The concept of whole-brain death is under attack again. Scholars are arguing that the concept of brain death per se--regardless of the focus on "higher," "stem" or "whole"--is fundamentally flawed. These scholars have identified what they believe are serious discrepancies between the definition and criterion of brain death, and have ...

Definition in the living premature infant of the anatomical and temporal characteristics of development of critical brain structures is crucial for insight into the time of greatest vulnerability of such brain structures. We used three-dimensional magnetic resonance imaging (3D MRI) and image-processing algorithms to quantitate total brain volume and total ...

The asphyxial injury to neonate brain seems to be mediated through a cascade of biochemical events during ischaemia--reperfusion which includes excitatory amino acids, free radicals and accelerated programmed cell death (Apoptosis). The diagnosis of asphyxia requires rigorous approach based on background clinical information, certain diagnostic tests and exclusion of alternative ...

OBJECTIVE: To determine whether cytomegaloviral (CMV) parotitis reflects a disseminated disease that increases vulnerability to unexpected death. DESIGN: Necropsy-based cross-sectional study comparing incidences of brain stem microglial nodules and visceral lymphocytic infiltrates in patients with and without CMV parotitis. SUBJECTS: One hundred twelve infants and young children comprising a study ...

Brain death can be diagnosed in the full-term newborn, even when less than 7 days of age. An observation period of 48 hours is recommended to confirm the diagnosis. If an EEG is isoelectric or if a CBF study shows no flow, the observation period can be shortened to 24 ...

Posture, quantity of spontaneous movement patterns, quality of general movements (GMs), and behavioural state organisation were studied in nine infants affected by documented brain malformations. A single 1 h video recording of five infants and two or more serial video recordings of another four infants were performed after birth. The ...

This study addressed the hypothesis that in human infants severe in utero insults induce a significant proportion of brain cells to undergo apoptosis. Morphologic criteria were used to quantify apoptosis and necrosis in the cingulate gyrus of two groups of infants: six infants who died after severe birth asphyxia with ...

OBJECTIVES: To investigate if the concentration of interleukin-6 (IL-6) in the cerebrospinal fluid (CSF) is affected by perinatal asphyxia, and to examine the relation of IL-6 levels in the CSF to the severity of hypoxic-ischemic encephalopathy (HIE), to brain damage, and to the neurological outcome. METHODS: Asphyxiated term neonates were ...

OBJECTIVE: The purpose of this study was to clarify the influence of timing of brain insults causing abnormal outcome in preterm infants. METHODS: One hundred and thirty-one preterm infants were examined. The timing of brain insult was estimated from EEG or clinical findings. Development was assessed until a corrected age ...

OBJECTIVE: We studied the effect of neonatal hypoglycaemia on the local cerebral metabolic rate for glucose (LCMRglc). MATERIALS AND METHODS: Eight newborn infants with neonatal hypoglycaemia were studied. The LCMRglc in the whole brain, in five cerebral regions and in skeletal muscles were quantitated using positron emission tomography (PET) and ...

The Levene model in 7-day-old rats is the most often used model of hypoxia-ischaemia (HI) in immature animals. The rat central nervous system is immature at birth and corresponds neurodevelopmentally to the term human infant during the second postnatal week. The Levene model of HI differs from clinical asphyxia with ...

Ten early neonatal sudden death victims (ENSD) were selected for neuropathological and immunohistochemical examinations. The gestational ages of the victims ranged from 36 to 42 weeks, and the postnatal ages from 8 hours to 10 days of life. In 6 of 10 patients, softening with rarefaction was observed in the ...

The development of the human lateral vestibular nucleus was studied on serial sections of the brain of 8 fetuses and neonates at 12-40 weeks of gestation, an infant at 2 months of age and an adult of 63 years using a microscope with a drawing tube and an image-analysing computer ...

Recent neuroimaging and neuropsychological research in adults and infants suggests that the neural system for language is widely distributed and shares organizational principles with other cognitive systems in the brain. Connectionist modelling has clarified that networks operating with associative mechanisms can display properties typically associated with genetically predetermined and dedicated ...

OBJECTIVE: The purpose of this study was to describe the normal sonographic appearance and measurement of normal major cranial sutures in neonates and infants. SUBJECTS AND METHODS: High-resolution sonograms of sagittal, coronal, and lambdoid sutures were obtained for two autopsy specimens and correlated with histologic sections obtained at identical locations. ...

Primary craniosynostosis, the premature closure of one or more cranial sutures, occurs in up to one in 2,500 births. Secondary causes of craniosynostosis include disorders that lead to failure of brain development and conditions that influence bone metabolism. The craniosynostoses result in skull deformities and increased intracranial pressure as the ...

We studied 19 infants with a mean age of 3.8 months who presented with features consistent with acute lead encephalopathy following the use of traditional medicines. All presented with convulsions; CT scans of the brain on admission showed brain oedema in four, atrophy in four and normal findings in 11. ...

To examine how a family's understanding of brain death may affect the decision to donate, an interview study was conducted with the immediate next of kin of 164 medically suitable organ donor candidates. Telephone interviews were conducted with members of both donor and nondonor families 4 to 6 months after ...

We report on an infant girl with severe RSH or Smith-Lemli-Opitz syndrome with hyperbilirubinemia. The infant died at age 2 months. Sterol analysis of liver and brain tissues showed marked elevations of 7-dehydrocholesterol with decreased levels of cholesterol. Immunocytochemical analysis demonstrated remarkable increases in low-density lipoprotein (LDL) receptors in these ...

The whole-brain criterion of death was first formally proposed by the "Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death" in a "Special Communication" published in JAMA in 1968. Since then, all states in the United States and many western countries have endorsed this ...

A standardized removal and dissection procedure is presented for human infant brain. A previously unreported cistern of the pineal gland must be severed at autopsy in order to preserve the gland's anatomic integrity during brain removal. Utilization of these methods to investigate Sudden Infant Death Syndrome brain tissue should facilitate ...

Nestin is an intermediate filament protein found in CNS progenitor cells. Nestin reappears in CNS tumor cells and reactive astrocytes after CNS injury. In this study we investigated whether nestin could be detected in the cerebrospinal fluid (CSF) of newborn infants and whether expression levels change with gestational age (GA) ...

Jaws and branchial arches together are a basic, segmented feature of the vertebrate head. Seven arches develop in the zebrafish embryo (Danio rerio), derived largely from neural crest cells that form the cartilaginous skeleton. In this and the following paper we describe the phenotypes of 109 arch mutants, focusing here ...

Previous studies of the brains of normal infants demonstrated lower lactate (Lac)/choline (Cho), Lac/creatine (Cr), and Lac/ N-acetylaspartate (Naa) peak-area ratios in the thalamic region (predominantly gray matter) compared with occipitoparietal (mainly unmyelinated white matter) values. In the present study, thalamic Cho, Cr, and Naa concentrations between 32-42 weeks' gestational ...

A large percentage of newborns are exposed to pharmacological agents that affect the brain in connection with pain management during labor. The two most commonly used agents are meperidine, administered intravenously or intramuscularly, and bupivacaine, administered by the epidural route. Over the years, infant behavioral assessments have been used in ...

Recently, a new assessment technique by which to evaluate brain function in the fetus and newborn infant has been developed. The method is based on the assessment of the quality of General Movements (GMs). GMs are complex movements involving all parts of the body. They are present throughout fetal life ...

PURPOSE: To provide a practical standard for normal development of gyri and sulci in preterm and term neonates. MATERIALS AND METHODS: Thirty-nine living preterm infants without substantial neurologic problems underwent magnetic resonance (MR) imaging of the brain. Five infants who were born at term but died of a nonneurologic disorder ...

The association of tuberous sclerosis with Down syndrome is exceedingly rare. An infant with this unusual association is reported with a description of brain and ocular abnormalities which were referable to both conditions. There was anteroposterior foreshortening of the brain and Brushfield spots in the iris, which are described in ...

We have studied a case of acute, fulminating multiple sclerosis (MS) (Marburg type) at the pathological and biochemical levels. Postmortem examination of the brain revealed extensive areas of gross rarefaction in the hemispheric white matter. Histologically, well-demarcated areas of demyelination with a large influx of macrophages and a subtle perivascular ...

The aims of this study were 1) to define normal perinatal maturational changes in proton metabolite peak-area ratios in two regions of the neonatal brain, the thalamic and occipitoparietal regions, and 2) to investigate abnormalities of these ratios after perinatal hypoxia-ischemia. Fifty-four infants were studied: 35 normal control infants at ...

A patient with acute lymphoblastic leukaemia was mistakenly given vincristine intraventricularly, as part of an intensified course of chemotherapy. Despite a CNS washout and supportive treatment, the patient developed progressive ascending paralysis, gradually lapsed into coma and died some 10 days later. Autopsy and post-mortem histological examination showed evidence of ...

PURPOSE: To determine whether textural features derived from sonographic pixel intensities differ significantly between healthy infants and infants who have had acute clinical hypoxic episodes. METHODS: Neurosonographic and calibration phantom-processed image data were evaluated prospectively from 9 infants (age range, 1 to 163 days) with at least 1 episode of ...

An 11-month-old infant suffering from microcephalus, developmental delay, severe failure to thrive and marked cortical atrophy on brain CT is presented. The cause of this condition was total calorie malnutrition induced by the emotional dysfunction of the mother. Improvement of the maternal-infant relationship, combined with appropriate nutrition, transformed the infant ...

In infants, extreme extension or rotation of the head can occlude one or both vertebral arteries. We sought to determine whether small communicating arteries or asymmetric vertebral arteries could predispose the brain stem to ischemia should such head movements occur. In 68 infants, the carotid, posterior communicating, precommunicator posterior cerebral, ...

AIM: To measure the local cerebral metabolic rate for glucose (LCMRGlc) in neonatal brains during maturation using positron emission tomography (PET) and 2-[18F]fluoro-2-deoxy-D-glucose (FDG). METHODS: Twenty infants were studied using PET during the neonatal period. The postconceptional age ranged from 32.7 to 60.3 weeks. All infants had normal neurodevelopment and ...

Postnatal brain development of healthy prematurely born infants was assessed to study possible influence of premature birth and early extrauterine environment on structural, biochemical, and functional brain development. Myelination and differentiation of gray and white matter were studied by in vivo magnetic resonance (MR) imaging (MRI), changes in cerebral metabolism ...

The characteristics of rhythmical kicking movements of preterm infants with documented brain damage (BD), who later showed a severe motor impairment, are described and compared with those of low-risk (LR) preterm infants. Spontaneous movements were videotaped for 60 min in the incubator or in a warmer. A first group of ...

Computed tomographic scan-based examination of the cerebrospinal fluid-filled spaces before and after fronto-orbital advancement in infants with unilateral coronal synostosis was performed. In infants who had not undergone surgery, pronounced compression of the ipsilateral frontal brain substance, frontal subarachnoid space, and frontal horn of the lateral ventricle were evident, with ...

The aim of the study was to examine the astroglial reactivity in brains of fetuses and newborns during the third trimester of gestation. The immuno-histochemical reaction of glial cells with glial fibrillary acidic protein (GFAP) was used. The periventricular white matter damage due to pre- and perinatal hypoxia or sepsis ...

Total thiamine (the sum of thiamine and its phosphate esters) concentrations are two- to fourfold lower in human brain than in the brain of other mammals. There were no differences in the total thiamine content between biopsied and autopsied human brain, except that in the latter, thiamine triphosphate was undetectable. ...

PURPOSE: To investigate imaging findings in premature infants who had profound asphyxia. METHODS: CT (three patients), MR (three patients), and ultrasonography (four patients) studies of five patients who had profound asphyxia before the postconceptional age of 32 weeks were retrospectively reviewed. The patients ranged from 1 day to 4 months ...

Event-related brain potentials generated in an auditory oddball paradigm were recorded in term and preterm infants. The amplitudes of these brain potentials were significantly larger when generated by a rare improbable stimulus compared to a common frequently presented stimulus. While the magnitude of this novelty detection effect depended on the ...

Changes of the midline structures of the brain, including the pons, cerebellar vermis, and corpus callosum, induced by adrenocorticotropic hormone (ACTH) therapy in 7 infants with infantile spasms were investigated using magnetic resonance imaging. Decreased volume of these parts of the brain was induced in almost all infants. Decreased volume ...

OBJECTIVE: Because stress in utero may enhance neuromotor maturation, we hypothesized that infants born to mothers with preeclampsia would have a shorter absolute latency V and interpeak latency I-V period (brain-stem conduction time) of brain-stem auditory evoked response (BAER) than infants born to normotensive mothers. STUDY DESIGN: A retrospective cohort ...

OBJECTIVE: The purpose of this study was to correlate normal brain anatomy as seen on posterior fontanelle cranial sonography with anatomical sections of the premature infant brain. MATERIALS AND METHODS: Images obtained from 93 cranial ultrasound examinations performed via both the anterior and posterior fontanelle in 53 infants, ranging in ...

A survey is given of current knowledge of the interrelationship between facial, cranial and brain development in humans. First, normal facial, cranial (mandible, maxilla, palatine bone, cranial base, theca cranii, dentition), and brain development are described separately. Then, developmental interrelationships are illustrated under normal and pathologic conditions (cleft lip and ...

OBJECTIVE: The objective of this study was to assess respiratory responses of newborn infants with myelomeningocele through pneumograms and carbon dioxide challenge, and to evaluate the possibility of predicting which patients with myelomeningocele acquired respiratory symptoms related to the Arnold-Chiari deformity and brain-stem dysfunction. METHODS: All surviving infants with spina ...

Glucose is the predominant cerebral energy source under physiological conditions, although other substrates may support cerebral metabolism. The present study was undertaken to determine if lactate is present in the immature human brain, and if so, whether or not concentrations of lactate differ between small-for-gestational-age and appropriate-for-gestational-age infants. Thirty stable, ...

The dominant conception of brain death as the death of the whole brain constitutes an unstable compromise between the view that a person ceases to exist when she irreversibly loses the capacity for consciousness and the view that a human organism dies only when it ceases to function in an ...

It is usually accepted that GPEtn is only an intermediate in glycerophospholipid degradation. However, some years ago J. P. Infante published a review-hypothesis concerning the possible involvement of GPEtn and GPCho in the biosynthesis of acyl-specific glycerophospholipids in mammalian tissues. This paper reports the results obtained by incubating brain cortex ...