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  • 1
    Digitale Medien
    Digitale Medien
    Editorial comment (1993)
    Springer
    Child's nervous system 9 (1993), S. 347-347 
    Details
    ISSN: 1433-0350
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00302039
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  • 2
    Digitale Medien
    Digitale Medien
    Congenital frontal bone defect with intact overlying scalp (1993)
    Springer
    Child's nervous system 9 (1993), S. 485-487 
    Details
    ISSN: 1433-0350
    Schlagwort(e): Congenital skull defect ; Frontal bone ; Regeneration ; Cranioplasty
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract An unusual case of a congenital frontal bone defect with intact overlying scalp and intact underlying dura mater is reported. Although spontaneous healing by the intact underlying dura mater by regeneration was expected, it did not occur. Cranioplasty was done for protective and cosmetic purposes. A review of the literature of congenital skull defects shows that spontaneous regeneration does not occur in this rare anomaly.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00393559
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  • 3
    Digitale Medien
    Digitale Medien
    Slit ventricles as a cause of isolated ventricles after shunting (1985)
    Springer
    Child's nervous system 1 (1985), S. 189-193 
    Details
    ISSN: 1433-0350
    Schlagwort(e): Childhood hydrocephalus ; Slit ventricle ; Isolated unilateral hydrocephalus ; Isolated fourth ventricle ; CSF hydrodynamics
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In a follow-up study of 164 hydrocephalic children without tumors treated with ventriculoperitoneal shunts, 46 (28.0%) developed slit ventricles, 5 (3.0%) developed isolated fourth ventricles, and 4 (2.4%) developed isolated unilateral hydrocephalus. All of the patients with isolated unilateral hydrocephalus and 3 with isolated fourth ventricles had associated slit ventricles, 2 of whom had enlarged ventricles as double-compartment hydrocephalus. Reopening of the foramen of Monro or the aqueduct was achieved in one of the former and two of the latter cases with re-expansion of the slit ventricles. It is suggested that in some cases, the slit ventricle could be a causative factor in post-shunt isolated ventricle.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00270760
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  • 4
    Digitale Medien
    Digitale Medien
    Neurological and medico-social problems of spina bifida patients in adolescence and adulthood (1996)
    Springer
    Child's nervous system 12 (1996), S. 181-187 
    Details
    ISSN: 1433-0350
    Schlagwort(e): Spina bifida ; Adulthood ; Natural history ; Long-standing over ventriculomegaly in adult (LOVA) ; Indications for surgery
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Chronological changes in the neurological manifestations of spina bifida are well recognized in the early developmental periods: fetal, neonatal, infantile, pre-school and school life. However, little has been written about the medical and medico-social problems of spina bifida patients in adulthood. Patients now in this age group had the condition diagnosed and managed in an era when modern neurosurgical concepts were only just beginning to be established with the aid of invasive methodology. In our series of 141 cases of spina bifida, 18 patients (13.5%) were over 16 years of age. These included 9 cases each of spina bifida aperta (myeloschisis) and spina bifida occulta (spinal lipoma). The ages ranged from 16 to 47 years (mean: 23.5 years) in the former and from 16 to 57 years (mean: 29.2 years) in the latter group. During the long-term follow-up with quantitative analysis of the spinal neurological changes using the spina bifida neurological scale (SBNS), the final outcomes appeared very grave. Except for 1 case in each group-1 grade III in the spina bifida aperta group and 1 grade II in the spina bifida occulta group-all patients over the age of 27 years were classed as having grade IV disease. There were 2 patients with spina bifida aperta in whom postoperative paraplegia appeared after delayed radical repair (at the ages of 3 years and 18 years) and 3 patients with spina bifida occulta in whom obvious neurological deterioration was observed as the natural history with ongoing paraparesis at the spinal level or late onset of sexual problems. The other group included 2 patients with spinal lipoma in whom late neurological deterioration was observed and who were obliged to undergo a second operation in spite of aggressive early procedures performed during infancy. Among the patients with spina bifida aperta, 2 had marked ventriculomegaly as a form of long-standing overt ventriculomegaly in the adult (LOVA). After the CSF shunt procedure both these patients had problems with delicate shunt dependence and requested fine shunt flow regulation. Two patients in this group also suffered from severe depression. This study involves a limited number of patients, but it may be useful for reference on various points: (1) future prospects for the management of pediatric cases of spina bifida as practiced in the majority of hospitals; (2) natural histories of untreated cases and surgical indications for preventive procedure in spinal lipoma in early infancy; and (3) internationally differing levels of management of spina bifida and the historical development of individual countries' approaches to the problems.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00301248
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  • 5
    Digitale Medien
    Digitale Medien
    Neurovascular developmental interaction: a specific form of vascular maldevelopment in the malformed brain (1996)
    Springer
    Child's nervous system 12 (1996), S. 242-247 
    Details
    ISSN: 1433-0350
    Schlagwort(e): Fetal brain ; Vascular development ; Neuronal maturation ; Overgrowth ; Hypervascularization
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The process of the development of the intracranial vessels was studied by means of immunohistochemical analysis of factor VIII in normal and exencephalic chick fetuses. The results revealed that the development of blood vessels in exencephalic brain was far advanced beyond the norm, with intense immunoreactivity to factor VIII on postincubation day 16 exceeding that on day 21 in normal controls. Compared with results regarding the direction of the overgrowth in the neuronal maturation process in the previous study using the chick exencephaly model, the findings of overmatured blood vessels were compatible with NSE- and somatostatin-positive elements that appeared especially in the overgrowth foci. The results of the present study suggested the pathogenic development of the “area cerebrovasculosa” in the neural placode as a phenomenon consequent upon hypervascularization in response to neuronal overgrowth, as seen in human cases of exencephaly or anencephaly. We emphasize the significance of this specific phenomenon in the development of the fetal central nervous system, namely neurovascular developmental interaction.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00261803
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  • 6
    Digitale Medien
    Digitale Medien
    Neuronal overmaturation in dysraphism: ontogenic expression of neuropeptides in the fetal brain and developmental anomalies in exencephaly (1995)
    Springer
    Child's nervous system 11 (1995), S. 504-510 
    Details
    ISSN: 1433-0350
    Schlagwort(e): Dysraphism ; Neuronal maturation ; Neuron-specific enolase ; Somatostatin ; Overgrowth
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Starting from knowledge obtained in our previous studies of experimental dysraphism in chick embryos, the entity of neuronal over-growth observed in exencephaly was further investigated. The ontogenic expression of neuron-specific enolase (NSE), vasoactive intestinal polypeptide (VIP), and somatostatin was analyzed both in chick exencephaly of the natural product and in normal chick fetuses by carrying out immunohistochemical studies. In normal fetuses, immunostained elements positive for NSE first appeared in the spinal gray matter on postincubation day 16 and increased in intensity during the fetal period. By postnatal day 2, the cerebral peduncle, brain stem neurofibers, molecular layer of the cerebellum, corpus striatum, and piriform cortex became immunoreactive. No immunohistochemical reaction to VIP was observed during these stages. Somatostatin-positive elements were not identified during the fetal period, except in limited regions, such as the corpus striatum, which appeared to have weakly positive straining on day 21. The exencephalic fetuses, however, demonstrated extremely advanced neuronal maturation, with intense immunoreactivity already being manifest in various regions, including the corpus striatum, piriform cortex, spinal gray matter, and brain stem nuclei, on day 16 of the fetal period. Somatostatin-positive elements also appeared at this stage in chick exencephaly, but such immunoreactivity was localized, particularly in the overgrown foci. The present study showed that the neuronal maturation process in some neurons of exencephalic brain and spinal cord was definitely further advanced than that in normal controls. A possible clinical application of NSE and somatostatin measurement as markers for dysraphic states in the fetus is suggested.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00822839
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  • 7
    Digitale Medien
    Digitale Medien
    Pathophysiology of aqueductal obstruction in isolated IV ventricle after shunting (1986)
    Springer
    Child's nervous system 2 (1986), S. 282-285 
    Details
    ISSN: 1433-0350
    Schlagwort(e): Isolated IV ventricle ; Hydrocephalus ; Shunt complication ; CSF dynamics
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The authors report their cases of isolated IV ventricle and discuss their concepts of secondary obstruction of the aqueduct, analyzing CSF dynamics, pressure measurements, serial CT scan changes, and the outcome of various treatment modalities. Two distinctly different categories were identified: (1) functional obstruction in which the obstructed aqueduct reopened either as the result of decreasing the elevated infratentorial pressure (Raimondi's phenomenon) or from correction of overdrainage of the supratentorial system; (2) permanent obstruction with pathological occlusion of the aqueduct, necessitating a IV ventriculoperitoneal shunt. It is the pathophysiology and pathoanatomy of secondary obstruction of the aqueduct that determine the specific treatment to be used in managing the isolated IV ventricle syndrome.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00271938
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  • 8
    Digitale Medien
    Digitale Medien
    Trigonocephaly (metopic synostosis) (1987)
    Springer
    Child's nervous system 3 (1987), S. 259-265 
    Details
    ISSN: 1433-0350
    Schlagwort(e): Trigonocephaly ; Operation ; Technique
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The clinical features, surgical and anatomical concepts based on an evaluation of the development of the anterior cranial fossa in metopic synostosis are discussed. Thirteen cases of trigonocephaly of infancy during last 4 years are described. Five children were mentally retarded. A more marked triangular cranial configuration with acute nasopterional angle was associated with more severe mental retardation and other unfavorable conditions, including cardiopulmonary disorders and chromosome anomalies. From a quantitative analysis of the anterior cranial fossa development obtained from CT measurement in comparison with values in normal infants, the following procedures appeared to be important: (1) correction of acute nasopterional angle, achieving a flat forehead; (2) forward advancement of both pterions and anterolateral parts of the frontal bones, rebuilding the orbital roof and frontal eminences; (3) shortening of the overgrown midline structure by removal of the bony ridge of the metopic suture. Our procedure on the basis of these measurements for determination of surgical intervention is described.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00271819
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  • 9
    Digitale Medien
    Digitale Medien
    Hydrocephalus in premature infants (1989)
    Springer
    Child's nervous system 5 (1989), S. 76-82 
    Details
    ISSN: 1433-0350
    Schlagwort(e): Premature infants ; Hydrocephalus ; Etiology ; Pathophysiology ; Shunt and shunt problems
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Twenty-onepremature infants with various underlying conditions developed hydrocephalus. The characteristic clinical pictures as well as the therapeutic problems are discussed. The causative underlying conditions included intraventricular hemorrhage in the neonate or fetus, bronchopulmonary dysplasia, congenital malformations such as holoprosencephaly with chromosome anomalies, and others. The pathophysiological aspects were considered to be characterized by the underdevelopment of major cerebrospinal fluid pathway, extremely high intracranial compliance, and demyelinating process of the nervous system. The shunt problems in these patients with such low body weight were also unique, showing an extremely high incidence of postshunt hydrocele, shunt migration into the scrotum, shunt malfunction, slit-like ventricle, and isolated ventricles. Intensive management, combined with better control of the hydrocephalus with these concepts, will help to improve the long-term outcome of these premature infants.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00571114
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  • 10
    Digitale Medien
    Digitale Medien
    Massive congenital intracranial teratoma diagnosed in utero (1990)
    Springer
    Child's nervous system 6 (1990), S. 459-461 
    Details
    ISSN: 1433-0350
    Schlagwort(e): Congenital brain tumor ; Teratoma ; Intrauterine diagnosis ; Alpha-fetoprotein
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The authors describe a case of congenital intracranial teratoma. The patient was diagnosed to be hydrocephalic at 29 weeks' gestation, and to have a huge intraventricular mass lesion at 34 weeks' gestation. Subsequently, the patient underwent subtotal resection of the mass, resulting in a significant decrease in the remarkably elevated alpha-fetoprotein in serum and cerebrospinal fluid. Histological analysis revealed a malignant teratoma, also with alpha-fetoprotein-positive elements in the immunohistochemical study.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00302094
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