ABSTRACT
STUDY DESIGN: A study comparing magnetic resonance imaging findings of degenerative changes in intervertebral discs in young patients with previous wedge-shaped compression fracture and age-matched and sex-matched control subjects. OBJECTIVES: To find out the role of fractures in disc degeneration and to assess the clinical outcome of the patients. SUMMARY OF BACKGROUND DATA: Several experimental studies have postulated that trauma is one of the major reasons for disc degeneration. Wedge compression fractures in vertebrae of children have been considered insignificant, but this has not been verified in the literature. METHODS: Fourteen patients 8.8 to 20.8 years of age (mean, 15.5 years) with a history of wedge-shaped vertebral compression fracture at least 1 year previously (mean, 3.8 years) and asymptomatic healthy control subjects were studied by thoracolumbar spine magnetic resonance imaging. The patients also underwent a clinical examination. RESULTS: Eight (57%) of the 14 patients had disc degeneration, and seven of them had it at the trauma level. Of these 7 subjects, 6 also had endplate damage at this level. The association between endplate damage and adjacent intervertebral disc degeneration was significant (P < 0.01). Only 2 of the patients were symptomatic. In the control group, only 1 subject had disc degeneration with endplate changes and disc herniation. CONCLUSIONS: The patients had more disc degeneration than did those in the control group. Endplate injury was strongly associated with disc degeneration. No correlation between previous vertebral fracture and back pain was seen in this study.
Subject(s)
Intervertebral Disc , Spinal Fractures/diagnosis , Adolescent , Adult , Child , Female , Humans , Intervertebral Disc/diagnostic imaging , Intervertebral Disc/injuries , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/injuries , Magnetic Resonance Imaging , Male , Radiography , Retrospective Studies , Spinal Fractures/diagnostic imaging , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/injuriesABSTRACT
The degree and direction of craniofacial asymmetry in the frontal plane was studied in a sample of 26 shunt-treated hydrocephalic children aged 5 to 18 years. Thirteen of the children had the regulating shunt fixed on the right side of the head and 13 on the left. The shunt had usually been inserted during the first years of life. An age- and sex-matched group of healthy school children and students served as controls for cephalometric assessment by means of linear and angular measurements. Considerable craniofacial asymmetry was found in the shunt-treated hydrocephalic children, the direction of asymmetry being related to the laterality of the regulating shunt device. The most marked asymmetric changes were recorded in the maxillary and mandibular regions, probably due to the adaptive nature of these regions.
Subject(s)
Cerebrospinal Fluid Shunts/adverse effects , Facial Asymmetry/etiology , Hydrocephalus/surgery , Skull/pathology , Adolescent , Bone Diseases/etiology , Cephalometry , Child , Child, Preschool , Facial Asymmetry/pathology , Female , Humans , Male , Mandible/pathology , Maxilla/pathology , Orbit/pathology , Rotation , Time FactorsABSTRACT
Basicranial changes were studied in a sample of 29 shunt-treated hydrocephalics, aged 7 to 18 years, by analyzing differences in angular relationships between structures seen on roentgenologic cephalograms taken at intervals of about 2 years following initial examination. In addition, the natural head position was recorded in 24 subjects at a follow-up examination. The cranial base among the boys showed increased flexure during the follow-up period. This finding was reflected in a decrease in the angle between the sphenoidal and clival planes and that of the nasion-sella-basion. Head posture, calculated in terms of the craniovertical and cervicohorizontal angles, was more forwardly flexed in the shunt-treated subjects than in the corresponding controls.
Subject(s)
Cephalometry , Cerebrospinal Fluid Shunts , Hydrocephalus/surgery , Postoperative Complications/etiology , Adolescent , Child , Female , Follow-Up Studies , Humans , Male , Maxillofacial Development , Sex FactorsABSTRACT
Craniofacial morphology was studied in a sample of 37 hydrocephalic subjects, 7 to 18 years of age, most of whom had had their first shunt operation performed in early childhood and were presently undergoing shunt treatment. The patients were grouped according to age and sex, and cephalometric radiograms were made. Similar radiograms from a north Finnish population and pretreatment radiograms from children having orthodontic cure were used as controls. The cephalograms were analyzed using linear, angular, and proportional measurements. Both cranial and facial morphological deviations were observed among the shunt-treated patients. The calvarium was thickened and the neurocranium enlarged; the cranial base flexure was increased, particularly among the older boys; and increased facial prognathism was observed. These craniofacial aberrations seemed to be exacerbated by a prolonged shunting time. A class I dental interrelation was found in all but two patients.
Subject(s)
Cerebrospinal Fluid Shunts , Facial Bones/pathology , Hydrocephalus/pathology , Skull/pathology , Adolescent , Cephalometry , Child , Female , Humans , Hydrocephalus/therapy , Male , Maxillofacial DevelopmentABSTRACT
Mediastinal masses in children younger than 2 years often cause symptoms from tracheal compression, but clinical indications later in childhood are less frequent. Mediastinal teratomata arise in the anterior region, and when they produce symptoms these are usually manifestations of tracheal compression, pain, pleural perforation or secondary infection of the tumour. Pericardial perforation is a rare and life-threatening complication. A case of sudden pericardial perforation and cardiac tamponade caused by a mediastinal teratoma is described.
