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Biomedical subjects

J Shillito

Publications and source records attributed to J Shillito.

At least 37 records · Page 2Linked to original sources
PubMed1981

Chiari I "malformations"--an acquired disorder?

Caudal herniation of the hindbrain, indistinguishable from the Chiari I deformity, may occur after the establishment of spinal subarachnoid shunts and become symptomatic years after the procedure. Examples are presented and others are cited from the literature. It is proposed that the force responsible for the displacement is the difference in pressure between the cranial and spinal compartments. On the basis of these observations and other considerations as well, a similar process, disproportionate absorption of cerebrospinal fluid from the spinal region, might account for the spontaneous form of the Chiari I deformity.

Absorption↗
PubMed1980

Extradural masses at the foramen magnum in children.

This report describes the clinical features, treatment, and sequelae in 3 children with extradural masses in the region of the foramen magnum. Such lesions are rare, their nature diverse, and their treatment hazardous. The common presenting feature was neck stiffness.

Child↗
PubMed1977

Syringomyelia following lumboureteral shunting for communicating hydrocephalus. Report of three cases.

Three patients are described in whom syringomyelia was identified long after the treatment of communicating hydrocephalus by a lumboureteral shunt. The reason for syrinx formation in these cases could not be determined. In two there was either autopsy-proven or presumed evidence for arachnoiditis, and in the third patient the symptoms of syringomyelia were acutely aggravated by temporary obstruction of shunt. The development of a pressure drop from the intracranial compartment to the spinal compartment with crowding at the foramen magnum is also a suggested mechanism.

Adolescent↗
PubMed1976

Strokes in children.

Nine cases have been presented in detail to illustrate some of the varied causes of sudden neurological deficit in childhood: arteriovenous malformation, cryptic hamartoma, berry aneurysm, mycotic aneurysm, intraspinal arteriovenous malformation, brain tumor, migraine, arteritis, and multiple sclerosis. The Boston Children's Hospital experience with aneurysms and intracranial arteriovenous malformation has been summarized. It is noteworthy that a cutaneous hemangioma overlay one cranial and one intraspinal arteriovenous malformation. One small but deep cerebral arteriovenous malformation apparently destroyed itself after its second hemorrhage. Not only have multiple sclerosis and a brain tumor mimicked a vascular lesion, but a series of vascular accidents was misdiagnosed first as multiple sclerosis then as a thalamic tumor. The many possible causes of childhood strokes has been thoroughly cataloged in the Report of the Joint Committee for Stroke Facilities in 1973 (11). Children may be more susceptible to strokes because of congenital abnormalities such as congenital heart disease, hemophilia, and sickle cell anemia, or by diseases which more commonly occur in this age group, such as leukemia. The likelihood of brain abscess in cyanotic congenital heart disease is stressed. Arteriographic studies in our series have been safe; however, there have been reports of probable worsening of symptoms in children with multiple cerebral occlusive lesions in the presence of homocystinuria.

Adolescent↗
PubMed1975

Infections of cerebrospinal fluid shunts: epidemiology, clinical manifestations, and therapy.

During a 10-year period shunt infections occurred in 27% of the 289 hydrocephalic patients who had cerebrospinal fluid shunts inserted at Children's Hospital Medical Center. The rate of infection did not vary with the type of shunt. Staphylococcus epidermidis and Staphylococcus aureus were responsible for one-half and one-quarter of the infections, respectively. Removal of the infected shunt in conjunction with administration of systemic antibiotics was effective therapy. Use of systemic antibiotics alone was generally ineffective and was associated with an increased mortality rate. Infection itself was a significant risk factor, raising the mortality rate from 17% to 40%. Clustering of infection within two months of surgery and similar rates of infection for ventriculo-atrial and ventriculo-peritoneal shunts indicate that the infecting organisms are usually introduced during the perioperative period. The possibility that prophylactic antibiotics or different shunt materials might reduce the infection rate requires further study.

Blood↗
PubMed1971

Spontaneous intracerebral haemorrhage in patients suspected of multiple sclerosis.

Two cases of spontaneous intracerebral haemorrhage in adolescent girls suspected of having multiple sclerosis are reported. Surgical evacuation of haematomas in the left thalamus and left side of the pons, respectively, was performed with excellent recovery in both cases. Some clinical and pathological aspects of small arteriovenous malformations are discussed and the pertinent literature reviewed.

Adolescent↗