Randomised trial of early tapping in neonatal posthaemorrhagic ventricular dilatation
Article Abstract:
Posthemorrhagic ventricular dilatation is the enlargement of the cerebral ventricles, or brain cavities, following bleeding into the brain. This disorder can lead to hydrocephalus, an increased accumulation of cerebrospinal fluid (CSF), which surrounds the brain and spinal cord, in the ventricles. More than 50 percent of affected infants develop cerebral palsy, paralysis on both sides of the body due to brain damage or birth injury, and delayed development occurs in one third of patients. Posthemorrhagic ventricular dilatation may result from blockage by blood clots of pathways by which CSF is drained from cerebral ventricles. This may lead to increased CSF pressure within the ventricles. A CSF tap is a method of emptying excess CSF from the cerebral ventricles to relieve pressure. The effectiveness of treatment by early repetitive CSF taps was compared with that of conservative management in 156 infants at 15 centers. Before follow-up was accomplished, 30 infants had died and six had moved away. During the first two weeks of the study, infants who received early treatment had five times more taps and 12 times more CSF removed. CSF was found to be infected in seven infants receiving early treatment and four infants treated conservatively. Sixty-two percent of infants from both groups required ventricular shunts, or artificial passages, to remove excess CSF and relieve pressure in the brain. The infants were examined at 12 months of age to assess development of their nervous systems. Neuromotor signs were abnormal in 103 infants, and disabilities were detected in 88 patients. These findings suggest that early treatment was not beneficial in children without lesions of the functioning tissue in the brain. Most children with parenchymal lesions had impaired neuromotor function, and early treatment reduced the incidence of other disabilities. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
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The iris in Williams syndrome
Article Abstract:
Williams syndrome is characterized by mental deficiency, an elfin-like appearance of the face, and narrowing of the aorta, a major blood vessel. This disorder may also be associated with narrowing of the pulmonary artery (a blood vessel supplying the lungs), abnormalities of the teeth, and increased blood calcium levels in infancy. The most common features of Williams syndrome include early feeding problems, mild slowing of growth, mental deficiency, a friendly and outgoing personality, hoarse voice, small wide-spaced teeth, and various abnormalities of the heart. Other studies have reported a characteristic pattern of the iris, the colored contractile membrane of the eye. This pattern has been described as stellate, or star-shaped, and may be caused by the underdevelopment of the supporting tissues within the eye. However, the stellate pattern of the iris may also occur in normal individuals, although the incidence is not known. The incidence of a stellate pattern of the iris in patients with Williams syndrome was shown to range from 69 to 100 percent. The usefulness of the stellate pattern as a diagnostic marker in patients with Williams syndrome was assessed. The eyes of 43 children with Williams syndrome and 124 normal subjects were photographed, and the photographs were examined by three ophthalmologists and four geneticists. A stellate pattern on the iris was detected in 51 percent of patients with Williams syndrome and 12 percent of normal subjects. This characteristic pattern was more difficult to detect in dark-colored eyes. These findings suggest that the stellate pattern on the iris may be useful in the diagnosis of Williams syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
User Contributions:
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