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At least 613 records · Page 34Linked to original sources
PubMed1992

Doppler flow velocities in children with controlled hydrocephalus: reference values for the diagnosis of blocked cerebrospinal fluid shunts.

Doppler flow velocities in the middle cerebral artery of children with blocked cerebrospinal fluid shunts show changes that can be used as a non-invasive method for assessing shunt function. The velocities also change with age, and the purpose of this study was to define a reference range of values for children with controlled hydrocephalus. Flow velocities were measured in 248 asymptomatic children with shunts and an age-reference range was derived. Twenty children were subsequently admitted with suspected shunt malfunction and 11 of these required a shunt revision. On admission 9 of the 11 children requiring operation had Doppler values outside the reference range, whereas none of the children whose symptoms settled without surgery had abnormal values. The reference range will facilitate the use of transcranial Doppler for the assessment of children with suspected shunt malfunction.

Adolescent↗
PubMed1992

Intracranial arachnoidal cysts.

Twenty-eight cases of intracranial arachnoidal cysts diagnosed during the period 1978-1990 are analyzed. All cases were investigated with computed tomography (CT), 5 with magnetic resonance imaging (MRI) and 5 with ultrasonography (US). Seventeen were located in the middle cranial fossa, 3 in the quadrigeminal cistern, 2 were parasagittal, 3 suprasellar and 3 were located in the posterior fossa. Twenty-three of the 28 patients were treated surgically, craniotomy with fenestrations was used in 3 cases. Different varieties of shunts were inserted in 8 cases and in the last 15 patients the only surgical treatment was the insertion of cysto-peritoneal (CP) drainage (without a valve) with excellent results. MRI and/or CT follow-up revealed disappearance of the cyst in 13 out of 22 cases and 7 experienced a marked reduction. In 2 patients the cyst showed little change. There were no cases of infection and no deaths.

Adolescent↗
PubMed1990

The use of two-dimensional Doppler sonography (color Doppler) in the diagnosis of hydranencephaly.

Hydranencephaly, first described by Cruveilhier, may be defined as a rare condition in which the cerebral hemispheres are replaced by membranous sacs filled with cerebrospinal fluid. Cerebral angiography is especially useful in differentiating hydranencephaly and severe hydrocephalus, massive subdural hygromas and alobar holoprosencephaly, but it is no better than other neuroradiological diagnosis methods in the neonate. This report outlines the diagnostic use of two-dimensional Doppler (color Doppler) in a child with hydranencephaly. Color Doppler was performed using an SSA-270A (Toshiba) with a 3.75 MHz phase-array sector scanning probe and no sedation. In this study, color Doppler demonstrated the internal carotid artery in the proximal portion, but the secondary and tertiary branches were not observed. In summary, color Doppler permitted early, easy diagnosis of hydranencephaly. In addition, the use of color Doppler was beneficial in diagnosing other anomalies of the central nervous system in neonates.

Blood Flow Velocity↗
PubMed1993

Heterogeneity of neurological syndromes in survivors of grade 3 and 4 periventricular haemorrhage.

To evaluate the topographical neurological distribution, patterns of abnormal tone and related functional neuromotor impairment after grade 3 and grade 4 intraventricular/periventricular haemorrhage (IPVH), 33 children with previous grade 3 or 4 IPVH of mean gestational age 30.9 weeks (range 25-40 weeks) and mean birth weight 1743 g (range 866-3600 g) were examined neurologically at 4.7 years (range 0.75-10.8 years). Neurological signs were absent in 10/33 cases which were equally distributed between the grade 3 and grade 4 IPVH groups. The largest single topographical neurological distribution was hemiparesis in 8/23, followed jointly by diplegia (cerebral paraplegia) in 6/23 and triplegia in 6/23 cases and finally quadriplegia in 3/23 cases. Grade 4 IPVH tended to result in asymmetrical syndromes, accounting for 7/8 cases of hemiparesis and 5/6 cases of triplegia, whereas all 3/3 cases of quadriplegia followed grade 3 IPVH. The 6/23 cases of diplegia were shared between the grade 3 and grade 4 IPVH groups. Tone was normal in 7/8 of the hemiparetic subjects. Dystonia was the commonest tone abnormality, affecting 8/23 children with neurological disturbance, followed by ataxia/hypotonia in 4/23 and mixed dystonia/hypotonia in 3/23. Only 1/23 cases had signs of spasticity. Spasticity is rare following severe IPVH. Diplegic children had a better functional neuromotor grade than hemiparetic children, who in turn did better than triplegic children. Ataxia hypotonia resulted in better functional outcome than dystronia, which in turn was more favourable than mixed tone patterns. Cranial imaging by ultrasound (US) or computed tomographic (CT) scanning proved an unreliable prognostic indicator except in the case of hemiparesis, for which US scans correctly predicted the affected side in 5/7 cases. The neurological syndromes following severe IPVH differ from the classical encephalopathy of prematurity, and this should lead to a re-appraisal of the trends in the prevalence of cerebral palsy. Caution should be exercised in the interpretation of cranial imaging with regard to pessimistic prognoses in the presence of changes or undue optimism in their absence.

Brain Damage, Chronic↗
PubMed1991

The lounging position for posterior fossa surgery: anesthesiological considerations regarding air embolism.

The sitting position for operations in the posterior fossa remains controversial in both adults and children, primarily because of the risk of air embolism. The reports on the incidence of this complication are varied. We retrospectively reviewed the data on 704 patients (age range 1-82 years) operated on in a lounging position for varied posterior fossa pathology from January 1984 up to December 1989. As diagnostic monitoring, we uniformly employed a Doppler ultrasound device, an atrial catheter, and capnometry. In 37 adults (5.5%) and 9 children (9/34) air embolism was diagnosed, without either morbidity or mortality. A lounging position, together with adequate infusion therapy and ventilation with PEEP, considerably reduces the risk of air embolism.

Adolescent↗
PubMed1984

Ultrasound in follow-up of the postoperative brain. Preliminary report on six cases.

The authors report on their early results in the ultrasound (US) follow-up of postoperative brain pathology, both supra- and infratentorial. The use of US is dependent on the presence of an acoustic window in the skull after craniotomy. Five patients were investigated via a suboccipital craniotomy and one patient via a temporal skull defect. In the patients with a suboccipital craniotomy the greatest part of the posterior fossa, the 3rd and lateral ventricle could be made visible. In a patient with a temporal craniotomy the involved parts of the brain were demonstrated satisfactorily. If a skull defect persists after surgery US may be of value in the follow-up of postoperative conditions, such as the assessment of tumour residue or recurrence, hydrocephalus, postoperative complications and response to radio- or chemotherapy.

Adolescent↗
PubMed1985

Ultrasonography of supra-aortic trunks.

Ultrasonography by the Doppler technique combined with B-mode echotomography are useful methods in the investigation of disease of the major arteries in the neck supplying the brain. The investigations are described together with the significance of major findings.

Brain Ischemia↗
PubMed1975

[Two-dimensional ultrasonic diagnosis of brain tumors and subdural hematomas by electronic sector scanning (author's transl)].

Electronic sector scanning (ESS) is a new two-dimensional ultrasonic technique which provides continuous and instantaneous cross-sections of intracranial structures through the intact skull, including the ventricles and large cerebral arteries, by means of a stationary probe. 2. The efficiency of the ESS in the diagnosis of brain tumors and extracerebral hematomas in 295 neuroradiologically controlled cases out of an unselected number of patients during 1972-1974 is described. 3. Supratentorial brain tumors can be detected directly with the ESS by abnoramal reflections of the tumors as well as indirectly by displacement of intracranial reference structures, mainly the ventricular borders. In 239 cases of suspected brain tumor, 126 were neurodiologically confirmed as supratentorial brain tumors. Among these 126 brain tumors the correct localization was determined by the ESS in 86.5%. 4. The highest reliability of the ESS proved to be the direct demonstration of frontal tumors (93%), whereas space-occupying lesions near the midline could be shown only in 79%. Up to now there have been difficulties in the diagnosis of tumors situated near bony structures, e.g., calvarian meningiomas. 5. Subdural hematomas (56 patients) could be lateralized correctly in 93%. Hwever, direct demonstration of the border of the hematomas could be achieved only in 48,2%. Chronic subdural hematomas in children are easier to recognize and the border could be demonstrated in 18 out of 19 cases. 6. The clinical applicability and diagnostic values of the ESS as a nontraumatic investigation procedure are discussed in comparison to cerebral angiography, pneumoencephalography, brain scintigraphy, and CAT scan. scintigraphy, and CAT scan.

Age Factors↗
PubMed1984

CCT and sonographic findings in congenital craniopharyngioma.

In a case of congenital craniopharyngioma results of the sonographic and CCT examinations are reported and compared with postmortem macroscopic cuts. Comparison is made of clinical data from six cases with congenital craniopharyngioma as reported in the literature.

Craniopharyngioma↗
PubMed1992

Hemodynamic and electrophysiological evaluation following extracranial/intracranial bypass surgery.

We examined 50 patients with an extracranial/intracranial bypass using transcranial Doppler blood flow mapping, somatosensory evoked potentials, and computer-assisted EEG analysis. The investigation was supplemented by temporary compression of the extracranial supplying vessel. Transcranial Doppler sonography revealed in addition to 4 patients with nonpatent anastomoses, a bypass-mediated retrograde flow in the ipsilateral middle cerebral artery beyond a depth of 40 mm in the majority of patients. In 9 patients, retrograde flow could be demonstrated in the whole proximal (M1) MCA segment. The precommunicating segment of the anterior cerebral artery (A1) could be reliably insonated in all but 5 patients. Bypass-compression dependent alterations in the SSEP and in EEG analysis were only observed in a small number of patients. Transcranial Doppler sonography, with the aid of the flow mapping system, appears therefore, to be a reliable and repeatedly performable noninvasive technique for the assessment of intracranial hemodynamics following bypass surgery.

Adult↗