[Computer tomography of the brain in children. II]

The second part of the study "Computerized tomography of the brain in children" is a continuation of the first one published in Supplement for the Collection of Scientific Works by Charles University's Medical Faculty in Hradec Králové from 1990. The former is issued from analyzing 1283 pathological CT findings investigated in newborns and children up to 15 years of age. The present study is concerned with not only the precise diagnosis of the lesion site but also with the type diagnosis and observation of further development of either affected or operated on children brain. When investigating ventriculomegalies, altogether with critical approach to the CT possibilities in diagnosing various types of hydrocephaluses and atrophies, which have been the most frequent pathological findings in this set, the authors also proceeded by monitoring reparative capacities of the brain tissue or post-surgery drainage complications. The problems of children CT investigation are similar to those in adults as far as the brain abscesses, empyemas and non-bacterial encephalities are concerned. A possibility of repeated examinations is of importance in selecting therapeutical approaches and observing their effect. A considerable amount of viral inflammations and the toxoplasmosis appear to be specific for children's age with yet intrauterine course of several of them. They result in severs cerebral damage, hydrocephalus and atrophy with frequent both periventricular and parenchyma calcifications. The acute meningitis did not show unambiguously positive CT findings, though they are frequent to result in mainly the obstructive or hyporesorptive types of hydrocephalus as well as atrophic changes. Only the 8 per cent of post-inflammatory intracranial patients showed normal time-delayed CT finding. From neurocutaneous syndromes, those most frequently occurring were cerebral manifestations of tuberous sclerosis. Apart from periventricular calcifications within the hamartomatous node, the three patients showed large pseudotumorous formations responsible of the deformity of lateral ventricles. In the frame of neurofibromatosis, the authors diagnosed the stenosis of aqueducts, conditioned with adjacent gliosis, and the dysplasia of the base of medial cranial fossa which caused the temporal lobe to prolapse into the fossa subtemporalis and the orbit. The exceptional finding in this set of patients was that of angioreticuloma within the ponto-cerebellar angle in a 10 year-old boy. According to literature, this type of hamartoma does not occur in children of prepubertal age. In 37 children of our set, the extra- or intraparenchymal cavities were diagnosed. Those most frequently occurring were arachnoidal cysts at the pole of temporal lobe as well as porencephalic intraparenchymal cysts.(ABSTRACT TRUNCATED AT 400 WORDS)