Impact of aortic valve calcification severity on device success after transcatheter aortic valve replacement.

Aortic valvular calcium score (AVCS) can identify severe aortic stenosis (AS) and provide powerful prognostic information. In severe and symptomatic AS, patients can be referred for a transcatheter aortic valve replacement (TAVR). The aim of this study was to determine whether AVCS, measured on the preoperative contrast enhanced multislice computed tomography (MSCT), is associated with device success (DS), major adverse cardiac events (MACEs) and paravalvular leak (PVL) after TAVR.

[Geometrical growth models of the fetal forebrain, cerebellum, brainstem and change of the cranial base angles during fetal period].

Introduction: Brain growth plays likely an important role for the skull growth. In the fetus, there exists an heterochrony for the growth of supratentorial (forebrain) and infratentorial regions (brainstem and cerebellum). The aim of the study was thus to model geometrically the growth of these two regions and to compare it with the inflection of the base of skull.

Abnormal Sylvian fissure on prenatal cerebral imaging: significance and correlation with neuropathological and postnatal data.

Objective: To illustrate and determine the significance of abnormal Sylvian fissure development (or abnormal operculization) in cases in which prenatal cerebral imaging is suggestive of underlying cortical dysplasia.

Methods: This was a retrospective study of 15 fetuses at 24-34 weeks in which abnormal operculization was identified on prenatal cerebral imaging and for which follow-up data were available. The imaging findings were correlated to macro- and microscopic neuropathological data (n = 11) or to postnatal clinical and imaging findings (n = 4).

[Neuropathological study of 134 fetuses in HIV infected mother].

A neuropathological study performed in 134 foetuses from HIV infected mothers, between 16 and 35 weeks of gestation, revealed two cases of hypoxic-ischemic brain damage, related to long labor and drug abuse. Immunostains against HIV proteins were negative in all cases. Nests of migrating cells in the cerebrum and cerebellar heterotopias were found in most cases and were considered to be common findings in fetal brain.

Sexual differences in anthropometric measurements in French newborns.

Sexual differences in anthropometric measurements have been studied in a sample of 17,787 preterm and full-term infants, born between 1980 and 1990 in the maternity of Clamart Hospital (Hauts-de-Seine, France). Body weight, body length, head and chest circumferences were found significantly larger in male newborns. Conversely, the subscapular and tricipital skinfold thicknesses had higher values in females.

Lethal familial fetal akinesia sequence (FAS) with distinct neuropathological pattern: type III lissencephaly syndrome.

We report on a distinct pattern of primary central nervous system (CNS) degeneration affecting neuronal survival in the brain and spinal cord in 5 fetuses with fetal akinesia sequence (FAS). This neuropathological pattern is characteristic of a lethal entity that we propose calling type III lissencephaly syndrome. Parental consanguinity and the recurrence in sibs support a genetic cause.

Abnormal cortical plate (polymicrogyria), heterotopias and brain damage in monozygous twins.

We report 5 cases of abnormal cortical plate (polymicrogyria or microgyric-like pattern) and heterotopias associated with hypoxic-ischemic brain injuries in monochorionic diamniotic twin fetuses of respectively 22, 26, 28, 31, 32 weeks gestation. These fetuses belonged to a series of 5 pairs of patients (10 cases) presenting with the characteristic features of the twin-to-twin transfusion syndrome. Three of them (2 donors and 1 recipient) were macerated and the brains were not available for study.

Periventricular leukomalacia: correlation between MR imaging and autopsy findings during the first 2 months of life.

Purpose: To correlate magnetic resonance (MR) imaging and pathologic findings in premature infants with periventricular leukomalacia (PVL).

Materials And Methods: Eight premature infants with PVL who died after 3-7 weeks of life were studied with in vivo T1-weighted MR imaging, and imaging patterns were compared with hypoxic-ischemic injuries at pathologic analysis.

Results: Cavities were seen as zones of absent or weak signal intensity.

Focal cerebral anomalies and retinal dysplasia in a 23-24-week-old fetus.

A 23-24-week-old fetus was the product of a normal pregnancy terminated because of diaphragmatic hernia and hydrocephalus diagnosed by ultrasound. Karyotype on fetal blood was normal. At autopsy, hydrocephalus was associated with multiple large intrameningeal nodules and focal cerebral dysplasia resembling type II lissencephaly.

Growth velocity of some fetal parameters. II. Body weight, body length and head circumference.

In this study, fetal growth velocities of the body weight, crown-heel length, crown-rump length and head circumference were established from 478 normal fetuses and neonates, aged 8-41 gestational weeks. The growth rates were computed by time intervals, and the velocity curves were plotted with their 95% confidence intervals. The body weight displayed an accelerating pattern of growth until 34-35 weeks and a breakdown of the growth rate afterwards, as we already observed for the brain weight in another study published in Biology of the Neonate.

Growth velocity of some fetal parameters. I. Brain weight and brain dimensions.

In this study, fetal growth velocities of the brain weight (whole brain and infratentorial part) and of the right and left fronto-occipital diameters were established from 420 normal fetuses and neonates. The age of the subjects ranged from 10 to 41 gestational weeks. Growth rates were computed by time intervals, and velocity curves were plotted with their 95% confidence intervals.

Intrauterine brain damage in nonimmune hydrops fetalis.

Nonimmune hydrops fetalis has been described in a large number of pathological conditions, but brain aspect has been poorly explored. We report the neuropathological findings in a series of 38 fetuses and neonates with anasarca of various origin. Fourteen fetal cerebral ultrasonograms were available; 8 presented some abnormalities.

Congenital hypothalamic hamartoma syndrome: nosological discussion and minimum diagnostic criteria of a possibly familial form.

We report on congenital hypothalamic hamartomas, discovered at autopsy in 3 unrelated fetuses. In the first 2 patients, the tumor was associated with skeletal dysplasia only. In the third patient, it was part of a non-random congenital malformation association, suggestive of Meckel syndrome.

Growth velocity of the biparietal diameter, abdominal transverse diameter and femur length in the fetal period.

In this study, fetal growth rates of the biparietal diameter (BPD), abdominal transverse diameter (ATD) and femur length were established from 4333 ultrasound examinations. The age of the fetuses ranged from 7 to 40 gestational weeks. The growth rates were computed by periods of 3 weeks, and the velocity curves were plotted with their 95% confidence interval.

Differential growth between the fetal brain and its infratentorial part.

From 298 normal fetuses, we established normative curves of the development of the brain in relation to gestational age and to body weight. Means and standard deviations were calculated. There exist good curvilinear relationships, expressed by polynomial models, between brain weight--body weight and brain weight--gestational age with a wider scatter in large fetuses.

Brain damage in monozygous twins.

A series of 15 monochorionic twins with a great variety of cerebral lesions is reported. Seven cases illustrate the classical situation: the recipient twin was affected and his co-twin, the donor was macerated. In 5 cases, the lesions were described in the donor twin as well and once, as early as 22 weeks.

Cerebral midline developmental anomalies: spectrum and associated features.

Cerebral midline anomalies are defects of anatomical relationships between the two hemispheres. They include holoprosencephalies, septal and commissural agenesis. Agenesis of the olfactory tract (arhinencephalies) are often included in the spectrum of holoprosencephalies and the facial phenotype is thought to be affected and characteristic in the midline development abnormalities.

Fetal hydrocephalus. Clinical significance of associated anomalies and genetic counseling: a pathological approach.

We report on a consecutive series of 94 cases of fetal hydrocephalus. Pathological and neuropathological findings have been thoroughly analysed in order to define more precisely the clinical significance of associated anomalies and their implications in genetic counseling. In 90.

[Echographic aspects of cerebral sulci in the ante- and perinatal period].

70 fetuses (10 to 37 weeks) and 30 full term infants were examined by ultrasound (U.S.).

Infantile familial encephalopathy with cerebral calcifications and leukodystrophy.

Two sets of siblings, in two different families, presenting with congenital and progressive neurological disorders, cerebral calcifications and leukodystrophy are reported. In the first family, the diagnosis of brain calcifications in two infants was based on skull X-rays; in the second family, ultrasound scans showed hyperechoic areas in the basal ganglia and periventricular white matter in both infants. Neuropathological studies confirmed the calcifications and revealed severe abnormalities of the white matter with GFAP positive gliosis.

[Critical study of erythrocyte bilirubin and predictive factors of kernicterus in premature low birth weight infants].

Among 217 premature neonates with birth-weights less than or equal to 1,500 g who died, in whom post mortem examination was carried out during the years 1978-1984, 11 cases of kernicterus (5%) were found. A comparative study was undertaken between these 11 children and 42 children of the same population matched for birth-weight, gestational age and life duration. The following clinical and biological perinatal data were found more frequently in the kernicterus group: meningitis (3/11 vs 0/42), p less than 0.