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Head injury in the child
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Helen Whitwell, Christopher Milroy
In most infants (up to 9 months old), this is the most common finding, with 78 per cent of cases showing widespread neuronal hypoxia and a large proportion having a history of apnoea or respiratory arrest (Geddes et al. 2001b). Radiological studies using diffusion-weighted MRI in the investigation of non-accidental head injury have identified changes of cerebral ischaemia rather than traumatic lesions as the major abnormality (Suh et al. 2001; Biousse et al. 2002; Stoodley 2002). In some cases, older areas of hypoxic-ischaemic damage may be seen suggesting previous injury, although as in the cases of long-term survivors other causes, such as birth injury, should be sought. In long-term survivors with severe damage, gross cerebral atrophy may develop (Figure 15.13).
Medical Problems in Alcoholics
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
Patients with a clear problem should have a CT scan of the head, a neurological evaluation, and a careful functional assessment to determine improvement; this often requires psychological consultation. The prognosis for the mental function and depression changes is excellent; some amount of reversibility is always found, which rapidly improves for the first 60 days of abstinence. Mild degrees of cerebral atrophy may reverse on CT scan, but severe changes remain. Cerebellar injury is nearly always permanent in its clinical manifestations.
Argininosuccinic aciduria
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
Abnormalities of the EEG are common [17]. Cerebral atrophy may be evident on computed tomography (CT) or magnetic resonance imaging (MRI). Others may have episodes of hyperammonemic encephalopathy and coma thought to be Reye syndrome or encephalitis. Hyperammonemia is often precipitated by infection and such an episode may be fatal.
Choroid plexus and CSF: an updated review
Published in British Journal of Neurosurgery, 2022
Dana Hutton, Mohammed Gadoora Fadelalla, Avinash Kumar Kanodia, Kismet Hossain-Ibrahim
NPH is a condition clinically characterised by the triad of: dementia, gait disturbance, and urinary incontinence. It presents similarly to other dementias, however brain imaging reveals ventriculomegaly without concomitant cerebral atrophy.33 NPH has been assumed to result from insufficient CSF reabsorption of the arachnoid granulations. This can occur secondary to thickening of the arachnoid mater from previous subarachnoid haemorrhage or meningitis. However, in most cases the cause remains uncertain – idiopathic NPH (INPH). Whatever the cause of NPH, slight transmantle pressure gradients arise, and cause hyperdynamic CSF flow through the aqueduct. NPH can still be termed ‘normal’ pressure despite being at a new, higher level, as over time CSF formation is dampened to achieve a stable state.33 CT features of NPH have been demonstrated in Figure 3.
Peripheral and central hearing impairment and their relationship with cognition: a review
Published in International Journal of Audiology, 2019
Grace Kellee Nixon, Julia Zoe Sarant, Dani Tomlin
Cognitive impairment is one of the most prevalent and expensive health conditions affecting older adults (Access Economics 2006; Gurgel et al. 2014). It encompasses a spectrum of disorders that can affect psychomotor function, memory, executive function, attention and learning, and ranges from mild cognitive impairment (MCI) through to dementia (Gurgel et al. 2014). In this review, the term cognitive impairment includes both MCI and varying forms of dementia. This includes having poorer performance on cognitive tests that does not interfere with daily life (MCI), as well as a clinical diagnosis of dementia. The World Health Organisation (2017) classifies dementia as a chronic health condition which leads to a deterioration in thinking, behaviour, ability to perform everyday tasks, and memory and is clinically diagnosed under the guidelines presented in the Diagnostic and Statistical Manual V (Dementia Australia 2012; Gauthier, Reisberg et al. 2006). Depending on dementia subtype, the morphology of an individual’s brain may differ, but commonly cerebral atrophy (particularly of the hippocampus) is one of the first notable physiological symptoms (Wurthmann et al. 1995; Alzheimer's Society 2017). Early research has also demonstrated significant relationships between Alzheimer’s Dementia (AD) and increased atrophy of the temporal lobe (Scheltens et al. 1992; Erkinjuntti et al., 1993).
Progress in gene and cell therapies for the neuronal ceroid lipofuscinoses
Published in Expert Opinion on Biological Therapy, 2018
Anthony Donsante, Nicholas M Boulis
Four males with CLN2 disease and two females with CLN1 disease were enrolled in the trial (age 2.9–9.4 years; 28–58 months from diagnosis). All exhibited significant cognitive dysfunction and four exhibited severe cerebral atrophy and seizures. Most of the adverse events that were reported were consistent with the immunosuppressive agents or the disease itself. All but four serious adverse events resolved themselves. Three patients exhibited dysphagia and reduced oral intake, leading to the placement of gastrostomy tubes. One patient developed respiratory failure that resulted in death. Brain autopsy of this patient identified no abnormalities at the injection sites other than the expected needle tracks. Abnormalities in the brain were consistent with the patient’s disease. Two other patients died during long-term follow-up (918 and 1245 days posttransplant) with similar findings.