Asunto(s)
Meningitis/tratamiento farmacológico , Complejo Vitamínico B/uso terapéutico , Adolescente , Niño , Preescolar , Combinación de Medicamentos , Femenino , Humanos , Lactante , Masculino , Meningitis/clasificación , Tiamina/uso terapéutico , Resultado del Tratamiento , Vitamina B 12/uso terapéutico , Vitamina B 6/uso terapéuticoRESUMEN
Transcranial dopplerography was performed in 125 children with late (1-3 years) neurologic sequelae of acute neuroinfections. Decreased blood flow velocity (BFV) in middle cerebral arteries of (0.61 of the value in control group) was found in patients with movement disorders. Impairment of the intracranial venous outflow together with both acceleration and asymmetry of blood flow in basal veins was prevalent in children with intracranial hypertension and hydrocephaly syndrome. Hyperconstriction of cerebral vessels together with a low BFV (30% of the initial value) was observed during hyperventilation on the side of the lesion in patients with epileptic syndrome. In children with cerebrasthenic syndrome the effect of cavinton treatment depended on the type of changes in cerebral blood flow: positive effect was found in patients with asymmetric decrease of BFV in anterior cerebral arteries.
Asunto(s)
Infecciones del Sistema Nervioso Central/diagnóstico por imagen , Ultrasonografía Doppler/métodos , Enfermedad Aguda , Velocidad del Flujo Sanguíneo/fisiología , Circulación Cerebrovascular/fisiología , Niño , Preescolar , Humanos , Hidrocefalia/diagnóstico , Hipertensión Intracraneal/diagnóstico , Índice de Severidad de la Enfermedad , Factores de TiempoRESUMEN
Spectral and visual analysis of EEG was performed in 156 children with acute neuroinfections. It revealed some variants of EEG tracings, related to different grades of a compensation of intracranial hypertension (ICH), the changes in cerebral blood flow and a level of a damage of brainstem in dislocation syndrome. In patients with compensated and subcompensated ICH a polyrhythmic EEG was registered, while the changes in cerebral blood flow were moderate. 91% of the patients of these groups completely recovered. The patients with decompensated ICH and with mesencephalic level of brain dislocation had slow monotonous EEG; those with bulbar lesion had a suppression of bioelectric activity; a decrease of cerebral blood flow as well as an impaired autoregulation were observed. 5 patients from this group died, and the others survived with neurologic impairments of different degree. The conclusion was made about the dependence of EEG character in acute period of neuroinfection on the grade of the elevation of intracranial pressure and on the level of the brainstem damage and about the possibility to prognose an outcome of the disease on the basis of EEG characteristics.
Asunto(s)
Meningitis Bacterianas/diagnóstico , Enfermedad Aguda , Encéfalo/irrigación sanguínea , Tronco Encefálico/irrigación sanguínea , Niño , Preescolar , Electroencefalografía , Hemodinámica/fisiología , Humanos , Lactante , Meningitis Bacterianas/complicaciones , Pronóstico , Seudotumor Cerebral/complicaciones , Seudotumor Cerebral/diagnóstico , Flujo Sanguíneo Regional , Índice de Severidad de la EnfermedadRESUMEN
A subdural exudate (SE) complicating bacterial meningitis in 28 children was diagnosed by the findings at diaphanoscopy, subdurography, thermography, CT, EEG, echo-EG, rheo-EG in the evidence of aggravating neurological symptoms. SE drainage was carried out in all the cases, in 20 patients it was bilateral. CNS age-specific anatomicophysiological features responsible for emergence of the exudate primarily in the anterior hemispheric compartments subject to consequent atrophy are considered when assessing mechanisms of the exudate development in infants.