Cerebrovascular disease in neonates. Evaluation of four cases.

The clinical and neurological study in four neonates infants with cerebral infarction are reported. The purpose of this study is to call attention for the clinical course, cranial ultrasound, computed tomography and laboratories tests, in order to evaluate the neurological sequelae. A careful evaluation has be taken in order to determine the significance of clinical and laboratory tests for syndromic, topographic and etiologic diagnosis after one year ambulatorial follow-up.

Cerebrovascular disease in newborn infants. Report of three cases with clinical follow-up and brain SPECT imaging.

The clinical and neurological findings of three neonates with the diagnosis of cerebrovascular disease are reported. The neuropsychological evaluation disclosed impairment of fine motor function, coordination, language, perception and behavioral disturbances. Brain SPECT imaging revealed perfusional deficits in the three cases.

[Hypoxic-ischemic encephalopathy in newborn infants. Acute period and outcome]. / Encefalopatia hipóxico-isquêmica em recém-nascidos a termo. Aspectos da fase aguda e evolução.

Ninety four neonates with hypoxic ischemic encephalopathy HIE attended at the University of Ribeirão Preto since 1982 were studied in terms of the neurological alterations during the acute phase and outcome over a mean period of 47 months. From 43 newborns with HIE I, 40 recovered within 96 hours and 3 died. Among 40 infants with HIE II, 37.5% recovered within the first week, and the others continued abnormal beyond the 7th day. All 11 infants with HIE III died before the second month of life. The HIE I group had no motor sequelae. Among the HIE II group, 34.5% showed cerebral palsy and 17.7% neuromotor retardation. 80.0% of those with sequelae persisted abnormal beyond 7th day of life, during the acute phase of the HIE. Epilepsy occurred in 17.5% of cases with HIE grade II, only among those with neuromotor sequelae. The IQ test did not show statistically significant difference between the HIE I, II without motor sequelae and the control groups. The authors reaffirm the value of the findings in the acute phase of HIE on the outcome of these patients.

[Neurologic semiology in a population of hearing impaired children]. / Semiologia neurológica numa população de crianças deficientes auditivas.

A random sample of 42 sensorineural hearing impaired children (severe and bilateral) was studied, from special classes in Campinas, with chronological ages varying between 4 and 7 years old. The children of this sample were compared with two control groups of 42 children of the same chronological age, from regular classes of private and public schools. All of them were submitted to the traditional neurological examination. Hearing impaired children showed differences as to head circumference and muscle tonus. In the other examined items we found motor hyperactivity, cerebellar and ocular syndromes although there were no significant differences between the groups.

[Evaluation of the static equilibrium in a population of hearing impaired children]. / Avaliação do equilíbrio estático numa população de crianças deficientes auditivas.

A random sample was organized with 42 children with congenital sensorineural auditory deficit (severe and bilateral) from special education schools in Campinas. Chronological ages ranged from 4 to 7 years of age. This sample was compared with two control groups of 42 children of the same chronological age but attending normal classes. All were submitted to 9 tests of the set of static equilibrium of the Evolutive Neurologic Examination. It was observed that in the position of equilibrium with opened eyes (test 8) there were no differences between the groups. In the Romberg position, the hearing impaired children of 4, 5 and 6 years of age showed a significant decrease in the ability to do the test (test 9); those of 7 years of age had equal ability whether of the control or the deficient groups. Hearing impaired children were less able to do other static equilibrium tests (heel-toe or one foot or tip-toe standing tests, with opened or closed eyes: tests 10, 12, 16, 20, 24, 25 and 26). The use of detailed neurological semiology allowed us to support the alteration of the static equilibrium in this group of hearing impaired children.

[Visual-spatial function in cerebral palsy and proposal of a new test computer-assisted]. / Função vísuo-espacial em paralisia cerebral e proposta de novo teste com a ajuda de computador.

The first idea of this study is that there may be a disturbance of the visuo-spatial function in cerebral palsy. This idea is based upon the theories of Luria and Piaget. The second idea of this study is that the computer can help the investigation of visuo-spatial function. With the intention of evaluating the spatial function in cerebral palsy, the literature related to these themes was revised. We justify the proposal of a new test to study visuo-spatial function. This test uses straight lines in four different orientations and the subject has to recognize and arrange them individually or sets of them. This was done through the use of pencil and paper, and computer. The results confirm that there is a spatial disturbance and that a better understanding of the subject's difficulties was made possible through the use of the computer and the Logo computer language.

[Purulent meningitis in children during the 1st year of life]. / Meningites purulentas em crianças no primeiro ano de vida.

A series of 169 children with diagnosis of acute purulent meningitis during the first year of life was studied. Clinical and neurological findings are discussed, and for this purpose patients were separated in subgroups concerning their age. The great frequency in suckling until 6 months of age is emphasized.

[Bacterial meningitis in infants: neurological aspects]. / Meningites bacterianas no lactente. Aspectos neurológicos.

Clinical, neurologic and laboratory aspects of bacterial meningitis in the newborn infant are critically reviewed taking into account author's experience. Pathophysiologic data on acute phase phenomena in the CNS are analysed for this purpose.