In patients with cerebral palsy (CP), cerebral visual impairment (CVI) is frequently found in addition to ophthalmological disorders. Lesions in the visual areas are found in CT scans of CP patients with CVI. The aim of the present study was to determine the prevalence of these specific findings in CP patients with CVI. CT scans of 49 cerebral palsy patients were studied; CVI was diagnosed in 36 patients; in 13 patients, visual acuity was normal. In 8 patients, comparison with an MRI scan was possible (6 with CVI, 2 with normal acuity). The CT scans were scored according to the criteria used by Van Nieuwenhuizen (1987): normal, abnormalities of the white matter adjacent to the posterior horns of the lateral ventricles, abnormalities of the white matter located under the visual cortex, abnormalities of the visual cortex and abnormalities elsewhere. Abnormalities in the visual areas were found in 15% of the normal acuity group and in 53% of the CVI group. In 17 of the 19 CVI patients with abnormalities in the visual areas, the lesions were located in the white matter surrounding the posterior horns (89%). MRI imaging revealed the same abnormalities as the CT scans in 6 patients, but in one patient the abnormality was seen in more detail and in one patient the lesion in the occipital area was seen only on MRI. MRI examination seems to detect at least as many, but in some cases even more specific lesions in CVI patients compared to CT scanning, but the numbers were too small to allow any definitive conclusions to be drawn.
Fifty patients with disease involving the psoas compartment were analyzed. There were 27 patients with inflammation, 17 with tumor, and 6 with hemorrhage. In all but 3 cases the disease did not originate in the psoas but spread there from neighboring structures. Disease processes followed the fascial planes in patients with abscesses and hemorrhage but were less predictable with tumors. All three types of lesions were similar radiographically and were often indistinguishable. Asymmetry of the muscle mass, regions of decreased density, and opacification of fat in the peri- and pararenal compartments were the most frequent signs of disease. Computed tomography is recommended as the diagnostic procedure of choice.
The Vitrea workstation provides fast and accurate volume data from spiral CTA follow-up of endovascular aneurysm repair. This software may enhance the acceptability of volume surveillance in daily practice.
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