Dilatation Of Lateral Ventricles Research Articles

Large Encephalocele at the Anterior Fontanel

The authors report a newborn girl with a large meningoencephalocele, 18.5 cm in diameter, at the anterior fontanel. She had several accompanying anomalies, including microcephalus, cleft palate, and a uvula bifida. A plain skull x-ray revealed craniolacunia and a computed tomography (CT) scan showed maldevelopment of the cerebrum. The mass was resected, after which the fontanel was noted to bulge. CT demonstrated dilated lateral ventricles. A successful shunting procedure permitted the infant to leave the hospital in good general condition.

Evaluation of the developmental toxicity of β-(3,4-epoxycyclohexyl)ethyltrimethoxysilane in Fischer 344 rats and New Zealand white rabbits

β-(3,4-epoxycyclohexyl)ethyltrimethoxysilane (ECEMS, CAS No. 3388-04-3) is mutagenic in vitro and weakly carcinogenic in mice after dermal application. Timed pregnant Fischer 344 rats and New Zealand white rabbits were dosed with ECEMS in corn oil by gavage on gestational days (gd) 6 through 15 at doses of 0.0, 0.25, 1.0, or 2.5 ml ECEMS/kg for rats and 0.0, 0.05, 0.25, or 0.75 ml ECEMS/kg for rabbits. At termination on gd 21 (rats) or gd 29 (rabbits), live fetuses were examined for external, visceral, and skeletal alterations. In rats, maternal toxicity was observed at 1.0 and 2.5 ml/kg, as evidenced by reduced weight gain and food consumption during treatment, clinical signs of toxicity, reduced body weight on gd 21 (corrected for gravid uterine weight), and increased relative liver weight. There were no significant differences among groups on pre- or postimplantation loss, fetal body weight/litter, or on the incidence of malformations. Minimal fetal toxicity, dilated lateral cerebral ventricles and reduced ossification in the forelimbs, was observed at 2.5 ml/kg. In rabbits, maternal mortality ( 2 20 does) and slightly (but statistically significantly) elevated maternal relative kidney weight were observed at 0.75 ml/kg. Clinical signs of toxicity were observed at 0.25 and 0.75 ml/kg. Pre- and postimplantation loss, fetal body weight/litter, and the incidence of malformations were all unaffected by treatment. Minimal fetal toxicity, extra (13th) ribs and reduced ossification in lumbar arch 4, was observed at 0.75 ml/kg ECEMS. Therefore, administration of ECEMS during organogenesis in rats and rabbits produced maternal toxicity at 1.0 and 2.5 ml/kg in rats and at 0.25 and 0.75 ml/kg in rabbits. Minimal fetal toxicity was observed at 2.5 ml/kg in rats and at 0.75 ml/kg in rabbits. No embryotoxicity or teratogenicity was observed in either species at any dosage. The “no observable effect level” (NOEL) for maternal toxicity was 0.25 ml/kg for rats and 0.05 ml/kg for rabbits; the NOEL for developmental toxicity was 1.0 ml/kg for rats and 0.25 ml/kg for rabbits.

Evaluation of the Developmental Toxicity of β-(3,4-Epoxycyclohexyl) ethytrimethosysilane in Fischer 344 Rats and New Zealand Whit Rabbits

Evaluation of the Developmental Toxicity of β-(3,4-Epoxycyclohexyl)ethyltrimethoxysilane in Fischer 344 Rats and New Zealand White Rabbits. TYL, R. W., BALLANTYNE, B., FISHER, L. C, AND FRANCE, K. A. (1988). Fundam Appl Toxicol. 10, 439–452. β-(3,4-epoxycyclohex-yl)ethyltrimethoxysilane (ECEMS, CAS No. 3388-04-3) is mutagenic in vitro and weakly carcinogenic in mice after dermal application. Timed pregnant Fischer 344 rats and New Zealand white rabbits were dosed with ECEMS in corn oil by gavage on gestational days (gd) 6 through 15 at doses of 0.0,0.25, 1.0, or 2.5 ml ECEMS/kg for rats and 0.0,0.05,0.25, or 0.75 ml ECEMS/kg for rabbits. At termination on gd 21 (rats) or gd 29 (rabbits), live fetuses were examined for external, visceral, and skeletal alterations. In rats, maternal toxicity was observed at 1.0 and 2.5 ml/kg, as evidenced by reduced weight gain and food consumption during treatment, clinical signs of toxicity, reduced body weight on gd 21 (corrected for gravid uterine weight), and increased relative liver weight. There were no significant differences among groups on pre- or postimplantation loss, fetal body weight/litter, or on the incidence of malformations. Minimal fetal toxicity, dilated lateral cerebral ventricles and reduced ossification in the forelimbs, was observed at 2.5 ml/kg. In rabbits, maternal mortality (2/20 does) and slightly (but statistically significantly) elevated maternal relative kidney weight were observed at 0.75 ml/kg. Clinical signs of toxicity were observed at 0.25 and 0.75 ml/kg. Pre- and postimplantation loss, fetal body weight/litter, and the incidence of malformations were all unaffected by treatment. Minimal fetal toxicity, extra (13th) ribs and reduced ossification in lumbar arch 4, was observed at 0.75 ml/kg ECEMS. Therefore, administration of ECEMS during organogenesis in rats and rabbits produced maternal toxicity at 1.0 and 2.5 ml/kg in rats and at 0.25 and 0.75 ml/kg in rabbits. Minimal fetal toxicity was observed at 2.5 ml/kg in rats and at 0.75 ml/kg in rabbits. No embryo-toxicity or teratogenicity was observed in either species at any dosage. The ”no observable effect level” (NOEL) for maternal toxicity was 0.25 ml/kg for rats and 0.05 ml/kg for rabbits; the NOEL for developmental toxicity was 1.0 ml7sol;kg for rats and 0.25 ml/kg for rabbits.

Hemimegalencephaly: MR imaging in five children.

Hemimegalencephaly is a rare brain malformation characterized by cerebral asymmetry and cortical dysplasia. Infants with the condition present with early seizures and severe encephalopathy. Five patients were studied with computed tomography and magnetic resonance (MR) imaging. MR imaging was the most efficient diagnostic method for this rare entity. It demonstrated brain hemispheric hypertrophy with lateral ventricle dilatation, abnormal gyral pattern, and a thick cortex on the enlarged side. The images correlate well with the known pathologic data.

Changes in cerebral microvasculature in congenital hydrocephalus of the inbred rat lew/jms: Light and electron microscopic examination

The vascular apparatus in congenitally hydrocephalic rat brains was studied. The characteristic findings were structural changes in the small vessels with formation of an intracerebral cavity in the periventricular white matter. Stenotic or occluded blood vessels were located in an edematous area adjacent to the dilated lateral ventricles. Electron microscopically, the endothelial cells of capillaries and venules in the periventricular edematous region showed an irregular surface with indentations, and contained numerous plasmalemmal vesicles. Occluded capillaries were found in the border zone between the edematous and nonedematous area. These vascular changes indicate the presence of a disturbed microcirculation in the hydrocephalic brain.

Morphological aspects of the development of hydrocephalus in a mouse mutant (SUMS/NP).

The SUMS/NP is a mouse mutant with a recessive gene for congenital hydrocephalus. The condition is detectable outwardly at 3 days after birth and affected animals die soon after weaning. The heads of fetuses from 14 to 20 days gestation and at 1, 4, 5, 12 and 18 days after birth have been sectioned for light microscopy and the volume of the lateral ventricles measured in all but the three oldest ages. At 16 days gestation and earlier all fetuses had a relatively large lateral ventricle volume. Hydrocephalus was first detected from volume measurements at 18 days gestation and generally became progressively more severe with age. Hydrocephalic animals, in addition to lateral and third ventricle dilatation, always showed a reduction in the cross-sectional area of the cerebral aqueduct or a total absence of the aqueduct. All hydrocephalics, with the exception of two fetuses, also had cystic cavitation of the forebrain around the lateral ventricles. Electron microscopy of animals with a reduced aqueduct showed the ventral part to be absent in hydrocephalics.

Focal vulnerability of developing brain: CT studies on disproportionally dilated lateral ventricles.

Cranial computed tomography (CT) of 108 cases with dilated lateral ventricles was reviewed to elucidate the relationship between focal vulnerability of developing brain and disproportional dilatation of lateral ventricles. CT findings of 108 cases with symmetrical dilatation of lateral ventricles were classified into three types by morphometry of lateral ventricles: anterior horn predominant type (31 cases), diffuse type (36 cases), posterior horn predominant type (41 cases). Posterior horn predominant type has a tendency to occur in congenital anomalies and premature brain damage, and anterior horn predominant type in infantile brain damage. This disproportional dilatation of anterior or posterior horns suggests a vulnerability of periventricular structure in developing brain.

Teratogenic potential of the mycotoxin, citreoviridin, in rats

Citreoviridin produced by the fungus Penicillium citreo-viride was administered by gavage to groups of 9–16 pregnant Fisher 344 rats either on days 8–11 (group A) or on days 12–15 (group B) of gestation. Doses of 0, 5, 10 or 15 mg/kg body weight were given daily in a constant volume of 1 ml/kg body weight in dimethylsulphoxide. Six rats in each high-dose group died during the dosing period. Compared with control groups, mean daily feed consumption was significantly reduced in the 10- and 15-mg/kg animals in both groups A and B. Weight gain during pregnancy in both groups was reduced with increasing dosage; dams in control groups gained an average of 75 g/rat compared with 30 g overall gain in group A, or 9 g overall gain in group B, both at a dose of 15 mg/kg. Male and female pup weights were reduced with increasing dosage for both groups A and B. The post-implantation foetal loss rate was significantly increased to 33% in group A high-dose animals. The main effect of citreoviridin on skeletal development in both groups A and B was one of retardation. No internal abnormalities were observed in group A pups. Some smaller than average pups from dams in group B that were treated with the high dose of citreoviridin had slightly dilated lateral ventricles of the brain and, in some cases, a palate defect. The foetotoxicity induced by citreoviridin was observed only at doses that also induced maternal toxicity.

NOSOCOMIAL OUTBREAK OF CAMPYLOBACTER JEJUNI MENINGITIS IN NEWBORN INFANTS

In a nosocomial outbreak of Campylobacter jejuni infection 11 newborn infants (7 female, 4 male) had meningitis. The outbreak was caused by a single strain of C jejuni, as demonstrated by biotyping (biotype I), serotyping (LAU 7/PEN 18 on heat-stable antigens, a new serotype on heat-labile antigens), and the identical susceptibility pattern and outer-membrane-protein profile on sodium dodecyl sulphate/polyacrylamide gel electrophoresis. Specific antibodies against the outbreak strain (enzyme-linked immunosorbent assay and Western blot) developed in all the babies. They were treated with gentamicin and ampicillin. All but one baby, who had a moderately dilated left lateral ventricle after the meningitis, recovered well. The source of infection could not be clearly determined. Thus, C jejuni can cause serious nosocomial infection; it should be considered as a possible agent of meningitis of unknown origin, particularly in newborn infants and other compromised hosts.

Reproduction studies of VP 16-213 (V)--Intravenous administration to rats prior to and in the early stages of pregnancy

VP 16-213 (etoposide, abbr. to VP), an oncostatic drug, was administered intravenously to male Crj: CD (Sprague-Dawley) rats for 61 days and to female rats of the same strain for 14 days prior to mating at dose levels of 0.05, 0.2 and 0.8 mg/kg/day. These animals were then mated under the consecutive administration of this drug and the females confirmed to be copulated were further dosed from day 0 through 7 of gestation. The summarized results obtained are as follows: Body weight increases were suppressed at the dose level of VP 0.8 mg/kg in males and females. VP 0.2 and 0.8 mg/kg decreased the thymic weight and 0.8 mg/kg decreased testicular and epididymal weight in males showing macroscopic atrophy of these organs, but these doses failed to affect the reproductive ability and so on in parent rats. As for fetuses, VP 0.8 mg/kg elevated the mortality, decreased the number of survivors and suppressed their growth. Furthermore, this dose raised the incidences of anophthalmia, microphthalmia, dilated lateral ventricles and unossified 5th and 6th sternums, as well as brought retarded ossification of sternums, cervical vertebrae, sacral and coccygeal vertebrae, metacarpus and thoracic vertebrae. Based on these results, the no-effect dose levels of VP under the present experimental condition were estimated to be 0.05 mg/kg/day against parent rats of both sexes and 0.2 mg/kg/day against their offspring.

Reproduction studies of VP 16-213 (I)--Oral administration to rats prior to and in the early stages of pregnancy

VP 16-213 (etoposide, abbr. to VP), an oncostatic drug, was administered orally to male Crj : CD (Sprague-Dawley) rats for 64 days and to female rats of the same strain for 15 days prior to mating at dose levels of 1, 3 and 10 mg/kg/day. These animals were then mated under the consecutive administration of this drug and the females confirmed to be copulated were further dosed from day 0 through 7 of gestation. The summarized results obtained are as follows: VP 10 mg/kg suppressed the body weight increase in females from day 8 of pre-mating through day 20 of gestation, but did not affect the body weight in males. VP 10 mg/kg decreased the organ weights of testes, epididymides and thymus in males and induced atrophy of these organs macroscopically, but did not affect their reproductive performances. As for fetuses, VP 10 mg/kg elevated the mortality and induced anophthalmia, microphthalmia and dilated lateral ventricles, as well as suppressed their growth and the ossification processes of sternums, sacral and coccygeal vertebrae, metacarpus, thoracic vertebrae and pubis. Based on these results, the no-effect dose level of VP under the present experimental condition was estimated to be 3 mg/kg/day against parent rats of both sexes and their offspring.

Reproduction studies of VP 16-213 (II)--Oral administration to rats during the period of fetal organogenesis

VP 16-213 (etoposide, abbr. to VP), an oncostatic drug, was administered orally to pregnant Crj: CD (Sprague-Dawley) rats from day 7 through 17 of gestation at dose levels of 1, 3 and 10 mg/kg/day. The summarized results obtained are as follows: VP 10 mg/kg suppressed the maternal body weight increase from day 12 through 20 of gestation. VP 10 mg/kg brought the inhibition of fetal growth accompanied by the lowered values in body weight and body length. Furthermore, the elevated incidences of skeletal anomalies and unossified 5th and 6th sternums, as well as retarded ossification of thoracic vertebrae were also noted in this dose level. VP 10 mg/kg induced anophthalmia, microphthalmia and dilated lateral ventricles in fetuses (F1), as well as unilateral anophthalmia in offspring (F1). VP 10 mg/kg increased the days required for opening of eyelids and descending of testes in offspring (F1), but failed to affect their learning ability, motility, motor activity or emotional development. VP 10 mg/kg suppressed the growth of genital organs in F1 rats of both sexes, but failed to affect their reproductive ability or gestation period. As for F2 newborns derived from F1 rats whose dams had ever received VP 10 mg/kg during the period of fetal organogenesis, the number of implantations and survivors as well as birth indexes lowered due to changes in these items restricted to a few litters. Based on these results, the no-effect dose level of VP under the present experimental condition was estimated to be 3 mg/kg/day against dams and their offspring.

Colloid cysts with and without ventriculomegaly: Role of intraoperative real-time ultrasound

Intraoperative real-time ultrasound was used to assist localization and surgical removal of colloid cysts in patients without ventriculomegaly. In the most commonly used surgical approach for removal of colloid cysts, dilated lateral ventricles can expedite the localization of lesions because, once entered surgically, a dilated ventricle offers more space near the foramen of Monro in which to work. Additionally, the enlargement of the foramen of Monro, seen with hydrocephalus, provides greater accessibility to the colloid cyst. In patients with symptoms related to intermittent obstruction of cerebral fluid flow but with normal-sized ventricles, the precise localization of the foramen of Monro and colloid cyst is more difficult and may result in unnecessary exploration/resection of brain. Using intraoperative ultrasound, the colloid cyst and adjacent anatomic structures can be clearly visualized regardless of ventricular size. Intraoperative ultrasonography has a unique role in the operative treatment of patients with colloid cysts and nondilated ventricles.

Experimental transcerebral fistula. Perineural olfactory CSF flow in the normal, hydrocephalic, and postoperative hydrocephalic dog shown by radionuclide ventriculography.

Cerebrospinal fluid dynamics were studied in eight dogs during normal, hydrocephalic, and postoperative phases. Radionuclide-labeled substances introduced into the normal ventricular system flow out of the exits from the fourth ventricle to the convexity subarachnoid spaces superiorly to be absorbed in the sagittal sinus, and basorostrally to the exits from the perineural olfactory sheath into the nose to produce physiological cerebrospinal fluid (CSF) rhinorrhea. Serial radionuclide ventriculography of the head following intraventricular isotope injection of labeled proteins and chelate into the kaolin-induced hydrocephalic system shows a high degree of ventricular stasis with no perineural olfactory nerve flow (rhinorrhea). An operative transcerebral fistula, fashioned from a dilated lateral ventricle to the convexity subarachnoid space, reestablishes perineural olfactory flow of CSF into the nose, as demonstrated by the radionuclide ventriculography studies. This suggests a potential method for treatment of hydrocephalus. Serial imaging studies in this surgically modified system clearly demonstrate radionuclide flow through the patent fistula to distal absorption sites, thereby bypassing the basal obstruction. Moreover, augmented CSF pressures associated with obstructive hydrocephalus can be controlled by such treatment. The application of this method in treating clinical hydrocephalus is discussed with emphasis on fistula arachnoid closure to assure fistula patency.

Bluetongue virus-induced hydranencephaly in cattle.

Direct inoculation of bluetongue virus into 125-day bovine fetuses resulted in development of hydranencephaly. The earliest lesions after virus inoculation were a severe necrotizing encephalitis, which was most prominent in the cerebrum, and an associated nonsuppurative meningitis. At birth, the brains of infected fetuses had thin-walled cerebral hemispheres, dilated lateral ventricles, and cerebral cysts. No gross lesions were observed in the brain stem or cerebellum. Two morphologically different lesions were present in the brain of a fetus sacrificed 20 days after virus inoculation. There were discrete foci of hemorrhagic cerebral necrosis that resembled infarcts and widespread microcavitations of the intermediate and subventricular zones. Changes consistent with vascular damage were present in the brains of fetuses sacrificed 12 and 20 days after virus inoculation. Calves with bluetongue virus-induced hydranencephaly would have poor viability, but they would not be expected to have any significance as virus reservoirs.

Hydrocephalus and abnormal digits after failed first-trimester prostaglandin abortion attempt

The possible teratogenic effects of prostaglandins (PGs) in humans have not been investigated in detail, yet these drugs appear to be deleterious in laboratory animals. A case report is presented of congenital anomalies in a newborn infant whose mother received intravaginal PG 7 weeks after conception but failed to abort. The infant was delivered after 34 weeks' gestation with a birth weight of 2.34 kg. The mother had been placed in an experimental protocol using intravaginal PG 15-methyl F2alpha. She received 1 mg, then another 3 mg after 1 hour and was sent home with instructions to call in 24 hours if no tissue was passed. She experienced nausea, vomiting, and intense abdominal cramping but no vaginal blood or tissue loss occurred. She then decided to continue the pregnancy and did not mention these events when she went to a different clinic for prenatal care. Routine ultrasound examination at 24 weeks disclosed dilated lateral cerebral ventricles, which progressively enlarged over the next 3 weeks. No other anomalies were seen. Amniotic fluid alpha-fetoprotein concentration was normal, and karotype was 46,XY. Referral was made to Yale-New Haven Hospital, where at 27 weeks a silastic catheter was placed by Dr. Richard Berkowitz through the fetal skull into the left lateral ventricle under ultrasound guidance, creating a ventriculoamniotic shunt. There was an initial decrease in the size of the left lateral ventricle and improvement in thickness of the corticle mantle. The right ventricle remained enlarged, and the left dilated again after 4-6 weeks, indicating probable blockage of the shunt. The infant was delivered at 34 weeks by cesarean section after pulmonary maturity was demonstrated by amniotic fluid L/S ratio. At birth the Apgar score was 9 at 5 minutes and maturity ratings were consistent with 34-35 weeks. The head was large, the circumference being 34 1/2 cm. The face was not dysmorphic but the ears appeared slightly small. The most striking abnormality concerned the digits of all 4 limbs; all were tapered and shortened with hypoplastic or absent nails. There was a left simian crease. The infant had a shrill cry and was hypertonic but a good suck was present. Radiographs of the hands revealed missing or hypoplastic distal phalanges of all fingers; the middle phalanges of the 3rd and 4th digits of the right hand also were absent. More proximal osseous structures were normal. A search of the literature failed to reveal a report of the association of hydrocephalus and these digital anomalies.

Cortical and central atrophy in chronic schizophrenia. A controlled study.

CT of the brain was carried out in 43 chronic schizophrenics of more than 5 years' duration and less than 60 years of age, and 39 normal controls matched for age, sex and education. There was no statistical difference between controls and schizophrenics as regards cortical atrophy (as measured by the interhemispheric and Sylvian fissures and mean sulcal width). Highly significant differences were found regarding central atrophy. Third ventricle measurements were normal in 9.3%, there was slight enlargement in 37.2%, moderate in 48.8% and extreme in 4.7%. The cella media index denoting lateral ventricle dilatation showed changes in 46.5%, slight in 9.3% and the remaining 44.2% were normal. This study shows that a large number of chronic schizophrenics have an associated central atrophy.

Cribside neurosonography: real-time sonography for intracranial investigation of the neonate

A prospective study was made of 94 real-time sonographic sector scans of 56 neonates in a 6 month period. The examinations were performed using the anterior fontanelle as an acoustic window. In 17 cases, computed tomography (CT) head scans were available for comparison. In no case did the CT and sonographic examination disagree as to the size of the lateral ventricles. Abnormalities detected by sonography include ventriculomegaly, intracerebral hematomas, a congenital glioma, and several cystic lesions. Sonographic sector scanning produces excellent, detailed images of dilated lateral and third ventricles, uses no ionizing radiation, is less expensive than CT, and can be performed in the isolette, minimizing the risk of hypoxia and hypothermia. At Methodist Hospital Graduate Medical Center, sonography has replaced CT as the initial method of investigation of ventricular size. CT plays a complementary role in the evaluation of the posterior fossa, intracranial hemorrhage, and mass lesions.

Analysis of Cranial CT-scan Findings in Cerebral Palsy

CT-scan findings of 87 cerebral palsied children were studied.They consist of 23 cases of spastic quadriplegia, 9 cases of diplegia, 12 cases of paraplegia, 24 cases of athetosis and mixed type, and 19 cases of hemiplegia.In the former four types, ventricular dilatation and cortical atrophy were measured and abnormal changes in cerebral substance and cerebellar atrophy were observed.Spastic quadriplegia showed most intense changes in every aspect of the abnorma-lities, while paraplegia had almost normal appearance. Athetosis and mixed type had moderate changes, Hemiplegia always showed asymmetrical view on CT-scan, dilatation of lateral ventricle or atrophy of hemisphere in contralateral side being observed.

Hydrocephalus in a Guaynan Squirrel Monkey, Saimiri sciureus

A case of communicating hydrocephalus in a squirrel monkey is described. Shortly after birth it exhibited systemic twitching and severe depression. Grossly there was a wide dilation of lateral ventricles. Microscopically there was subependymal astroglial proliferation in the lateral ventricles and the aqueduct of Sylvius. Injury or inflammation can both cause such a case of hydrocephalus.