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Biomedical subjects

W S Ball

Publications and source records attributed to W S Ball.

At least 73 records · Page 4Linked to original sources
PubMed1990

Reversal sign on CT: effect of anoxic/ischemic cerebral injury in children.

A retrospective study was performed to determine the clinical and pathologic features, etiology, and outcome of children with the reversal sign. The reversal sign, a striking CT finding, probably represents a diffuse, anoxic/ischemic cerebral injury. CT features of the reversal sign are diffusely decreased density of cerebral cortical gray and white matter with a decreased or lost gray/white matter interface, or reversal of the gray/white matter densities and relatively increased density of the thalami, brainstem, and cerebellum. Twenty children with the reversal sign were retrospectively analyzed. We divided the patients into three groups: (1) acute reversal, (2) intermediate group, and (3) chronic reversal. There were nine cases of trauma (seven of child abuse); nine hypoxia/anoxia incidents (birth asphyxia, drowning, status epilepticus); one bacterial meningitis; and one degenerative encephalitis. All acute- and intermediate-group patients had respiratory problems requiring ventilator support and intensive care. In five of seven patients who died, autopsy findings were consistent with anoxic/ischemic encephalopathy. Surviving patients have profound neurologic deficits with severe developmental delay. The CT reversal sign carries a poor prognosis and indicates irreversible brain damage.

Brain Edema↗
PubMed1989

Choroideremia and hypopituitarism: an association.

Choroideremia is a rare X-linked, progressive, degenerative disease of the retina and choroid. We describe 2 patients, one a female, with choroideremia documented to have hypopituitarism and neurological abnormalities. We hypothesize that this previously undescribed association results from a degenerative process involving tissues of neural origin, or from contiguous submicroscopic gene deletions in the X chromosome region that define choroideremia and possibly hypopituitarism.

Adolescent↗
PubMed1989

Management of cerebral cavernous angiomas in children presenting with seizures.

Until recently intracranial cavernous angiomas were thought to be rare vascular malformations that usually presented in adulthood as an intracerebral hemorrhage, an expanding mass lesion, or with the new onset of seizures. Prior to the advent of computed tomography (CT), and more recently magnetic resonance imaging (MRI), their diagnosis in childhood was extremely rare. However, the CT and MRI features of cavernous angioma are quite distinctive and allow early diagnosis and treatment. Advances in surgical techniques permit successful removal of these potentially devastating lesions and amelioration of the associated seizure disorder. Seven children with cerebral cavernous angiomas have been treated at the Children's Hospital Medical Center since 1980. Six children presented with seizures and one with an intracerebral hemorrhage. All had characteristic findings on CT and/or MRI and underwent surgical excision of symptomatic lesions. Intraoperative sonography, electrocorticography, and cortical mapping were used when indicated and were found to be helpful in the surgical management of these patients. Our experience suggests that symptomatic cerebral cavernous angiomas in children are not as rare as previously thought and that surgical treatment using modern neurosurgical techniques is both safe and appropriate and can be helpful in the management of associated seizures.

Adolescent↗
PubMed1989

Cranial chordomas in infancy and childhood. A report of two cases and review of the literature.

Cranial chordomas are uncommon, accounting for less than 1% of all intracranial neoplasms. Although they are presumed to arise from congenital notochordal remnants, it is rare for these tumors to present in childhood. Only 35 cases of cranial chordomas have been reported in children 16 years of age or younger. We report 2 additional cases of pediatric cranial chordomas. One occurred in a 4 month old infant and to our knowledge represents the earliest age of presentation yet reported. The second case documents the value of MR imaging in delineating the extent of the tumor and defining its relationship to adjacent structures.

Child↗
PubMed1989

Mediastinal hemorrhage during extracorporeal membrane oxygenation.

A case of mediastinal hemorrhage along with hemorrhage into a pneumatocele while on extracorporeal membrane oxygenation (ECMO) is presented. Computerized tomography of the chest was utilized to support the diagnosis. Barotrauma to the lungs best explains the inciting event that allowed the hemorrhage to occur once the patient was heparinized for ECMO. This complication serves to point out the importance of commencing early ECMO support before widespread pulmonary and mediastinal barotrauma develops.

Barotrauma↗
PubMed1989

Computed arthrotomography as an adjunct to pediatric arthrography.

Computed arthrotomography was compared with conventional arthrography in ten cases and with both pluridirectional arthrotomography and conventional arthrography in five cases. Six elbows, five hips, three ankles, and one wrist were examined. Indications included pain, locking, congenital hip dislocation, posttraumatic joint deformity, and postinfectious joint deformity. Compared with conventional arthrography, computed arthrotomography provided additional information in ten of 15 (67%) cases and provided the same information in four cases. Arthrography and computed arthrotomography were complementary in one case. Compared with pluridirectional arthrotomography, computed arthrotomography provided additional information in two of five (40%) cases. In the remaining three cases, computed arthrotomography and pluridirectional arthrotomography provided equal information. In no case did pluridirectional arthrotomography provide additional information. Computed arthrotomography was useful in demonstrating loose bodies, differentiating air bubbles from loose bodies, and determining the intra- or extraarticular location of ossific densities. Computed arthrotomography appears to be a useful adjunct to arthrography in detecting loose bodies and in evaluating anatomically complex cases.

Adolescent↗
PubMed1989

Percutaneous drainage of chest abscesses in children.

Seven patients ranging in age from 3 to 18 years underwent percutaneous drainage of eight intrathoracic abscesses. Five of the abscesses were mediastinal or paramediastinal and resulted from esophageal perforation or esophageal anastomotic leakage. The abscesses resolved in each case, with a mean catheter drainage time of 28 days and no need for surgical intervention. Three of the abscesses were intrapulmonary, and each lay adjacent to a pleural surface. All three lung abscesses resolved within 19-24 days, without thoracotomy or wedge resection.

Abscess↗
PubMed1989

Congenital nasolacrimal mucoceles: CT evaluation.

A congenital nasolacrimal mucocele, a lacrimal sac mucocele with intranasal extension, is an uncommon mass arising in the medial canthal region of the orbit. The authors describe four infants who presented with medial canthal masses and nasal airway obstruction. All underwent computed tomographic (CT) evaluation, which revealed the triad of cystic dilatation of the lacrimal sac, dilatation of the nasolacrimal duct, and an intranasal cystic mass. Appropriate therapy was determined following identification of the intranasal cystic component. Relevant discussions of the embryology, clinical presentation, and the characteristic CT findings of infants with congenital nasolacrimal mucoceles are included.

Female↗