| 1. |
|
|
| 2. |
- Lindén, Thomas, 1962, et al.
(författare)
-
Protective effect of lesion to the glutamatergic cortico-striatal projections on the hypoglycemic nerve cell injury in rat striatum.
- 1987
-
Ingår i: Acta neuropathologica. - 0001-6322. ; 74:4, s. 335-44
-
Tidskriftsartikel (refereegranskat)abstract
- In rat striatum severe hypoglycemia causes an irreversible nerve cell injury, which does not become manifest until during the post-insult recovery period. This injury can be ameliorated by lesions of the glutamatergic cortico-striatal pathway, which suggests that an "excitotoxic" effect mediated by the glutamatergic input is the likely cause of the post-hypoglycemic nerve cell destruction. In this paper we further characterize the protective effect of abolishing the glutamatergic innervation to striatum at the ultrastructural level. Two weeks after a unilateral cortical ablation rats were subjected to 30 min of severe hypoglycemia with isoelectric EEG and killed either immediately after the insult or following 60 min of recovery induced by restoring the blood glucose levels. Immediately after the hypoglycemic insult the structure of striatum was similar on both sides (except for the changes attributable to the ablation); i.e., the neurons and their dendrites had pale cytoplasm with condensed mitochondria, sparse RER and pinpoint ribosomes. After 60 min restitution numerous striatal neurons on the non-protected, non-ablated side had turned variably dark and condensed, whereas underneath the ablation they remained similar as immediately after hypoglycemia. This sequence indicates that the most likely cause of nerve cell destruction on the non-protected side is the "excitotoxic" effect mediated by the glutamatergic innervation, which is superimposed on the action of the hypoglycemic insult per se. Furthermore, the primary condensation of neurons and their dendrites indicate existence of another type of acute "excitotoxic" nerve cell injury which differs from the previously described injury characterized by neuronal swelling.
|
|
| 3. |
|
|
| 4. |
- Fernell, Elisabeth, 1948, et al.
(författare)
-
Epidemiology of infantile hydrocephalus in Sweden: a clinical follow-up study in children born at term.
- 1988
-
Ingår i: Neuropediatrics. - : Georg Thieme Verlag KG. - 0174-304X .- 1439-1899. ; 19:3, s. 135-142
-
Tidskriftsartikel (refereegranskat)abstract
- The long-term outcome of infantile hydrocephalus (IH) in children born at term during a period of active shunt treatment was studied in a population-based survey. The series consisted of 68 children greater than or equal to 6 years old and born in 1967-78 in the south-western Swedish health care region. The clinical follow-up included neuro-paediatric assessment, Stott's test of motor impairment, the WISC test, CT and EEG analyses. Nineteen of the 68 children (28%) had cerebral palsy, 17 (25%) minor motor dysfunction and 32 (47%) no motor dysfunction; mental retardation was present in 26 (38%), 16 with an IQ 50-70 and 10 with IQ less than 50; 42 children (62%) had normal intelligence and epilepsy was found in 15 (22%). Compared with a non-shunted IH series from the 1950s, the survival of IH children had considerably increased. Of constituents characterizing the IH syndrome from the time prior to shunting, ataxia, divergent squint and the special "Cocktail-party behaviour" had significantly decreased, all of which conditions are highly related to chronic expansion of the ventricular system. The frequencies of other impairments such as mental retardation and epilepsy were fairly similar, reflecting the present increased survival of IH children with primarily non-IH-dependent brain damage. IH children with associated brain parenchymal defects had the poorest outcome, and those without had in general a much more favourable one. Thus the single most important factor for the outcome of IH was found to be the presence or absence of associated primary brain damage or maldevelopment.
|
|
| 5. |
- Fernell, Elisabeth, 1948, et al.
(författare)
-
Epidemiology of infantile hydrocephalus in Sweden. Current aspects of the outcome in preterm infants.
- 1988
-
Ingår i: Neuropediatrics. - : Georg Thieme Verlag KG. - 0174-304X .- 1439-1899. ; 19:3, s. 143-145
-
Tidskriftsartikel (refereegranskat)abstract
- The outcome in a population-based series of 61 Swedish preterm infants born in 1967-82 with infantile hydrocephalus (IH) was investigated. Sixteen (26%) died before the age of two years. The available information was updated when the 45 surviving children were at least four years and six months old. A structured follow-up examination was performed in the 13 children who had passed the age of six years. Among the 45 survivors, 47% had cerebral palsy, 51% mental retardation and 33% epilepsy. The overall outcome for preterm infants with IH was found to be poorer than that for fullterm ones. Prognostic factors correlating to a poor outcome were an obvious origin of IH (pre- or perinatal) and a gestational age of less than 28 weeks. It is concluded that handicapped IH children born very or extremely prematurely constitute a new, and to a large extent severely brain-damaged group that has entered the Swedish IH panorama since the end of the 1970s.
|
|
| 6. |
- Fernell, Elisabeth, 1948, et al.
(författare)
-
Epidemiology of infantile hydrocephalus in Sweden. I. Birth prevalence and general data.
- 1986
-
Ingår i: Acta Paediatrica Scandinavica. - 0001-656X. ; 75:6, s. 975-981
-
Tidskriftsartikel (refereegranskat)abstract
- The livebirth prevalence of infantile simple hydrocephalus (IH) was investigated in a Swedish population-based survey. The study comprised all liveborn infants with IH apparent before the age of one year and born in the study area between 1967-82. A total of 202 infants fulfilled these criteria; of these, 141 (70%) were born at term and 61 (30%) were preterm. The mean prevalence was 0.53 per 1,000, with a slightly increasing trend from 0.48 in 1967-70 to 0.63 in 1979-82. The increase was entirely referable to the preterm group, in which the prevalence rose from 0.13 per 1,000 in 1967-70 to 0.30 in 1979-82. There was no tendency to an increase in the term group. In 12 of 23 children born very preterm the origin of the IH was a diagnosed cerebral haemorrhage. This is compatible with the increased risk of the latter condition that has been found in very preterm newborns. The mortality among children with IH was highest before the age of one year (15%), after which it was 1.2% per year.
|
|
| 7. |
- Fernell, Elisabeth, 1948, et al.
(författare)
-
Epidemiology of infantile hydrocephalus in Sweden. II. Origin in infants born at term.
- 1987
-
Ingår i: Acta Paediatrica Scandinavica. - 0001-656X. ; 76:3, s. 411-417
-
Tidskriftsartikel (refereegranskat)abstract
- The aetiology of infantile hydrocephalus (IH) was studied in a population-based series of 141 children with IH, born at term in southwestern Sweden 1967-82. A prenatal aetiology was present in 81 children (57%), a pre- and perinatal in 6 (4%), a perinatal in 27 (19%), and a postnatal in 8 (6%); the origin in 19 children (13%) remained untraceable. A variety of aetiologies were revealed or indicated among prenatal conditions. The dominant intrauterine infection was toxoplasmosis. The predominant perinatal condition was posthaemorrhagic IH. The broad outline of outcome differed between pathogenetic groups. Children with a clear prenatal onset of IH were found to be at high risk for early death or multiple neurological impairments. Thirteen of 63 (21%) within this group had died before 2 years of age and 34 of the 50 (68%) survivors showed major neurological dysfunction. This contrasted to the incidences of 3% deaths and 30% sequelae in children with IH of other onset.
|
|
| 8. |
- Fernell, Elisabeth, 1948, et al.
(författare)
-
Epidemiology of infantile hydrocephalus in Sweden. III. Origin in preterm infants.
- 1987
-
Ingår i: Acta Paediatrica Scandinavica. - 0001-656X. ; 76:3, s. 418-423
-
Tidskriftsartikel (refereegranskat)abstract
- The aetiology of infantile hydrocephalus (IH) was studied in a population-based series of 61 children with IH born 1967-82 at less than 37 weeks of gestation. A prenatal origin was present in 17 children (28%), a pre- and perinatal in 17 (28%), a perinatal in 26 (43%) and a postnatal in one (1%). The predominant single cause was postaemorrhagic IH, which was diagnosed in 19 (31%). In addition, an undiagnosed cerebral haemorrhage was considered to be the cause in another 25%. The outcome differed between pathogenetic groups. Children with a clear onset of IH (pre-, peri- or postnatal) were found to be at high risk for early death or multiple impairments. Sixteen of 39 (41%) within these groups had died before 2 years of age and 18 of the 23 (78%) survivors showed major neurological dysfunction. This contrasted to no mortality and 41% major dysfunction in children with a less clear onset of IH. A new subgroup consisting of infants born before 28 weeks of gestation emerged in the early 1980s. All infants with IH in this group developed a severe multihandicap condition.
|
|
| 9. |
- Fernell, Elisabeth, 1948, et al.
(författare)
-
Overt hydrocephalus at birth--origin and outcome.
- 1987
-
Ingår i: Child's Nervous System. - 0256-7040. ; 3:6, s. 350-353
-
Tidskriftsartikel (refereegranskat)abstract
- Based on a survey of the population, which included 202 infants with infantile hydrocephalus those who had had overt hydrocephalus at birth were selected and analyzed with respect to origin and outcome. The present series consisted of 47 infants (23% of the total series), 83% of whom were born at term and 17% before term. In the study period 1967-1982, the prevalence was 0.12/1,000 births. Among infants with maldevelopment of the CNS and/or other organs, the mortality before 2 years of age was 37%, and among the survivors the rate of neurological sequelae was 88%. The corresponding figures for infants with uncomplicated hydrocephalus, i.e., without other maldevelopment, was 20% and 44%, respectively. The prognosis was especially poor for infants born before term. It was concluded that the prognosis was largely determined by maldevelopment affecting the CNS macro- or microarchitecture.
|
|
| 10. |
- Fernell, Elisabeth, 1948, et al.
(författare)
-
Ventriculoatrial or ventriculoperitoneal shunts in the treatment of hydrocephalus in children?
- 1985
-
Ingår i: Zeitschrift für Kinderchirurgie. - : Georg Thieme Verlag KG. - 0174-3082. ; 40 Suppl 1, s. 12-14
-
Tidskriftsartikel (refereegranskat)abstract
- The data on all 881 primary or revision shunt operations performed on 158 paediatric patients treated in Gothenburg, Sweden from 1967 to 1984 and 101 patients treated in Oulu, Finland from 1968 to 1983 were pooled for the purpose of comparative evaluation of the function of ventriculoatrial (VA) and ventriculoperitoneal (VP) shunts. Ventriculoperitoneal shunting was the method of choice in Gothenburg and ventriculoatrial shunting in Oulu. The results of the 723 operations (305 VA and 418 VP shunts) were evaluated as the other 158 operations were for ventriculostomas, shunt removals and other procedures. 80 children had exclusively VA shunts and 133 children had exclusively VP shunts. Irrespective of the method of analysis the VP shunts were more frequently infected. The estimated relative risk for obstruction of the shunt (Meyer-Kaplan method) was shown to be significantly higher in VA shunts, but only at a low level of statistical significance (p less than 0.1). All other shunt complications were distributed uniformly in both groups. There was, however, a trend towards a higher mortality among children with exclusively VA shunts. Therefore it was concluded that despite the higher risk for infection in VP shunts, these still should be considered a safer choice, as the complications of VA shunts present greater risks.
|
|
