Computed tomography of the brain in kwashiorkor: a follow up study.

Abstract

Computed tomography of the brain was performed initially and after nutritional rehabilitation on 12 children with kwashiorkor. The severe cerebral shrinkage evident initially resolved after nutritional rehabilitation. The mechanism and significance of this reversible abnormality remains to be determined.The effect of severe protein energy malnutrition on the developing brain remains a controversial issue. In a previous report the presence of cerebral atrophy or brain shrinkage in eight children with kwashiorkor was described.' The precise nature of the loss of brain volume was uncertain. To determine the implications of these findings a follow up study was undertaken.Patients and methods Twelve children aged 11 to 28 months (median 17-7 months) were studied. Seven were girls and all were admitted primarily for management of severe protein energy malnutrition. One child had significant gastroenteritis that required rehydration and correction of a metabolic acidosis.On inclusion into the study the children were assessed clinically and by means of computed tomography of the brain. All subjects were normally hydrated and clinically stable at the time of the computed tomography. The scans were carried out two to three weeks after admission. The tomograms of the brain were performed according to standard procedures without contrast.Consent was obtained from the parents in each case. The study was approved by the ethical committee of the Medical Faculty of the University of the Orange Free State.The children were discharged for further nutritional rehabilitation at home. They were followed up and re-evaluated on average 14 months after the initial assessment.

Brain tissue volume segmentation in patients with anorexia nervosa before and after weight normalization

“…Others have found that IGF-1 levels are reduced in patients with anorexia nervosa (Counts, Gwirtsman, Carlsson, Lesem, & Cutler, 1992;Golden et al, 1994;Grinspoon, Baum, et al, 1996;Grinspoon, Gulick, et al, 1996;Hall, Lundin, & Pó voa, 1988;Hill, Hill, McClain, Humphries, & McClain, 1993;Hochberg et al, 1992;Rappaport, Prevot, & Czernichow, 1980;Tanaka, Maesaka, & Suwa, 1985;Winterer et al, 1985). As in anorexic patients, CT and MRI studies of patients with protein caloric malnutrition have demonstrated reduced brain tissue volumes, which are reversible following nutritional normalization (Gunston, Burkimsher, Malan, & Sive, 1992;Househam, 1991;Househam & De Villiers, 1987). Note: CSF = cerebrospinal fluid.…”

Executive Functions of Postweaning Protein Malnutrition in Mice

“…In human studies, atrophy of the brain has been reported in patients with severe protein (or protein energy) malnutrition 44) and anorexia nervosa (AN). 45) MRI studies have found a positive relationship between the amount of weight loss and the degree of atrophic changes.…”

Protein-Energie-Malnutrition und Organdysfunktion1

“…Computertomographische Untersuchungen des Gehirns mangelernährter Kinder zeigten eine Hungeratrophie mit weiten Liquorräumen und dünnerem Kortex, aber unverändertem Kleinhirn und Hirnstamm. Diese Veränderungen waren nach Realimentierung vollständig reversibel [61,62]. Die mentale Retardation schwerst mangelernährter Kinder könnte auf morphologische Veränderungen der Dendriten zurückzuführen sein [63].…”