Clinical and neuroimaging profile of congenital brain malformations in children with spastic cerebral palsy.

PURPOSE: Analysis of the incidence of congenital brain malformations in children with spastic cerebral palsy (CP) in a hospital-based study. MATERIAL AND METHODS: The present study included 74 boys and 56 girls with spastic tetraplegia, diplegia, and hemiplegia CP. Magnetic resonance imaging MRI findings were analyzed in children with CP. RESULTS: Significant abnormalities relevant to the CP were evident on MRI in 124 (95.3%) subjects. Periventicular leukomalacia (PVL) was detected more frequently in children with spastic diplegia than in patients with tetraplegia or hemiplegia. Cerebral atrophy was found more often in the tetraplegic group compared to the diplegic patients. Porencephalic cysts were detected more often in children with spastic hemiplegia. Congenital brain anomalies were evident in 15 (10.7%) children with spastic CP. Brain malformations included: schizencephaly (5), agenesis corpus callosum (4), polymicrogyria (2), holoprosencephaly (2) and lissencephaly (2). Intractable epilepsy and mental retardation were observed more often in children with brain anomalies. Twelve patients with congenital brain malformations were born at term and three born at preterm. CONCLUSIONS: Neuroimaging results in children with CP may help determine the etiology and make better prognosis of CP.

[Investigations of thyroid function in children and adolescents after treatment of Hodgkin's disease].

Radiotherapy focused on the neck, upper mediastinum or cranium can raise the risk of thyroid dysfunction. The influence of radio- and chemotherapy on thyroid morphology and function after treatment of Hodgkin's disease in 31 children and acute lymphoblastic leucaemia in 36 children was evaluated. Clinical examination, estimation of blood TSH, FT4 levels as well as ultrasonographic scan were performed. In the group of children with Hodgkin s disease the blood level of ATG Antithyreoglobulins andMAB, microsmal antibodies were estimated. The results of clinical examination were normal in all patients. Thyroid function tests were also normal, except for one case with elevated TSH values (22.76 microIU/ml) and decreased FT4 values (0.65 ng/ml). Three patients (9.7%) with Hodgkin s disease and three (8.5%) with ALL (only one had cranial radiotherapy) had an abnormal image of thyroid in ultrasonography (hypoechogenicity, heterogenous ultrasound scan, solid nodule). The results of our investigations indicate that abnormalities found in the ultrasound scan in children and adolescents with Hodgkin's disease in whom treatment has been terminated, can be a first prodrome of thyroid pathology.

[Echinococcus granulosus cysts in the liver. Ultrasonography findings during medical treatment]. / Torbiele watroby wywolane przez Echinococcus granulosus. Zmiany w obrazie ultrasonograficznym w czasie leczenia.

Since the sensitivity and specificity of serologic tests for echinococcosis is low, the role of imaging techniques is increasing. The goal of this study was to determine the usefulness of ultrasonography in diagnostics and classification of liver hydatid cysts and in the follow up after antiparasitic treatment. The study group of 35 persons, 26 women (mean age 42 years) and 9 men (mean age 39 years) was selected. The echography diagnosis was made using Toschiba scanner (SSH 140 A) with 3.75 and 7.5 MHz transducers. All 35 patients had positive results of serological tests for echinococcosis (EIA and/or indirect hemagglutination). The liver hydatid cysts (h.c.) are classified into seven types according to Caremani et all: I--simple h.c., II--multiple h.c., III--h.c. with detachment of the wall, IV--h.c. with mixed pattern with or without septations, V--heterogenous h.c., VI--hyperechoic h.c., VII--calcified h.c. The antiparasitic chemiotherapy with albendazole (10 mg/kg) was applied to 23 patients with total number of 59 h.c. of types I, II, III, IV, V. The observation points that cysts types I, II, III, IV, V respond to antiparasitic treatment. Our findings show that the sonographic patterns of cyst degeneration are seen with greater frequency in treated cysts than in nontreated ones.

[Diagnostic difficulties in tuberculous meningoencephalitis]. / Trudnosci w rozpoznaniu gruzliczego zapalenia opon mózgowo-rdzeniowych i mózgu.

Five cases of tuberculous meningoencephalitis with severe course treated in the period 1991-1994 at the Department of Parasitic Diseases and Neuroinfections, Medical Academy in Bialystok are reported. Diagnostic difficulties encountered in these cases, the clinical courses and the results of the treatment are discussed. The always lethal outcome of untreated tuberculous meningoencephalitis requires antituberculosis treatment to be tried in all cases of meningitis with severe and protracted course, with equivocal results of cerebrospinal fluid analysis, and lacking effect of non-specific therapy.