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B-mode echoencephalography in the normal and high risk infant
ABSTRACTS
238
ischemia was mainly caused by extension type supra-condylar fracture of the humerus and type II by closed fracture of the radius and ulna, while in the lower limb fracture of the femoral shaft caused type I and fracture of the tibia type II ischaemia. Delay in diagnosis of the ischemia occurred in patients with head injury and significantly in children in Bryant's traction. Late diagnosis, with fully established ischemia, produced a poor result. Awareness of the possible complication, with a search for pain particularly on passive stretching of suspected muscles is the best way of detecting the lesion early in a potential reversible phase when arterial exploration in type I and decompression of compartment by fasciotomy in type II is indicated.--M. G. H. Smith
Indications for Osteosynthasis of the Upper Extremity in Children. P. Galle, L. Schmid, and E. Horcher. Acta Chir
Aust 11/2:41-43, 1979. Three hundred and forty-three childhood fractures of the upper extremities were treated within a 2-yr period. Only 33, (9.6%) underwent operation, including 8 replantations. Osteosynthesis is indicated only in clavicular pseudarthrosis, in joint fractures of the scapula as well as in irreducible and third grade compound fractures. Fractures of the radial or ulnar shaft are always treated conservatively.--G. Brandesky
Two-Stage Corrective Surgery for Congenital Deformities of the Spine. K. D. Leatherman and R. A. Dickson. J Bone
Joint Surg 61B:324-328, (August), 1979. A technique is described in which correction of congenital spinal deformity has been obtained, mainly in the presence of scoliosis with hemi-vertebrae or unilateral fusion bars. Of 60 patients, 50 had such scoliosis and the other 10 had congenital kyphosis, all of the latter with a neurologic involvement. Stress is placed on the two stage nature of the procedure, avoiding stretching of the spine by first stage anterior resection of the vertebral bodies followed by posterior element removal and posterior fusion a few weeks later, with Harrington rod fixation if needed. The operative technique is described in detail. The results produced a substantial correction of deformity and in the case of kyphosis neurologic improvement.--M. G. H. S m i t h
A Prospective Study of Children With Untreated Cattarall Group Perthes" Disease. M . E. Blakemore and M . H. M .
Harrison. J Bone Joint Surg 61B:329-333, (August), 1979.
To test the assertion that the natural history of Perthes' disease falling into the Catterall Group I classification cannot be improved by treatment a prospective study of 20 children (24 hips) was carried out. With a minimum followup of 4 yr, by three different techniques of assessment, the affected hips were found to be approaching normality, with none worsening during the period while no treatment was offered. Even the use of the hips subject to weight bearing in some degree of adduction while the contralateral hip (of severe grade of Perthes') was treated in a containment device did not cause deterioration.--M. G. H. S m i t h
The African Neonatal Hip and its Immunity From Congenital
Dislocation. A. P. Skirving and W. J. Scadden. J Bone Joint Surg 61B:339-341, (August), 1979.
In an effort to determine anatomical features which may endow the African with immunity to congenital dislocation of the hip, 20 fullterm African neonates who had died were examined. No significant differences between Africans and Caucasians could be found in terms of acetabular or femoral anteversion but the acetahulum was found to be deeper and to vary less in its depth in the African. This factor may be reievant.--M. G. H. S m i t h
NERVOUS SYSTEM B-Mode Echoencephalography in the Normal and High Risk Infant. M. L. Johnson, L. A. Mack, C. M. Rumack, el al.
Am J Roentgenol 133:375 381, (September), 1979. Twenty-five normal term infants and 41 high risk infants underwent B-mode echoencephalography. CT scans performed in the high risk infants revealed excellent correlation with echo findings. The 41 high risk infants were examined because of rapidly growing head size, craniomegaly at birth, or clinical suspicion of intracranial hemorrhage. Twenty-five infants had normal B-mode echoencephalograms and all had normal clinical examinations, short term follow-up and nine had normal CT scans. Twelve of 16 infants with CT evidence of intracranial hemorrhage developed hydrocephalus and all were detected by B-mode echoencephalograms. B-mode studies correlated well with CT scan and even were more accurate in measuring the ventricular size due to the large differences in acoustic impedence between brain and CSF. Occipital horn dilatation was found to be the most sensitive indicator of hydrocephalus. Intraventricular blood clot was identified in four infants and parencephalic cysts diagnosed in four infants. Echoencephalograms, enhanced by more sophisticated equipment, correlate well with CT scans in diagnosing hydrocephalus in infants and represent a less expensive examination with no ionizing radiation risk for follow-up examination of these patients.--Randall W. Powell Clonic Hemifaeial Spasm From Posterior Fossa Artariovanous Malformation. A. Pierry and M. Cameron. J Neural
Neurosurg Psychiatr 42:670-672, (July), 1979. This is a case report of a 21-yr-old woman who presented with a two year history of right sided clonic hemifacial spasm. CAT Scan and vertebral angiography revealed a large arteriovenous malformation on the right side of the posterior fossa. Clipping of the vessels and freeing of the facial nerve resulted in a cure. The Authors review the literature and conclude that over the last 30 yr, there is an increasing volume of evidence to support the hypothesis that hemifacial spasm is often caused by structural vascular abnormalities.--R. J. Brereton Hemophilic Neuromyopathy. C. R. Defaria, S. E. MeloSouza, and E. D. Pinherio. J Neural Neurosurg Psychiatr 42:600~605, (July), 1979.
The authors examined 10 hemophilic patients and found varying degrees of muscle atrophy. Serum enzyme levels
238
ischemia was mainly caused by extension type supra-condylar fracture of the humerus and type II by closed fracture of the radius and ulna, while in the lower limb fracture of the femoral shaft caused type I and fracture of the tibia type II ischaemia. Delay in diagnosis of the ischemia occurred in patients with head injury and significantly in children in Bryant's traction. Late diagnosis, with fully established ischemia, produced a poor result. Awareness of the possible complication, with a search for pain particularly on passive stretching of suspected muscles is the best way of detecting the lesion early in a potential reversible phase when arterial exploration in type I and decompression of compartment by fasciotomy in type II is indicated.--M. G. H. Smith
Indications for Osteosynthasis of the Upper Extremity in Children. P. Galle, L. Schmid, and E. Horcher. Acta Chir
Aust 11/2:41-43, 1979. Three hundred and forty-three childhood fractures of the upper extremities were treated within a 2-yr period. Only 33, (9.6%) underwent operation, including 8 replantations. Osteosynthesis is indicated only in clavicular pseudarthrosis, in joint fractures of the scapula as well as in irreducible and third grade compound fractures. Fractures of the radial or ulnar shaft are always treated conservatively.--G. Brandesky
Two-Stage Corrective Surgery for Congenital Deformities of the Spine. K. D. Leatherman and R. A. Dickson. J Bone
Joint Surg 61B:324-328, (August), 1979. A technique is described in which correction of congenital spinal deformity has been obtained, mainly in the presence of scoliosis with hemi-vertebrae or unilateral fusion bars. Of 60 patients, 50 had such scoliosis and the other 10 had congenital kyphosis, all of the latter with a neurologic involvement. Stress is placed on the two stage nature of the procedure, avoiding stretching of the spine by first stage anterior resection of the vertebral bodies followed by posterior element removal and posterior fusion a few weeks later, with Harrington rod fixation if needed. The operative technique is described in detail. The results produced a substantial correction of deformity and in the case of kyphosis neurologic improvement.--M. G. H. S m i t h
A Prospective Study of Children With Untreated Cattarall Group Perthes" Disease. M . E. Blakemore and M . H. M .
Harrison. J Bone Joint Surg 61B:329-333, (August), 1979.
To test the assertion that the natural history of Perthes' disease falling into the Catterall Group I classification cannot be improved by treatment a prospective study of 20 children (24 hips) was carried out. With a minimum followup of 4 yr, by three different techniques of assessment, the affected hips were found to be approaching normality, with none worsening during the period while no treatment was offered. Even the use of the hips subject to weight bearing in some degree of adduction while the contralateral hip (of severe grade of Perthes') was treated in a containment device did not cause deterioration.--M. G. H. S m i t h
The African Neonatal Hip and its Immunity From Congenital
Dislocation. A. P. Skirving and W. J. Scadden. J Bone Joint Surg 61B:339-341, (August), 1979.
In an effort to determine anatomical features which may endow the African with immunity to congenital dislocation of the hip, 20 fullterm African neonates who had died were examined. No significant differences between Africans and Caucasians could be found in terms of acetabular or femoral anteversion but the acetahulum was found to be deeper and to vary less in its depth in the African. This factor may be reievant.--M. G. H. S m i t h
NERVOUS SYSTEM B-Mode Echoencephalography in the Normal and High Risk Infant. M. L. Johnson, L. A. Mack, C. M. Rumack, el al.
Am J Roentgenol 133:375 381, (September), 1979. Twenty-five normal term infants and 41 high risk infants underwent B-mode echoencephalography. CT scans performed in the high risk infants revealed excellent correlation with echo findings. The 41 high risk infants were examined because of rapidly growing head size, craniomegaly at birth, or clinical suspicion of intracranial hemorrhage. Twenty-five infants had normal B-mode echoencephalograms and all had normal clinical examinations, short term follow-up and nine had normal CT scans. Twelve of 16 infants with CT evidence of intracranial hemorrhage developed hydrocephalus and all were detected by B-mode echoencephalograms. B-mode studies correlated well with CT scan and even were more accurate in measuring the ventricular size due to the large differences in acoustic impedence between brain and CSF. Occipital horn dilatation was found to be the most sensitive indicator of hydrocephalus. Intraventricular blood clot was identified in four infants and parencephalic cysts diagnosed in four infants. Echoencephalograms, enhanced by more sophisticated equipment, correlate well with CT scans in diagnosing hydrocephalus in infants and represent a less expensive examination with no ionizing radiation risk for follow-up examination of these patients.--Randall W. Powell Clonic Hemifaeial Spasm From Posterior Fossa Artariovanous Malformation. A. Pierry and M. Cameron. J Neural
Neurosurg Psychiatr 42:670-672, (July), 1979. This is a case report of a 21-yr-old woman who presented with a two year history of right sided clonic hemifacial spasm. CAT Scan and vertebral angiography revealed a large arteriovenous malformation on the right side of the posterior fossa. Clipping of the vessels and freeing of the facial nerve resulted in a cure. The Authors review the literature and conclude that over the last 30 yr, there is an increasing volume of evidence to support the hypothesis that hemifacial spasm is often caused by structural vascular abnormalities.--R. J. Brereton Hemophilic Neuromyopathy. C. R. Defaria, S. E. MeloSouza, and E. D. Pinherio. J Neural Neurosurg Psychiatr 42:600~605, (July), 1979.
The authors examined 10 hemophilic patients and found varying degrees of muscle atrophy. Serum enzyme levels