abscess↗

Cranial morphology in the 18p-syndrome.

Three of four recently described children with the 18p- syndrome were reinvestigated using cranial computerized tomography (CCT). More severe deformities were found in the cases with severe cerebral malformation, but there was no correlation with the degree of mental retardation.

Child↗

[The importance of linear fractures of the skull in infancy (author's transl)].

The importance of 33 infants with linear fractures of the skull caused by minor head injuries were studied. 32 of them were conscious and without neurological deficit. In 9 infants we noted transient focal pathological EEG changes. In 23 infants focal EEG findings due to functional disorders of the brain could not be demonstrated. But the considerable clinical importance of the linear fractures of the skull consists of the intracranial complications provoked by the anatomical specificities. This is demonstrated by an 8 months old infant, who developed an epidural hematoma after a minor head injury.

Accidents, Home↗

[Copper and zinc in cerebrospinal fluid of children with neurological diseases (author's transl)].

We examined CSF copper and zinc concentrations in 30 children with acute febrile illness and meningism (control group) and in 37 patients with shortlasting seizures, febrile or not, and acute viral meningitis. The trace elements were quantitatively measured by means of atomic absorption spectrophotometry. 1. It was shown that the concentrations of copper and zinc in CSF remain constant during childhood.--2. No increase could be found in the concentrations of copper and zinc in CSF caused by the neurological diseases of our patients. These data suggest that permanent cerebral lesions as a consequence of shortlasting seizures and viral meningitis would be very unlikely and that a transient dysfunction of metabolism does not liberate copper- and zinc-metallo-proteins in CSF. 3. There was no correlation between the protein concentration in CSF and copper and zinc concentrations in CSF.

Adolescent↗

[Fibromuscular dysplasia of the internal carotid and intracerebral arteries (author's transl)].

Fibromuscular dysplasia was found in six patients (four women over 50 years, a 20-year-old man and a five-year-old girl). Angiography (in five cases performed because of a cerebrovascular accident) gave the typical appearance of "knotted string" changes in the large and medium sized arteries. With marked localized arterial narrowing treatment is surgical. Conservative treatment remains sympotomatic because the cause of the disease is still unknown. Even surgical treatment brings only sympotomatic relief and, because of the slowly progressive nature, is indicated only when there are neurological signs.

Adult↗

[Stroke in the child: etiology, differential diagnosis, relevant diagnostic procedures and therapeutic possibilities].

Strokes in children occur in conjunction with arteriovenous malformations or with occlusive vascular diseases secondary to cardiac disease, intracranial infection, hematological and metabolic disorders. Recently several inborn errors of metabolism have been recognized as possible causes of strokelike events and should be considered in differential diagnosis. In a survey we describe our experience with stroke and strokelike episodes in childhood and discuss the approach selected for its management.

Adolescent↗

[Infarct of the basal ganglia in childhood--clinico-neuroradiologic findings and differential diagnosis].

Basal ganglionic infarctions during childhood are comparable in size and favourable prognosis with lacunary infarctions in adults. Considering their etiology they are comparable with capsular infarctions in adults. In four children with basal ganglionic infarctions and acute motoric hemiparesis, a quick and complete regression of clinical signs and CT-findings was observed. With regard to the differential diagnosis of basal ganglionic infarction we additionally report of a female patient with initially unilateral lesion who had silently developed the hemiparesis. In this case the clinical course and the neuroradiological follow-up findings suggested Leigh disease.

Adolescent↗

Hypoxic ischaemic encephalopathy: correlation between ultrasound and computed tomography.

Hypoxic ischaemic encephalopathy (HIE) is a major cause of motor and mental retardation. There ist no doubt that the haemorrhagic form of HIE can be detected by cerebral sonography, but it is of great interest to recognize non-haemorrhagic HIE as well. We demonstrate the follow-up of three patients with different types of non-haemorrhagic HIE: Periventricular leukomalacia in a critical ill premature infant 35 weeks gestational age, multicystic encephalopathy in a term newborn with severe perinatal asphyxia and circumscript ischaemic leukomalacia in a five month old infant with near miss event for sudden infant death. Correlation between ultrasound and computed tomography proved that non-haemorrhagic HIE produces global or circumscript high echogenicity in the first week after the hypoxic event whereas computed tomography shows pathologic hypodensity in the same areas. Cerebral sonography is a very helpful and harmless method for the difficult diagnosis HIE. In the case of periventricular leukomalacia, CT scan gives no further information and can be avoided. Concerning HIE of term newborns and small infants, CT scan remains necessary, to evaluate the extension of cerebral injury.

Asphyxia Neonatorum↗

[The problems of the decrease in periventricular density due to hypoxia in computer tomograms of new-born infants].

200 premature and mature neonates with clinical evidence of hypoxia or traumatic encephalopathy were examined by cranial computerized tomography (CT) during the first two weeks postnatally. The findings were compared with those in a "control group" consisting of 14 neonates with extraneural malformations. Cerebral hemorrhages were easily identified by their high density, in CT images. Bilateral areas of lowered density within the periventricular white matter, however, could not always be attributed to irreversible tissue damage prior to about 14 days after the hypoxic event in term newborns, and in preterm infants even later. During this early period of life an apparent decrease of periventricular density was regularly observed that must not be mistaken for a pathological change. In two cases persistent periventricular areas of decreased density were caused by neuropathologically verified foci of incomplete leucomalacia.

Cerebral Hemorrhage↗

[Cortical abnormalities of the brain. Morphologic and clinical findings].

Ten children at the age of 1-16 with various types of cortical dysplasias are demonstrated by means of computerized tomography. Clinical features of focal subcortical mass of heterotopic gray matter (focal pachygyria) are contralateral partial seizures (n = 5). Pachygyria commonly is associated with severe psychomotor retardation and epilepsy (n = 3). In two cases nodular heterotopias protruding the ventricular walls are accompanied by epilepsy only.

Adolescent↗