A case of villous hypertrophy or bilateral papilloma of the choroid plexus of the lateral ventricles is reported. The child exhibited known features associated with overproduction of cerebrospinal fluid, hydrocephalus that was difficult to control, ascites after ventriculoperitoneal shunting, and relief after surgical removal of the papillomatous tissue. A unique feature is the complexity of the telencephalic choroid plexuses as shown by computerized tomography and ultrasound in the newborn period.
Coxsackie B3 was cultured from 2 children who presented within two weeks of each other from the Cape Cod, Massachusetts, area showing opsoclonus and myoclonus. The organism was recovered from the cerebrospinal fluid of 1 patient and from the stools of both. Both children had cerebrospinal fluid pleocytosis and gradual, spontaneous resolution of their symptoms.
Fourteen younger (ages 6 to 10 years) and 11 older (ages 11 to 16 years) Duchenne Muscular Dystrophy (DMD) patients were tested with the WISC-R and neuropsychological language, visual-motor, and motor tasks. Older boys had an average IQ; younger boys were in the low average IQ range. Younger DMD boys were inferior to the older DMD group on tasks requiring some language and attentional-organizational skills, but not on visual-motor tasks. Older DMD boys were inferior on motor tasks. Results suggest that the reported low cognitive skills in DMD patients are not fixed or global, but reflect selective deficits in the younger boys. Possible bases for age differences in performance are discussed.
Five adults with signs of normal pressure hydrocephalus underwent ventriculolumbar perfusions. Average cerebrospinal fluid (CSF) formation rate, 0.313 \m=+-\ 0.020ml/min, was comparable with that for nonhydrocephalics, but due to the larger CSF compartment, turnover rate was approximately one third. Slow turnover was further aggravated by a CSF absorption deficiency.Normally, absorption begins at approximately 68 mm CSF pressure and increases linearly at a rate of 7.6\g=m\l/ min/mm CSF pressure. In four patients the rate was reduced to 2.5\g=m\l/min/mm CSF once a critical mean CSF pressure was reached. This absorption deficit, accompanied by elevated pressure plateaus and heightened pulse pressures may lead to ventricular enlargement and, secondarily, to symptoms associated with normal pressure hydrocephalus.Only two of these four patients showed good response to shunting. In two nonresponding patients, follow-up revealed evidence of complicating intrinsic brain disease.
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