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Query: UMLS:C0264733 (ventricular dilatation)
 2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of a simple technique for multiplane echocardiographic analysis and study of the effect of arrhythmia enabled us to investigate the mechanism of premature opening of the aortic valve in two patients with subacute aortic insufficiency. In one patient, premature opening evolved with the development of left ventricular dilatation and failure. In this case the prematurity of opening in each beat was related to diastolic filling time and was accompanied by septal recoil and by premature closure of the mitral valve. We classified this as the diastolic duration-dependent subgroup. In the second patient, who had a hypertrophied, non-dilated left ventricle, premature opening depended on atrial contraction and was independent of diastolic filling time. This case defined an atrial contraction-dependent subgroup. In the light of these findings we analyzed previously reported cases in patients with acute severe aortic insufficiency. These patients appear to fall into the diastolic duration-dependent subgroup.
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PMID:Pathophysiologic observations on premature opening of the aortic valve utilizing a technique for multiplane echocardiographic analysis. 43 54

Twins have higher rates of perinatal mortality, prematurity and its complications, low birth weight, intrauterine growth retardation, congenital anomalies and long-term developmental morbidity. In 31 twin pairs we evaluated the incidence and severity of peri-intraventricular hemorrhage (PIVH) and post-hemorrhagic ventricular dilatation. On ultrasonography minor PIVH (grades I and II) was observed in 26% of A twins and 25% of B twins (p less than 0.5). Major PIVH (grades III and IV) was less common, occurring in 3% of A twins and 6% of B twins (p less than 0.5). Ventriculomegaly, mostly regressive was equally distributed between the two groups of babies. From these results it can be concluded that with efficient antenatal care and skillful perinatal management of twin pregnancy, the incidence of major perinatal neurological complications such as PIVH and ventriculomegaly are not higher in the second-born twin.
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PMID:Neurosonographic assessment of twin pairs in the perinatal period. 240 69

A prospective neurological and developmental assessment at 12 months of age corrected for prematurity was performed on 54 surviving preterm infants of 34 weeks' gestation or less. The babies were allocated into three groups according to their ultrasound (US) appearances: Group I (n = 29), normal scan; Group II (n = 10), isolated periventricular-intraventricular haemorrhage (PVH); Group III (n = 15), association of PVH, periventricular leukomalacia (PVL) and ventricular dilatation. The developmental outcome evaluated with the Griffiths' development quotient (DQ) was good and similar in Groups I and II, while it was worse and variable in Group III. There was also a higher incidence of neurological abnormalities in Group III, as 47% of children only were found to be normal compared to 86% and 80% in Groups I and II, respectively. A major handicap was diagnosed in 5 children of Group III. Infants with small lesions of PVH or PVL or with ventricular dilatation developed as well as children with normal US scan, whereas more diffuse or extensive US changes of PVL had a poorer prognosis. The outcome of a cerebral injury seems to depend on the type, the size and localisation of the lesion, and to some extent, on the neuroplasticity of the developing brain.
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PMID:Neurodevelopmental outcome at 12 months of age related to cerebral ultrasound appearances of high risk preterm infants. 241 95

Peri-intraventricular hemorrhage (PIVH) is a major problem of preterm neonates: over 40% of infants with birth weight less than 1500 g have been found to experience this disorder. The posthemorrhagic hydrocephalus (PHH) is generally believed to occur secondary to obliterative posterior fossa arachnoiditis. Its management in critically ill premature infants with multiple medical problems has thus become quite significant. This paper reports the results of the placement of a temporary external ventricular drainage in three patients in whom progressive ventricular dilatation began within two weeks after severe neonatal PIVH. In all patients the hydrocephalus and increased intracranial pressure were controlled within three weeks of treatment. One infant died from other problems associated with his prematurity. Early demonstration of progressive ventricular dilatation by ultrasound and prompt external drainage has been found to be a safe initial method to treat PHH in preterm infants.
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PMID:Treatment of progressive posthemorrhagic hydrocephalus with temporary external ventricular drainage. Preliminary results. 353 86

A prospective neurological and developmental assessment was completed at ages 6, 9, and 12 months on 39 preterm infants under 34 weeks' gestation. In the newborn period each infant had an assessment of gestation and sequential neurological and ultrasound examinations and was placed in one of three groups: intraventricular haemorrhage (IVH) (n = 14), IVH followed by ventricular dilatation (n = 11), and control infants with no evidence of IVH (n = 14). When corrected for prematurity the Griffiths's developmental quotients (DQs) were normal at 6, 9, and 12 months for every infant except one aged 12 months. In contrast, the uncorrected DQs at 12 months were under 80 in only one of the 14 preterm infants without haemorrhage, compared with 2 of the 14 with IVH, and with 7 of the 9 with IVH and dilatation. There was also a higher incidence of neurological abnormality at each follow-up age in the infants with IVH plus ventricular dilatation, compared with those with IVH alone, or with infants without IVH. Similar differences were also demonstrated in 5 milestones reflecting gross motor, fine motor, and social or verbal development in the three groups at 6, 9, and 12 months. The neurological and developmental deficits seemed to relate more closely to the presence of post-haemorrhagic ventricular dilatation than to the size of the initial haemorrhage itself. These results may have important implications for therapeutic intervention in the management of newborn infants with IVH and ventricular dilatation.
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PMID:Developmental and neurological progress of preterm infants with intraventricular haemorrhage and ventricular dilatation. 713 63

The neurodevelopmental outcome of 78 infants with bronchopulmonary dysplasia (BPD) was compared with that of 78 control infants matched for birthweight. To determine the effect of the severity of BPD, 62 infants requiring oxygen at 36 weeks' postmenstrual age (sBPD) were compared with their matched controls. Infants were followed up to 2 years of age, corrected for prematurity, and were classified for neurological impairment, developmental delay, and neurodevelopmental disability. Seventy six (98%) BPD infants and 71 (91%) controls had follow up data available to two years. Neurological impairment, developmental delay, and neurodevelopmental disability occurred more frequently in infants with BPD than in controls but this was not significant. For infants with sBPD, the increased incidence of neurological impairment and definite developmental delay was not significant when compared with the controls, though neurodevelopmental disability occurred more frequently (odds ratio (OR) 3.6: 95% confidence intervals (CI) 1.1-11.8). Predictors of disability in infants with sBPD included periventricular haemorrhage (OR 19.4: 95% CI 4.3-86.6), ventricular dilatation (OR 12.8: 95% CI 2.9-57.3), and sepsis (OR 5.0: 95% CI 1.3-19.4). Adjusting for the presence of these factors, the association between BPD and disability was no longer apparent (OR 0.9: 95% CI 0.2-3.6). The findings suggest that BPD is not independently associated with adverse neurodevelopmental outcome.
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PMID:Neurodevelopmental outcome of preterm infants with bronchopulmonary dysplasia. 853 67

A 3D cellular anisotropic automata model with modifiable geometry is described. The modeling parameters include grain size, fiber orientation, and free-wall and septal thickness. From this modifiable model, three specific models corresponding to normal heart, left ventricular hypertrophy, and ventricular dilatation were generated. Each model is a conduction and propagation model in which the atria, the major atrial vessel bases, the ventricles, and the specialized conduction system are represented. Muscle tissues are modeled as bundles of fibers with anisotropic conduction speed of the activation wavefronts. Regional variations of conduction, refractory gradients, and regional potential gradients can also be specified before each simulation. Each element has adaptive properties with respect to cycle length and to the prematurity of incoming impulses. Action potentials can be specified for each cell and an equivalent source formulation is carried out to simulate the vectorcardiogram and the corresponding 12-standard-lead electrocardiogram.
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PMID:An interactive 3D anisotropic cellular automata model of the heart. 979 Jul 39

This study investigated the influence of bronchopulmonary dysplasia (BPD) on the motor development of children in the first two years of life. Sixty-four children with BPD and 53 control infants were assessed at eight months and two years corrected for prematurity using the neuro-sensory and motor development assessment (NSMDA). Results indicated a significant delay in gross motor performance of the study children at eight months. By two years, considerable catch-up had occurred, but a significant difference in postural control and balance between the study and control groups was identified. When corrected for periventricular haemorrhage and ventricular dilatation, although substantial, the difference was not statistically significant. When growth <10th centile was considered in the study infants, postural control, overall motor performance and neurological status were significantly less than in those whose growth was within normal limits.
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PMID:Bronchopulmonary dysplasia: a comparative study of motor development to two years of age. 1167 69

OBJECTIVE: To verify the predictive values of neonatal cerebral ultrasonography for motor and cognitive development of very low birth weight preterm babies after twelve months correct age. METHODS: The population studied was a cohort of preterm babies with birth weight less than 1,500g, who had been admitted in the Neonatal Intensive Care Unit of Instituto Fernandes Figueira, and were followed to 12-30 months corrected age for prematurity. A cerebral ultrasonography was performed before discharge. The results were classified as normal and abnormal (parenchymal hemorrhage, porencephaly, periventricular leucomalacia, ventricular dilatation). The babies were followed in the Follow-up Clinic and between 12-30 months correct age they underwent a neurological assessment with observation of the acquisition of motor milestones and submitted to Bayley Scales of Development. RESULTS: We studied 83 babies. Cerebral ultrasonography was normal in 68 babies (81.9%) and abnormal in 15 (18.8%). With a mean age of 21 months, 63 children (75.9%) had normal motor development and 20 (24.0%) had motor abnormalities. The cognitive development was normal in 68 children (81.9%). The negative predictive value of the cerebral ultrasonography for motor development was 85.3%, and for cognitive development, 86.8%. The positive predictive value of the cerebral ultrasonography for motor development was 66.7% and for cognitive development, 42.9%. CONCLUSIONS: The negative predictive values were greater than the positive predictive values in both areas of development. The probability for children with normal neonatal ultrasonography to have normal motor and cognitive development is greater than 85%.
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PMID:[Normal neonatal cerebral ultrasonography in preterm infants - Is it possible to calm down the parents?] 1468 63

Infantile hemiparesis may be associated with significant morbidity and may have a profound impact on a child's physical and social development. There are little published data evaluating the clinicopathologic features of patients with infantile hemiparesis. The present study retrospectively examines these clinicopathologic features in a surgical series of 21 patients with infantile hemiparesis. The study group was comprised of 21 patients, 13 females and 8 males, ranging in age from 5 to 41 years (mean, 20 years) at the time of surgery. Hemiparesis involved the right side in 16 patients and the left side in 5 patients. Imaging studies identified porencephaly in 8 patients (38%), encephalomalacia in 5 patients (24%), focal cerebral atrophy in 9 patients (43%), ventricular dilatation in 6 patients (29%), and white matter hyperintensities in 4 patients (19%). Concomitant neurologic diseases included medically intractable epilepsy in all 21 patients and visual field defects in 11 patients (52%). Significant perinatal history included prematurity in 7 patients (33%) and cesarean section, forceps delivery, placental abruption, fetal distress, and prolonged rupture of membranes each in 1 patient (5%). The remainder of the patients had an uncomplicated perinatal course (43%). Twelve patients underwent functional hemispherectomy (57%), 8 patients underwent lobectomy (38%) and 1 patient underwent "cyst" resection (5%). Histological evaluation demonstrated lesional (corresponding to radiographic findings) tissue in 15 of the 21 cases (71%). Infarction, malformations due to abnormalities of cortical development (cortical dysplasia) and gliosis with microcalcifications were each found in 6 patients (29%). Infarction and a geographically distinct area of cortical dysplasia were found to coexist in 1 case. Histopathologic findings in the 6 cases in which excised tissue was considered nonlesional included gliosis in all 6 of the cases, hippocampal sclerosis in 2 cases (10%), and neuronal heterotopia in 2 cases (10%). An osteoma was identified in 1 patient. The most common pathological findings observed in our series were infarction and cortical dysplasia, although radiographically, infarct-related changes were the most evident. Hippocampal sclerosis was encountered in 2 patients, suggesting that a subset of cortical dysplasias and hippocampal sclerosis may be caused by an in utero ischemic event.
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PMID:Clinicopathologic findings in patients with infantile hemiparesis and epilepsy. 1518 40


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