Patterns of Cerebral Arterial Injury in Children With Neurological Disabilities

Baumann, Robert J.; Carr, W.Allen; Shuman, Robert M.

doi:10.1177/088307388700200413

Cited by 7 publications

(1 citation statement)

References 10 publications

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“…These children often show considerable reorganization or sparing of function despite the presence of extensive unilateral cortical damage (97); in fact, about one third of congenital hemiplegics have a completely uneventful neonatal course (98). The consistent absence of correlation between structural features on neuroimaging (e.g., CT) and clinical (particularly cognitive) findings in congenital hemiplegics is believed to be caused, at least in part, by the complexity of reorganizational properties after brain injury (99,100).…”

Section: Studies In Congenital Hemiplegiamentioning

confidence: 98%

Review : Metabolic Imaging: A Window on Brain Development and Plasticity

Chugani

1999

Neuroscientist

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Various biochemical and physiological processes that undergo maturational changes during human brain development can be now studied in vivo using PET. The distribution of local cerebral glucose utilization shows regional alterations in the first year of life in agreement with behavioral, neurophysiological, and anatomical changes known to occur during development of the infant. Measurement of the absolute rates of glucose utilization with PET reveals that during the major portion of the first decade, the human brain has a higher energy (glucose) demand compared with both the newborn and adult brains. With adolescence, glucose utilization rates decline to reach adult values by age 16-18 years. This nonlinear course of cerebral glucose 'metabolic' maturation is also seen in a number of animal models and coincides with the developmental course of transient synaptic exuberance associated with enhanced brain plasticity and efficient learning. Evidence of brain reorganization detected with PET is discussed in children with unilateral brain injury and early sensory deprivation. NEUROSCIENTIST 5:29-40, 1999 During development, the brain undergoes complex organizational changes in preparation for optimal adaptive behavior. One interesting aspect of neurodevelopmental organization is its regressive nature, an example of which is the process of exuberant proliferation of neurons and their synaptic connections followed by elimination of the excess (1). Proliferation and overproduction of neurons in humans occur prenatally, whereas the elimination of excessively proliferated neuronal populations begins prenatally and continues until about the second postnatal year (2). In contrast, the overproduction and elimination (also referred to as &dquo;pruning&dquo;) of neuronal processes and their synaptic contacts in man is largely a postnatal phenomenon with a rather protracted course (3), and synaptic stabilization is a reiterative process that is highly dependent on experience and exposure of the individual (4-6).Because glucose and oxygen are the principal substrates for meeting the energy demands of the brain, measurements of the rates at which these substrates are utilized provide an assessment of the functional activity in the brain. Alternatively, the measurement of cerebral blood flow provides an indirect measure of the cerebral energy demand and functional activity. In 1957, Kennedy Address reprint requests to: ).and Sokoloff (7) demonstrated that the average global cerebral blood flow in children was 1.8 times that of normal young adults, and average cerebral oxygen utilization was 1.3 times higher in children than adults. These findings extended to humans the prior observation in rats that both oxygen and glucose consumption of excised brain regions (cerebral cortex, striatum, cerebellum, and brainstem) were higher between postnatal weeks 4 and 7 compared with adult values (8).With the advent of autoradiographic techniques for measuring local cerebral blood flow and glucose metabolism in laboratory animals, the energy ...

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Section: Studies In Congenital Hemiplegiamentioning

confidence: 98%

Review : Metabolic Imaging: A Window on Brain Development and Plasticity

Chugani

1999

Neuroscientist

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Neuropathologic findings in cortical resections (including hemispherectomies) performed for the treatment of intractable childhood epilepsy

et al. 1992

Acta Neuropathol

166

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Despite the use of hemispherectomy in the treatment of medically refractory seizures since the early 1950's, few studies published have documented neuropathologic findings in the resected specimens. This report describes the neuropathologic findings in 38 children who underwent either hemispherectomy or multilobar cortical resection as treatment for medically intractable epilepsy between 1986 and 1990. Examination of the resected specimens revealed a variety of abnormalities which fell into four broad categories. Malformations or hamartomatous lesions were the dominant finding in 15 patients, whereas encephalomalacic lesions were the most prominent abnormality in 16; chronic pathogen-free encephalitits (Rasmussen's encephalitis) was present in 3 and an additional 3 children had Sturge-Weber-Dimitri syndrome. There were no gross or microscopic abnormalities in 1 patient. This report provides the first comprehensive description of the pathologic findings in a series of children with refractory epilepsy of varying types treated by hemispherectomy-multilobar resection.

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Major brain lesions detected on sonographic screening of apparently normal term neonates

2004

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Major congenital or acquired structural abnormalities of the brain, with significant prognostic implications have rarely been emphasised in apparently normal infants. Our purpose was to investigate the prevalence and types of major brain lesions in clinically normal term neonates using sonography. From January 1999 to December 2001, we examined 2309 clinically normal term neonates within 3 days of birth. Of these, six (0.26%) had major brain lesions, including three cases of intracerebral haemorrhage (two grade II intraventricular and one temporal lobe haemorrhage), two of corpus callosum agenesis and one lacunar infarct in the territory of the left middle cerebral artery. One child was lost to follow-up, because of adoption, and four had borderline to significant developmental delay at a mean age of 24 months (range 12-36 months). Although the prevalence of major brain lesions was low, these infants have a higher risk of later neurodevelopmental disability, despite an early asymptomatic period. Universal neonatal brain ultrasound screening may help early diagnosis of rare major lesions, some of which have prognostic implications.

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Patterns of Cerebral Arterial Injury in Children With Neurological Disabilities

Cited by 7 publications

References 10 publications

Review : Metabolic Imaging: A Window on Brain Development and Plasticity

Review : Metabolic Imaging: A Window on Brain Development and Plasticity

Neuropathologic findings in cortical resections (including hemispherectomies) performed for the treatment of intractable childhood epilepsy

Major brain lesions detected on sonographic screening of apparently normal term neonates

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