Pediatric neuroscience最新文献_第9页

Hyperbaric oxygen in the treatment of elevated intracranial pressure after head injury. 高压氧治疗颅脑损伤后颅内压升高。

Pediatric neuroscience Pub Date : 1988-01-01 DOI: 10.1159/000120406

J A Brown, M C Preul, A Taha

{"title":"Hyperbaric oxygen in the treatment of elevated intracranial pressure after head injury.","authors":"J A Brown, M C Preul, A Taha","doi":"10.1159/000120406","DOIUrl":"https://doi.org/10.1159/000120406","url":null,"abstract":"This study is the first to evaluate the effect of hyperbaric oxygen (HBO) on elevated intracranial pressure (ICP) after severe head injury during documented controlled ventilation, hypocapnea, and minute-by-minute ICP data collection. We studied the effect of HBO at 2 atmospheres absolute (ATA) with 100% O2, on ICP in 2 patients, aged 5 and 21 years. Each patient had diffuse cerebral swelling after blunt trauma and after a gun shot wound, respectively. Both required controlled hyperventilation, osmotic diuretics and ICP monitoring. ICP, mean arterial blood pressure, pulse and atmospheric pressure were recorded at 1-min intervals during 1-hour treatments and for 15 min before and after HBO therapy. Controlled hyperventilation was continued during HBO therapy and PCO; was measured at intervals. Each patient underwent 4 treatments. Data was divided into 5 phases, all at 100% O2; (1) prior to therapy; (2) during pressurization from 1 to 2 ATA; (3) at 2 ATA; (4) during depressurization from 2 to 1 ATA, and (5) after HBO therapy. During pressurization the mean ICP dropped from 13 to 8 Torr, rising to 14 Torr during HBO therapy at 2 ATA, and to 16 Torr during depressurization to 1 atmosphere, then returning to 12 Torr after HBO therapy. We conclude from this preliminary work that HBO may lower ICP in head-injured patients with diffuse cerebral swelling during the first 15 min, or pressurization phase, of therapy. However, rebound elevations in ICP may occur during or after treatment. No lasting effects of treatment were seen after concluding therapy. The effect of HBO on elevated ICP has not yet been clarified, but deserves further careful study in those patients with severe enough injury to require ICP monitoring.","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"14 6","pages":"286-90"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14397555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

An unusual syndrome of pediatric brainstem trauma. 小儿脑干创伤的一种罕见综合征。

Pediatric neuroscience Pub Date : 1988-01-01 DOI: 10.1159/000120403

D D Galyon, J A Winfield

引用次数: 3

Pediatric cerebral abscess. 小儿脑脓肿。

Pediatric neuroscience Pub Date : 1988-01-01 DOI: 10.1159/000120407

S D Moss, D G McLone, M Arditi, R Yogev

{"title":"Pediatric cerebral abscess.","authors":"S D Moss, D G McLone, M Arditi, R Yogev","doi":"10.1159/000120407","DOIUrl":"https://doi.org/10.1159/000120407","url":null,"abstract":"Fifty-four consecutive cases of children with cerebral abscess from 1958 to 1987 are reviewed. Their average age was 6.6 years, ranging from 3 days to 19 years. A wide range of organisms and underlying diseases was encountered. The predominant mode of surgical therapy was craniotomy with resection of the abscess. Aspiration and craniotomy with drainage-evacuation were also employed in our series. No underlying disease was found in 10 (19%) of the children. Cyanotic heart disease (CHD) was present in 13 (24%) of the children. Four children had dental abscesses and 1 had otitis media. Seven (13%) children had abscesses secondary to hydrocephalus/shunt infections. Sinusitis and otitis accounted for 5 cases (9%). Four children (7%) had tuberculomas. One abscess was associated with a nasal dermal sinus and one was congenital. Fourteen (26%) patients had negative cultures. Fourteen (26%) abscesses contained streptococci of various types. Staphylococci were found in only 5 (9%) of the abscesses. The congenital abscess was caused by salmonella. Two abscesses (7%) were fungal. Both of these patients died. Six children (11%) were treated without surgical intervention. Three of them died. Forty-eight children had surgical intervention; 12 underwent aspiration, 14 underwent open evacuation of the abscess, and 22 had abscesses resected. Mortality in the aspiration group was twice that of the evacuation or resection group (17, 7 and 9%), respectively). The factor which correlated best with mortality was the patient's clinical status on admission. The advent of CT scan at our facility improved mortality by facilitating accurate diagnosis and surgical intervention. Overall mortality rates decreased from 31 to 5.7% and surgical mortality fell from 21 to 2.9%.","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"14 6","pages":"291-6"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14397556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 30

Posterior fossa mass and hydrocephalus in a 7-month-old boy. 一个7个月大男孩的后窝肿块和脑积水。

Pediatric neuroscience Pub Date : 1988-01-01 DOI: 10.1159/000120391

L Schut, F Gilles, L B Rorke

引用次数: 0

Josef Warkany's contributions to the evolution of neuroteratology. 约瑟夫·沃卡尼对神经畸形学发展的贡献。

Pediatric neuroscience Pub Date : 1988-01-01 DOI: 10.1159/000120360

R J Lemire

引用次数: 0

Choroid plexus carcinoma of the fourth ventricle. Report of a case in an infant. 第四脑室脉络膜丛癌。报告一例婴儿病例。

Pediatric neuroscience Pub Date : 1988-01-01 DOI: 10.1159/000120378

B R Griffin, G R Stewart, M S Berger, J R Geyer, M O'Dell, S Rostad

引用次数: 23

Aggressive physiologic monitoring of pediatric head trauma patients with elevated intracranial pressure. 颅内压升高的儿童颅脑外伤患者积极的生理监测。

Pediatric neuroscience Pub Date : 1988-01-01 DOI: 10.1159/000120397

S S Kasoff, T A Lansen, D Holder, J S Filippo

{"title":"Aggressive physiologic monitoring of pediatric head trauma patients with elevated intracranial pressure.","authors":"S S Kasoff, T A Lansen, D Holder, J S Filippo","doi":"10.1159/000120397","DOIUrl":"https://doi.org/10.1159/000120397","url":null,"abstract":"The management of pediatric patients with severe head trauma often requires aggressive physiologic monitoring and treatment. As intracranial pressure (ICP) increases, so does mortality. Yet attempts to decrease elevated ICP can cause physiologic and hemodynamic problems. In this retrospective analysis of 25 patients treated with ICP monitoring alone, ICP measurements plus mannitol, or ICP measurements plus pentobarbital (PB) induced coma/mannitol, survival rates were higher than predicted, particularly among the most severely injured. These results were apparently due to the intensive care and aggressive monitoring. Although barbiturates are known to decrease ICP, the adverse effects encountered, including hypotension, cardiovascular depression and arrhythmias, often outweigh the benefits. Hemodynamic abnormalities are unpredictable and monitoring with Swan-Ganz catheter is useful in managing patients with PB-induced comas. Many failures of PB therapy in pediatric patients may be related to undiagnosed decreases in cardiac output, resulting in decreased cerebral blood flow, even with well-controlled ICP.","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"14 5","pages":"241-9"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14283105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 74

Ventricular volume regulation: a mathematical model and computer simulation. 心室容积调节:数学模型和计算机模拟。

Pediatric neuroscience Pub Date : 1988-01-01 DOI: 10.1159/000120367

H L Rekate, J A Brodkey, H J Chizeck, W el Sakka, W H Ko

{"title":"Ventricular volume regulation: a mathematical model and computer simulation.","authors":"H L Rekate, J A Brodkey, H J Chizeck, W el Sakka, W H Ko","doi":"10.1159/000120367","DOIUrl":"https://doi.org/10.1159/000120367","url":null,"abstract":"A mathematical model of ventricular volume regulation based on fluid mechanical principles has been constructed using a systems engineering approach. The parameters used in the model are based on clinical observation, laboratory investigation, and presumptions that will be tested later. The model was constructed to be the basis of a computer simulation. Using the computer simulation, information obtained from the literature and laboratory hypotheses regarding pathophysiology, several enigmatic conditions were tested. The model predicted that over-production of cerebrospinal fluid, as in the case of choroid plexus papilloma, could by itself lead to distention of the ventricular system. In simulating pseudotumor cerebri, if cerebrospinal fluid absorption at the arachnoid villi is impaired and the brain itself is rendered incompressible by swelling, intracranial pressure rises and ventricular volume diminishes. Conversely, in normal-pressure hydrocephalus, if cerebrospinal fluid flow is restricted between the spinal and cortical subarachnoid spaces and the brain is made more compressible, the ventricular volume increases with minimal increases in intracranial pressure. This mathematical model and its associated computer simulation is useful in predicting the behavior of the volume of the cerebral ventricles to a variety of pathological phenomena.","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"14 2","pages":"77-84"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120367","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14207049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 74

Conservative management of thrombosed vein of Galen malformations. Report of two cases and a review of the literature. 盖伦畸形血栓形成静脉的保守治疗。报告两例病例并复习文献。

Pediatric neuroscience Pub Date : 1988-01-01

E J Zampella, P A Aronin, G T Odrezin, E R Duvall

引用次数: 0

Pituitary stalk agenesis: magnetic resonance imaging of 'ectopic posterior lobe' with surgical correlation. 垂体柄发育不全:“后叶异位”的磁共振成像与手术相关性。

Pediatric neuroscience Pub Date : 1988-01-01 DOI: 10.1159/000120379

B A Kaufman, B Kaufman, T B Mapstone

引用次数: 16