Ventriculomegaly and pericerebral CSF collection in the fetus: early stage of benign external hydrocephalus?

BACKGROUND AND PURPOSE: Mild ventricular dilatation or an asymmetric aspect of the atrium with prominent subrachnoid spaces is a challenging clinical condition in utero that requires prenatal MRI to rule out a destructive lesion or brain malformation. We report five cases that demonstrated benign external hydrocephalus postnatally, together with the prenatal MRI to define prenatal criteria of so-called benign external hydrocephalus. METHODS AND RESULTS: The prenatal MR images of five cases showing typical features of external hydrocephalus postnatally were reviewed. All cases showed in utero mild ventricular dilatation at the level of the atrium with enlargement of the subarachnoid spaces homo-, contra- or bilaterally, and predominantly in the parietooccipital areas. The head circumference was normal in all cases with no family history of macrocephaly. MRI did not demonstrate either abnormal signal within brain parenchyma or loss of the normal layering of the developing brain. CONCLUSION: Posterior mild ventricular dilatation and prominent subarachnoid spaces in a posterior distribution can be considered an early stage of benign external hydrocephalus that is nicely illustrated by MRI.

Diffuse choroidal hemangioma: report of a clinicopathological study in a 4-year-old boy.

The authors examined the clinicopathologic features of a 4-year-old boy with a diffuse choroidal hemangioma, yet without any features of the Sturge-Weber syndrome. The tumor occurred as a grayish intraocular mass with an overlying retinal detachment and was highly reflective in the ultrasonic examination. After contrast, the CT scan revealed diffuse thickening of the ocular wall associated with an enhanced irregular orbital mass. The pathologic examination revealed a cavernous hemangioma involving the entire choroid with extrascleral extension. Diffuse choroidal hemangioma occurring in childhood and unrelated to the Sturge-Weber syndrome is a rare condition that should be included in the differential diagnosis of retinoblastoma.

In vivo MRI of fetal brain cellular migration.

The multilayered pattern of the brain parenchyma corresponding to the cellular migrational process is demonstrated in the in vivo MR study of a 23-week-old fetus.

Attitudes toward certification. A pilot study.

The CNOR certification is a voluntary commitment that individual perioperative nurses make after considering financial, professional, and personal issues. The results of this survey indicate that CNOR certification is sought to fulfill personal and professional goals. A vital component in the delivery of quality perioperative patient care is the individual nurse. This is true whether or not the perioperative nurse is certified. One question is the value of the CNOR process in the validation of nurses for the delivery of perioperative patient care. It is easy to assume that if knowledge is present, the knowledge will be applied. Assumptions, however, can be misleading. These findings suggest that several nursing traits interact to promote quality perioperative patient care delivery, and CNOR certification is only one of those traits. Claims of CNOR outcomes should be based on documented support rather than assumption and speculation. Further investigation on a much larger and more inclusive scale is needed before suggesting specific changes to the present certification process. This project substantiates the process and the feasibility of conducting future studies. Using a modification of this survey tool in future studies would provide support to the reliability of these findings. This investigation shows that CNOR certification is an important topic to perioperative nursing. With current NCB:PNI proposals and other national considerations, CNOR certification will continue to be an important issue.

Case study: single lung transplantation for alpha 1-antitrypsin deficiency.

alpha 1-Antitrypsin deficiency predisposes individuals to emphysematous pulmonary changes. Single lung transplantation (SLTX) represents a promising, viable option for the management of alpha 1-antitrypsin deficiency/chronic obstructive pulmonary disease (COPD). The purpose of this case study is to discuss the relationship between alpha 1-antitrypsin deficiency. COPD, and SLTX, and the role of the perioperative nurse.

Case study: infant transplantation: a change of heart.

The majority of infant heart transplants are for the correction of hypoplastic left heart syndrome (HLHS). This article will describe the preoperative, intraoperative, and postoperative care for perioperative and pediatric intensive care areas implemented for HLHS infant heart transplantation at Medical Center Hospital, San Antonio, TX. The surgical procedure is given. Dimensions of psychosocial care and education of the parents are briefly described.

A patient classification system for the OR.

Changes are still occurring as we continue to refine the tool. We have now determined that not all OR nurses need to learn to use the tool. The head nurse or assistant head nurse can do it quickly. We are continuing to gather data and hope to have input from other hospitals interested in testing the tool.