Intracranial hemorrhage in premature infants.
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Cerebral Hemorrhage↗
Biomedical subjects
W C Hanigan
Publications and source records attributed to W C Hanigan.
Radiological and pathological findings in three cases of childhood pineocytomas.
The radiological and pathological findings in three children with pineocytomas are described. The patients presented with symptoms and signs of increased intracranial pressure. CT scans demonstrated obstructive hydrocephalus, but failed to visualize pineal masses that were subsequently seen on MR scans. A suboccipital, supracerebellar approach was used to obtain tissue for histological diagnosis and, in one case, achieve a total removal. Light microscopy demonstrated typical pineocytomatous rosettes without evidence of gangliocytic or astrocytic differentiation. Electron microscopy revealed numerous dense core vesicles with synaptic ribbons, suggesting neurosecretory capability. These three cases demonstrate the diagnostic advantage of MR imaging for tumors in the pineal region as well as the relatively well-differentiated histopathological characteristics of pineocytomas.
Brain Neoplasms↗
Clinical utility of magnetic resonance imaging in pediatric neurosurgical patients.
The clinical utility of magnetic resonance imaging in pediatric neurosurgical patients was reviewed in a series of 126 scans. MRI was determined to be superior or equivalent to other imaging techniques in the evaluation of intracranial hypertension, developmental abnormalities, or acute conditions involving the spinal cord. In 74% of the scans performed because of these clinical problems, adequate data were obtained for both specific anatomic diagnosis and surgical planning. The scan proved equivalent to CT in the imaging of structural abnormalities associated with seizure disorders or degenerative conditions. In acute head injuries and generalized infections of the central nervous system, MRI offered no advantage in diagnostic specificity, and had significant logistic limitations.
Acute Disease↗
Lawn dart injury in children: report of two cases.
Two cases of intracranial penetration by lawn darts are presented in this report. Both patients were children who developed infectious sequelae following primary closure of cutaneous puncture wounds. These injuries suggest that the darts produced a high-energy impact force that resulted in skull fractures and focal cerebral injury. When children present with puncture wounds or lacerations produced by lawn darts, intracranial penetration must be ruled out, using appropriate medical imaging. Parents should be advised regarding the need for medical reassessment should fever, headache, or local signs of infection occur.
Accidents, Home↗
MRI of cerebral vein thrombosis in infancy: a case report.
We diagnosed primary idiopathic cerebral vein thrombosis in an infant by MRI. The relative noninvasiveness of the scan, ease of imaging in multiple planes, and good image resolution suggest that the scan may be useful in this disorder.
Humans↗
Medical imaging of fetal ventriculomegaly.
Five cases of fetal ventriculomegaly are described in detail. Following ultrasonography, either computerized tomography or magnetic resonance imaging was used in an attempt to clarify the structural pathology of the ventriculomegaly. In two patients, a precise diagnosis was achieved while a probable diagnosis was established in a third patient. The diverse etiology of fetal ventriculomegaly in these five cases demonstrates that ancillary medical imaging may be necessary to achieve diagnostic precision prior to therapeutic intervention.
Adult↗
Diagnosis of subdural hemorrhage in utero. Case report.
A case is presented of subdural hemorrhage diagnosed in utero at 31 weeks of gestation by fetal ultrasonography. Following delivery, clinical examination of the infant revealed hydrops fetalis, right-sided cardiomegaly, hepatic dysfunction, and coagulopathy. Prompt resolution of these problems led to a retrospective diagnosis of premature closure of the foramen ovale as the precipitating event. The causes of previously reported cases of intrauterine cerebral hemorrhage are reviewed and compared to the present case.
Adult↗
Cerebral hemodynamics: effect of mannitol on the cerebral perfusion gradient.
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Blood Pressure↗
MRI and evoked potentials in a child with hydranencephaly.
Magnetic resonance imaging and evoked potential studies were performed on an infant with hydranencephaly. Magnetic resonance imaging demonstrated the absence of cortical tissue with a structurally intact mid- and hind-brain. Evoked potentials confirmed the loss of cortical activity with preservation of brainstem function. These diagnostic tests gave efficient and precise information concerning the extent of the intracranial pathology and prognosis.
Anencephaly↗
Magnetic resonance imaging of the Dandy-Walker malformation.
Five cases of the Dandy-Walker malformation are described using the magnetic resonance (MR) scan as a primary imaging technique. The patients' ages ranged from 34 weeks (in utero) to 41 years; their clinical and neuroanatomical characteristics encompassed the entire spectrum of the malformation. Clear visualization of the greatly enlarged posterior fossa, Dandy-Walker cyst, and absence of the inferior vermis established the pathological diagnosis and excluded other structural defects. In 3 patients, MR demonstration of the aqueduct and evidence of pressure on adjacent tissue aided in the surgical planning for ventricular decompression. The MR scan is a significant advancement in the radiological diagnosis of the Dandy-Walker malformation. The major technical advantage of the scan consists in its ability to delineate intracranial morphology in multiple planes.
Adult↗
Cerebral perfusion pressure in the high-risk premature infant.
Continuous monitoring of the cerebral perfusion pressure (CPP) and arterial blood gases was performed in 13 high-risk preterm infants. CPPs were monitored with a Ladd fiberoptic transducer. Blood gases were measured via umbilical artery lines. Monitoring was performed within 12 h following birth and continued for 48-72 h. The mean gestational age (+/- SD) was 30.6 +/- 3.1 weeks with a mean weight (+/- SD) of 1,326 +/- 511 g. Initial mean CPP (+/- SD) was 37.3 +/- 8.9 mm Hg with a mean initial intracranial pressure (ICP) of 2.7 +/- 1.8 mm Hg. During the trial period, a sustained CPP below 25 mm Hg for over 2 h was indicative of a poor neurological outcome. A sustained ICP over 7 mm Hg was indicative of intracranial hypertension, but occurred in relation to nursing events such as suctioning or positioning of the patient's head. Seven infants demonstrated significant linear relationships between CPP or ICP and levels of arterial pCO2 or pH. The mean Apgar scores were significantly higher for this group, but the presence of this relationship did not indicate a better neurological outcome.
Blood Pressure↗
MR imaging of a false carotid aneurysm.
Two months after a gunshot wound to the head of a 12-year-old boy, MR imaging outlined an asymptomatic false aneurysm of the carotid artery. The scan's ability to image in multiple planes with noninvasive visualization of pulsatile vessel flow suggests its use for follow-up examinations of traumatic injuries to the head or neck.
Carotid Artery Diseases↗