Kanagawa Children's Medical Research Articles

Effects of a Filter on ABR Threshold Evaluation and a Comparison between ABR and BR at Kanagawa Children's Medical Center

Effects of a Filter on ABR Threshold Evaluation and a Comparison between ABR and BR at Kanagawa Children's Medical Center

Intracranial Hemorrhage in Hemophiliacs

Intracranial hemorrhage has been the lethal complication in hemophilia and is also the most common cause of death in hemophiliacs in Japan. So, we studied retrospectively on intracranial hemorrhage for 127 patients with hemophilia (hemophilia B, 18) referred to Kanagawa Children's Medical Center. Reported are 6 month old boy with hemophilia A and 5 month old boy with hemophilia B, who had neurosurgical treatment for intracranial hemorrhage. The case with hemophilia B is the first reported case treated with neurosurgery in Japan.The results of retrospective studies are follows: Incidence; 23/127 (18.1%), Traumatic history; 8/23 (34.8%), Bleeding sites; unknown 16, subarachnoid hemorrhage 5, and subdural hematoma 2, Relapse of symptoms; 6/23 (26%) and Prognosis; antiepileptic drugs 9/23 (39%), mental deterioration 2 and cerebral palsy 1. Motality rate of surgical treatment for intracranial hemorrhage was high in hemophiliacs because of inadequate replacement therapy.But, long term adequate replacement therapy has now became possible. So, neurosurgical ireatment can be more safely performed in hemophiliacs when adequate replacement therapy is maintained. We think that neurosurg tcal treatment should be indicated for intracr anial hematoma in hemophiliacs as well as the cases without bleeding tendency.

SPINA BIFIDA MANIFESTA ORTHOPEDIC PROBLEMS AND THE ANALYSIS OF AMBULATORY FUNCTION

1) The interest in the spina bifida children with higher rehabilitation potential than C. P. is increasing recently in Japan.2) From 1970, over one hundred spina bifida children visited Kanagawa Children's Medical Center. We are approaching them from several aspects. The problems of orthopedic surgery and habilitation are reported in this paper including ambulatory function.3) The management of deformities of spine and lower extremities shoud be done under the proper understanding of their developing mechanism.4) We classified the level of paralysis into six groups according to the lowest level of the nerve preserved. The patients with intakt L5 show no paralytic hip dislocation and have independent ambulation with or without short leg braces.5) Therefore, L5 nerve is seemed to be the critical level for the spina bifida children.6) The children with the paralysis below this level can get indipendent ambulation until the age of three to four by proper management.