Dichotic listening in a child with a cerebral lesion: the "paradoxical" ipsilateral ear deficit.

Behavioral testing is reported for a child with a deep, left cerebral lesion that displaced the third ventricle across midline and compressed and elevated the lateral ventricle, presumably disrupting interhemispheric auditory pathways. The onset of the lesion was before 2 1/2 years of age. Cognitive screening tests indicated normal nonverbal (visual perceptual) and semantic (confrontation naming) abilities, but impaired syntactic skills. Audiological testing showed an isolated ipsilateral ear abnormality on dichotic testing only. All other audiological results, including monotic testing with the same speech materials, were normal. Results were comparable to findings in adults with similar lesions.

Clinical trials of vasoactive and antiserotonin drugs in Duchenne muscular dystrophy.

In clinical trials of vasoactive and antiserotonin agents in Duchenne muscular dystrophy, we found that methysergide, 8 mg daily, was associated with an average 44% improvement in Gower Time (i.e., time to arise from supine) and an average 16% improvement in ward walking time. We then did a double blind crossover study of methysergide and found an average improvement of 33% in head holding time with methysergide compared to placebo. In other tests, including grip strength, ward walking time, and Gower Time, methysergide average scores always were better than placebo average scores, but never by more than 12%, and at no time did the differences reach statistical significance. There was no clinical or laboratory evidence of toxicity of methysergide. We conclude, that under the conditions of testing, there was no statistically significant evidence for short-term benefit from methysergide in Duchenne muscular dystrophy.

Moderate, rapidly induced hypertension as a cause of intraventricular hemorrhage in the newborn beagle model.

Nine anesthetized, artificially ventilated, term newborn beagle puppies were given phenylephrine hydrochloride intravenously while systemic arterial, carotid arterial, and jugular venous blood pressures, and carotid arterial blood flow were monitored. Systemic blood pressure rose within seconds from a mean of 53.68 +/- 1.10 mm Hg to a mean of 81.92 +/- 5.14 mm Hg. Hypertension was maintained for up to one hour in each animal. Four of the nine pups had intraventricular hemorrhages that were visible to gross inspection at autopsy, and seven of the nine pups had subependymal hemorrhages. The blood pressures produced in these animals were within the range of those seen in premature infants. Thus, moderate, rapidly induced systemic hypertension may be a cause of intraventricular hemorrhage in the premature human newborn infant.

Intraventricular hemorrhage--an animal model.

Hemodynamic monitoring was carried out in 9 newborn beagle puppies exposed to hypercarbic insult. 4 animals were exposed to slowly increasing carbon dioxide tensions without hypoxemia; 5 animals were exposed to rapid, intense increase in carbon dioxide tensions without hypoxemia. 2 of the 5 puppies (40%) exposed to the rapid hypercarbia developed intraventricular hemorrhage characteristic of that found in the immature human. All of the puppies exhibited germinal matrix layers comparable to those of 30- to 32-week gestational age human infants. Significantly higher systemic arterial and jugular venous pressures were documented during the baseline and experimental periods in the 2 animals that bled. A predisposition to hemorrhage may have been present in these 2 animals because of hypertension in the baseline period. This preliminary study demonstrates that a histological model for IVH exists in an animal which is stable enough for extensive hemodynamic monitoring.

Vascular malformations of the pons in children.

Three children reported here and an additional five patients from the literature with angiomas of the pons had a total of 19 clinical episodes of neurologic "illness." Thirteen of these episodes were ictal and six were progressive in onset. The progressive onset was identical with that occurring in patients with tumors of the brain stem. Laboratory and radiographic studies were not uniformly helpful in differentiating this disorder from the more common brain-stem glioma. The survival of these patients varies from several hours to 15 years.

Eastern equine encephalomyelitis. Histopathologic and ultrastructural changes with isolation of the virus in a human case.

Enveloped Toga virus particles were demonstrated by means of an electron microscopy in the brain tissues of a 3-year-old girl with acute encephalitis. Areas of demyelinization and necrosis throughout the white matter and brainstem were revealed by light microscopy. These viral particles were identified as eastern equine encephalomyelitis virus in postmortem isolation of the virus utilizing young mice and complement-fixation studies. To the authors' knowledge, this is the first demonstration of eastern equine encephalomyelitis virus particles in human tissues by electron microscopy.