The etiology of infantile spasms/West syndrome remains unknown; the pathophysiology is poorly understood and the optimal course of treatment is controversial. The primary goal of this volume is to carefully assess all aspects of the disorder, provide the reader with a concise guide to the most effective and efficient means for establishing the diagnosis, formulating an appropriate treatment plan and assessing the outlook for long-term outcome.
Intended To Explain In A Familiar And Practical Manner, For The Use Of The Military Force Of The United States, The Modern Improvements In The Discipline And Movement Of Armies.
Cerebellar hemorrhagic injury (CHI) is being recognized more frequently in premature infants. However, much of what we know about CHI neuropathology is from autopsy studies that date back to a prior era of neonatal intensive care. To update and expand our knowledge of CHI we reviewed autopsy materials and medical records of all live-born preterm infants (<37 weeks gestation) autopsied at our institution from 1999-2010 who had destructive hemorrhagic injury to cerebellar parenchyma (n = 19) and compared them to matched non-CHI controls (n = 26). We favor the possibility that CHI represents a primary hemorrhage arising due to the effects of impaired autoregulation in a delicate vascular bed. The incidences of neuronal loss and gliosis in the inferior olivary and dentate nuclei, critical cerebellar input and output structures, respectively were higher in CHI compared to control cases and may represent a transsynpatic degenerative process. CHI occurs during a critical developmental period and may render the cerebellum vulnerable to additional deficits if cerebellar growth and neuronal connectivity are not established as expected. Therefore, CHI has the potential to significantly impact neurodevelopmental outcome in survivors.