Bulging Fontanelle Research Articles

Increased intracranial pressure with bulging fontanel. A symptom of vitamin A deficiency in infants.

Increased intracranial pressure with bulging fontanel. A symptom of vitamin A deficiency in infants.

Roseola Infantum

A bulging fontanel in an infant is generally regarded as a sign of serious central nervous system disease. It may be caused by meningitis, hydrocephalus, cerebral hemorrhage, brain abscess, or tumor. Benign intracranial hypertension, a syndrome of increased intracranial pressure with a normal ventricular system and a cerebrospinal fluid of normal composition, also will produce a bulging fontanel. Hypoparathyroidism,1hypovitaminosis A,2,3hypervitaminosis A,4hypophosphatasia,5marked anemia,6chlortetracycline therapy,7Addison's disease,8and pulmonary emphysema,9have been reported as causes of benign intracranial hypertension. Scattered reports10,11,12of the association of roseola infantum with a bulging fontanel have appeared in the literature. The following report of 2 cases is being presented as further illustration of this disease as a cause of benign intracranial hypertension. Case1.—A 5-month-old white boy was in good health until 3 days prior to admission, when the mother noted that

Late prognosis in asphyxia neonatorum.

SummaryEightyfive children treated at a children's hospital for asphyxia neonatorum were subjected to a follow‐up examination. Eighteen died during the newborn period. Sixtyfive of the 67 survivals were followed up. Among them 18 showed signs of a permanent cerebral injury (spasticity, mental retardation, convulsions). The late prognosis was correlated to different clinical symptoms during the newborn period. Children with convulsions, changed tonus, bulging fontanel, reduced sucking capacity have a conspicuously bad prognosis.

MICROCEPHALIA AS A COMPLICATION OF PNEUMOCOCCIC MENINGITIS

WITH THE advent of chemotherapy and subsequent recovery from a disease formerly 100 per cent fatal, hitherto unsuspected complications can be anticipated. The following case of microcephalia resulting from pneumococcic meningitis is therefore reported. REPORT OF A CASE S. N., a 2½ month old white girl, was admitted to Children's Hospital on March 19, 1946 with the presenting complaint of irritability, rigidity and pallor of seven hours' duration. Following her 3 a. m. feeding on the day of entry, the patient was noted to become listless, irritable and, then, semicomatose. She was seen by one of us (H. E. T.), who observed generalized twitching, bulging fontanel and semicomatose state. The temperature was 102 F. rectally. The patient was hospitalized immediately. On her admission respirations numbered 40 to 60 per minute. The lungs, however, were clear to percussion and auscultation. The heart rate was 170 with a tick-tack rhythm. Kernig's reflex

MENINGITIS DUE TO BACILLUS ACIDI-LACTICI IN A NEW-BORN INFANT

Bacillus acidi-lactici is a gram-negative bacillus closely allied to the colon bacillus group. It is frequently found in the intestinal canal, and is usually considered to be a harmless saprophyte without pathogenic significance. It may be present in water, and is commonly present in milk. 1 Greenthal 2 reported a case of meningitis due to Bacillus acidi-lactici that occurred in a premature colored girl, aged 1 month. The weight at birth was 4 pounds (1,814 Gm.). There were generalized convulsions, apathy, a bulging fontanel and, later, stupor. The infant refused feedings and appeared ill. There was no fever, vomiting, stiffness of the neck or retraction of the head, and no Kernig sign. The lumbar puncture yielded a thick, pure white, purulent fluid from which Bacillus acidi-lactici was recovered on culture. Death occurred on the eighth day after the onset of symptoms. At postmortem examination, Bacillus acidi-lactici was recovered from the