Dialysis disequilibrium syndrome occurring during continuous renal replacement therapy.

The dialysis disequilibrium syndrome (DDS) is characterized by progressive neurological symptoms and signs attributable to cerebral edema that occurs due to fluid shifts into the brain following a relatively rapid decrease in serum osmolality during hemodialysis (HD). Since continuous renal replacement therapy (CRRT) is less efficient at solute clearance than intermittent HD, it seems logical that this mode of therapy is less likely to cause DDS. This entity has not been previously reported to occur with this modality.

White matter integrity on fractional anisotropy maps in encephalopathic neonates post hypothermia therapy with normal-appearing MR imaging.

Background: Neonatal encephalopathy (NE) is a clinically defined neurological syndrome commonly caused by ischemia.

Objective: We investigated white matter integrity in children with NE using diffusion tensor imaging (DTI) and examined the hypothesis that white matter insults not visible on conventional MRI may have abnormal fractional anisotropy (FA) on DTI.

Materials And Methods: DTI was performed on 36 term encephalopathic neonates who had hypothermia therapy.

Magnetic resonance imaging in the analysis of pediatric orbital tumors: utility of diffusion-weighted imaging.

Purpose: To identify common radiographic features of pediatric orbital tumors by the use of magnetic resonance imaging (MRI) techniques, diffusion-weighted imaging (DWI), fat saturated T2, and pre- and postgadolinium T1. DWI is hypothesized to help identify and predict the malignancy of specific brain tumors. To our knowledge, a similar analysis in which the authors have used this combination of MRI techniques has not been performed with orbital tumors.

Postoperative cerebellar mutism syndrome following treatment of medulloblastoma: neuroradiographic features and origin.

Object: The origin and long-term outcome of cerebellar mutism syndrome (CMS), a postoperative syndrome of diminished speech, hypotonia, and ataxia that affects approximately 25% of patients with medulloblastoma, is poorly elucidated. The current study was undertaken to determine factors associated with development of CMS, a means to determine its severity or cause, and outcomes of patients with this syndrome.

Methods: The study included 28 children with medulloblastoma who either underwent an operation or were referred to the authors' institution soon after surgery.

The cerebellar mutism syndrome and its relation to cerebellar cognitive function and the cerebellar cognitive affective disorder.

The postoperative cerebellar mutism syndrome (CMS), consisting of diminished speech output, hypotonia, ataxia, and emotional lability, occurs after surgery in up to 25% of patients with medulloblastoma and occasionally after removal of other posterior fossa tumors. Although the mutism is transient, speech rarely normalizes and the syndrome is associated with long-term adverse neurological, cognitive, and psychological sequelae. The clinical, neuroradiographic, and neuropsychological findings associated with CMS as well as possible mechanisms of injury are reviewed.

Diffusion-weighted MR imaging of early methotrexate-related neurotoxicity in children.

Background And Purpose: Methotrexate is a major cause of treatment-related acute neurotoxicity in children with hematologic malignancies. The purpose of this study was to investigate whether diffusion-weighted MR imaging (DWI) detects acute methotrexate white matter neurotoxicity in this patient population.

Methods: Six children-three female and three male-with hematologic malignancies were studied at time of onset of neurologic dysfunction during the delayed intensification or consolidation phase of therapy, when intensive intrathecal methotrexate is given.

Choroid plexus carcinomas in children: MRI features and patient outcomes.

Choroid plexus carcinomas (CPC) are rare malignant intracranial neoplasms usually occurring in young children. The objectives of this study were to characterize the preoperative MRI features of CPC, determine the frequency of disseminated disease in the CNS at diagnosis, and assess patient outcomes. The preoperative cranial MR images of 11 patients with CPC were retrospectively reviewed for lesion location, lesion size, un-enhanced and enhanced MRI signal characteristics, and presence of disseminated intracranial tumor.

Dose reduction fluoroscopy in pediatrics.

Background: It is essential that we find ways to reduce radiation exposure to children and maintain image quality.

Objectives: We compared radiation dose, image quality, and spatial resolution when continuous and pulse fluoroscopy with a full and half dose are applied to a phantom. The film-screen technique was compared to fluoroscopy with the digitized spot technique (fluoro grab image) in procedures such as voiding cystourethrogram (VCUG).