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  • 1
    Electronic Resource
    Electronic Resource
    Growth and endocrine disorders in optic glioma (1990)
    Springer
    European journal of pediatrics 149 (1990), S. 825-828 
    Details
    ISSN: 1432-1076
    Keywords: Growth hormone ; Precocious puberty ; Growth ; Optic nerve diseases ; Radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hypothalamo-pituitary function in children with optic glioma may be impaired by the tumour itself and by the high cranial radiation doses used in treatment. This study evaluates the effect of optic glioma and its treatment on patient growth and pubertal development. Twenty-one patients (13 boys, 8 girls), treated for optic glioma by cranial irradiation (45–55 Grays) at a mean age of 5.4 years, were evaluated before (n=10) and/or after (n=21) irradiation. Growth hormone (GH) deficiency was present in only 1 patient tested before irradiation and in all patients after irradiation. Precocious puberty occurred in 7/21 cases, before irradiation in 5 patients and after irradiation in 2 patients. The cumulative height loss during the 2 years after irradiation was 0.2±0.2 SD (m±SEM) in 7 patients with precocious puberty and 1.1±0.2 SD in 14 prepubertal patients (P〈0.01). The corresponding bone age advance over chronological age, evaluated 1–3 years after irradiation, was 1.1±0.5 and −0.7±0.3 year in the two groups (P〈0.01). The mean height loss between time of irradiation and the final height was 2.3±0.6 SD (n=6). Primary amenorrhoea, associated with low oestradiol levels, occurred in two of the three girls of pubertal age. These data indicate that the high dose of cranial radiation used to treat optic glioma invariably results in GH deficiency within 2 years and that hGH therapy is required when GH deficiency is documented. Precocious puberty, resulting in apparently normal growth velocity in spite of GH deficiency, should be treated with luteinizing hormone-releasing hormone analogues because of the risk of accelerated bone maturation and reduced final height.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02072067
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  • 2
    Electronic Resource
    Electronic Resource
    A new surgical approach to the third ventricle with interruption of the striothalamic vein (1979)
    Springer
    Acta neurochirurgica 47 (1979), S. 135-147 
    Details
    ISSN: 0942-0940
    Keywords: Third ventricle ; surgical approach ; striothalamic vein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the removal of tumours that develop within the third ventricle, most approaches are not entirely satisfactory. Therefore, a new approach has been devised: transfrontal exposure of the anterior portion of the frontal horn; coagulation and section of the striothalamic vein in order to open up the roof of the third ventricle; use of a blunt spatula introduced in the foramen of Monro and pushed backwards under the choroïd plexus. This approach has been used in ten cases. Postoperative mortality has been nil; the surgical approach has not apparently been responsible for any sequelae. It is simple and gives a good view of the third ventricle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406399
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  • 3
    Electronic Resource
    Electronic Resource
    Medulloblastoma in childhood. Survival and functional results (1979)
    Springer
    Acta neurochirurgica 48 (1979), S. 1-15 
    Details
    ISSN: 0942-0940
    Keywords: Medulloblastoma ; survival ; functional results ; side-effects of radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors report on a series of 57 medulloblastomas in children operated upon between 1964 and 1976. Among these children, 44 completed the treatment with radiotherapy to the whole central nervous system. The postoperative mortality rate is 10.5%. Postoperative deaths occurred mainly in infants or when a tumour involved the brain stem. The five-year survival rate is 54% in the whole series. It rose to 71% in the patients who completed the treatment with radiotherapy. The study shows that the life of survivals is frequently impaired by mental or behavioural disturbances. IQ varies from 70 to 90 in 58% of the children; it is below 70 in 31%. Behavioural disturbances are found in 93% of cases. 82% have defective spatial orientation, dysphasia, or dysgraphia. In order to evaluate the responsibility of X-ray therapy for the development of these sequelae, the results have been compared to those of a series of cerebellar astrocytomas surgically removed, but not irradiated. The comparison shows that radiotherapy is at least partially responsible for the mental and behavioural disturbances. No relation was found between these disturbances and a persistent ventricular dilatation or an endocrine dysfunction. However the endocrine assessment showed growth hormone deficiency in 65% of the children, short stature in 55%, and compensated hypothyroïdism in 58%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406016
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  • 4
    Electronic Resource
    Electronic Resource
    Lumbosacral lipomas with spina bifida (1988)
    Springer
    Child's nervous system 4 (1988), S. 354-360 
    Details
    ISSN: 1433-0350
    Keywords: Lumbosacral lipomas ; Lipomyelomeningoceles ; Spinal-lipomas ; Spina bidida ; Occult spinal dysraphism ; Fat metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pathological and metabolic characteristics, as well as the anatomical and functional evolution of lumbosacral lipomas, were studied in a series of 73 patients operated on between 1970 and 1983. The pathological study showed that they are mainly composed of adipocytes, but that they also possess fibrous tissue, vessels, and nerve fibers. Innervated muscle fibers, contracting under proper nerve stimulation, were found in several cases. Lipogenesis and lipolysis are the same in lumbosacral lipomas and in normal fat tissue. However, these lipomas can grow with the rest of the fatty pool. Moreover, spontaneous progressive worsening of the clinical status has been observed in 36% of the cases. Surgery is efficient and not harmful to the patient. Postoperative mortality was nil. Early postoperative worsening occurred in 2.7% of the cases. The 6% rate of late postsurgical deteriorations should be compared to the 36% to 56% rate found when patients are not operated on. Three different mechanisms are responsible for clinical worsening: compression or stretching of the cord, and cord injury on the posterior upper limit of the spinal defect. In each case, one mechanism is prevalent. Three different types of lumbosacral lipomas can thus be individualized. The surgical implications of these data are discussed. The necessity for early and systematic surgical treatment is pointed out.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00270610
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  • 5
    Electronic Resource
    Electronic Resource
    Acute intracranial hematomas in term neonates (1986)
    Springer
    Child's nervous system 2 (1986), S. 191-194 
    Details
    ISSN: 1433-0350
    Keywords: Neonatology ; Intracranial hematomas ; Hydrocephalus ; Dystocic deliveries ; Perinatal anoxia ; Bleeding disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Acute intracranial hematomas in 17 term neonates are reported: 3 were subdural in the posterior fossa; 14 supratentorial, either subdural (8), intracerebral (1 frontal, 4 occipital) or intraventricular (1). The hematomas were aspirated in 3 cases and surgically evacuated in 10. In the remaining 4, the effusion was left in situ. Three patients died: 2 due to dramatic preoperative deterioration and 1 to hemostatic difficulties during surgery. In the 14 survivors, neurological sequellae are major in 3, nil or minor in 11. Comparison of these cases to the 110 others already published allows the following conclusions: (1) the cause of such hematomas is usually multifactorial, combining obstetrical trauma, anoxia and/or coagulation disorders; (2) early diagnosis of the hematoma requires early echography and/or tomodensitometry; (3) when the hematoma causes a midline shift, the authors advocate its early evacuation by aspiration, or craniotomy if it is clotted; (4) the prognosis is poor when there is associated severe perinatal anoxia; if there is no anoxia, the prognosis seems good, but as the follow-up is usually short, definite conclusions are difficult; (5) in our series hydrocephalus requiring treatment occurred in 2 of the 14 survivors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00706809
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  • 6
    Electronic Resource
    Electronic Resource
    The contribution of prenatal diagnosis to the understanding of malformative intracranial cysts: state of the art (2000)
    Springer
    Child's nervous system 16 (2000), S. 618-626 
    Details
    ISSN: 1433-0350
    Keywords: Keywords Intracranial cyst ; Prenatal ; Fetus ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  This review evaluates the contribution of prenatal diagnosis to the understanding of intracranial cysts. We describe the outcome of 54 fetuses in which prenatal investigations indicated the presence of such lesions. The cysts were diagnosed between 20 and 30 weeks of gestation. Most (63%) were supratentorial and interhemispheric. There was only a single sylvian cyst. In the infratentorial compartment, median retrocerebellar cysts were predominant. Incisural cysts accounted for 14.8% of the series. Nine pregnancies were interrupted because of the presence of associated brain disorders. Forty-five children are alive. Thirty-four had neuropsychological tests. Cysts rarely progressed, most frequently stabilized and often regressed postnatally. Hydrocephalus was rare. In two cases delivery was precipitated at 36 weeks to allow urgent treatment of rapidly evolving cysts. Thirteen children (28.2%) were treated postnatally, in general for developing cysts. The median follow-up for the whole series exceeds 4 years. Behavior, neurological development, and intelligence are normal in 88% of the cases, and 91% have a normal neurological status. Prognosis at the time of the prenatal consultation was correct in 89% of the cases. We emphasize the value of prenatal magnetic resonance imaging and karyotype studies to limit risks of incorrect prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810000316
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  • 7
    Electronic Resource
    Electronic Resource
    Vasomotor origin of intracranial pressure waves in hydrocephalic infants (1980)
    Springer
    European journal of nuclear medicine 5 (1980), S. 511-514 
    Details
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract By measuring cerebral blood volume (CBV) and intracranial pressure (ICP) variations at the same running time during sleep, it has been demonstrated that the ICP wave which appears during the REM sleep in hydrocephalic infants is produced by intracerebral vaso-dilatation. Nine infants with stabilized hydrocephalus were investigated by non-invasive means: REM phases were distinguished with the usual polysomnographic electrodes. Intracranial pressure was measured with a fontanel palpation transducer and CBV variations were obtained by recording 99mTc activity at the head level after in vivo labelling or red cells with 99mTc — pertechnetate. The timeactivity curves, obtained from regions of interest and selected on the sequential radioisotope images, show that an increased ICP wave, occurring during the REM period, is related to a simultaneous increase in the blood volume, limited to the cerebral sector and not to the area of the external carotid artery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00252041
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  • 8
    Electronic Resource
    Electronic Resource
    MRI study of lumbosacral lipoma in children (1989)
    Springer
    Pediatric radiology 19 (1989), S. 316-320 
    Details
    ISSN: 1432-1998
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The authors report 16 cases of lumbosacral lipoma in children studied by MRI. The exact position of the cord and its relationship to the lipoma were well demonstrated in all cases but one. There was as high incidence (25%) of syringomyelia in the terminal conus. Arnold Chiari malformation was never associated, which differentiates lumbosacral lipomas from myelomeningoceles. However, the nerve roots and their relationship to the lipoma were rarely visualized. Despite these drawbacks, MRI is the examination of choice if lumbosacral lipoma is suspected in children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02467302
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  • 9
    Electronic Resource
    Electronic Resource
    Lumbar spinal cord motion measurement with phase-contrast MR imaging in normal children and in children with spinal lipomas (1996)
    Springer
    Pediatric radiology 26 (1996), S. 265-270 
    Details
    ISSN: 1432-1998
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We assessed the normal movement of the lumbar spinal cord using phase-contrast MR imaging, and also the movement of the spinal cord in patients with spinal lipoma pre- and postoperatively. Phase-contrast MR imaging proved to be a valuable tool in this context.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01372108
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  • 10
    Electronic Resource
    Electronic Resource
    Jean François Hirsch (2000)
    Springer
    Child's nervous system 16 (2000), S. 838-839 
    Details
    ISSN: 1433-0350
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810000397
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