RESUMEN
The purpose of the present study was to define the late effects, both physical and psychological, of treating low-grade astrocytomas with radiotherapy. Fifty patients, half of whom received radiotherapy, underwent an assessment of neurological and neuropsychological function. There was no difference in neurological function between the two groups. The radiotherapy recipients, including those with cerebellar tumours, performed significantly worse on measures of intelligence and information processing. In addition, there was a greater incidence of special education needs in the irradiated group. We conclude that children with low-grade astrocytomas who receive radiotherapy have no greater neurological deficit but that the use of radiotherapy carries a penalty in terms of long-term cognitive function and confirmed the findings of many previous reports that supratentorial irradiation is detrimental. More surprisingly, it has been demonstrated that local field irradiation to the posterior fossa can also produce significant cognitive impairment.
Asunto(s)
Astrocitoma/radioterapia , Neoplasias Encefálicas/radioterapia , Encéfalo/efectos de la radiación , Trastornos del Conocimiento/etiología , Irradiación Craneana , Traumatismos por Radiación/etiología , Adolescente , Astrocitoma/patología , Astrocitoma/psicología , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/psicología , Niño , Preescolar , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Lactante , Inteligencia/efectos de la radiación , Masculino , Recuerdo Mental/efectos de la radiación , Examen Neurológico/efectos de la radiación , Pruebas Neuropsicológicas , Radioterapia Adyuvante , LecturaRESUMEN
We reviewed MRI of the brain and cervical spine in 11 patients with Morquio's disease. No abnormality was seen in the brain. The odontoid peg was abnormal in all patients, with varying degrees of cord compression due to an anterior soft tissue mass and indentation by the posterior arch of the atlas. The degree of cord compression was more marked than suggested by the symptoms and signs. We recommend MRI of the cervical spine in children with Morquio's disease before the development of neurological symptoms, to optimise the timing and type of surgical intervention.
Asunto(s)
Encéfalo/patología , Vértebras Cervicales/patología , Imagen por Resonancia Magnética , Mucopolisacaridosis IV/diagnóstico , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Mucopolisacaridosis IV/complicaciones , Médula Espinal/patología , Compresión de la Médula Espinal/diagnóstico , Compresión de la Médula Espinal/etiologíaRESUMEN
One hundred two patients with symptomatic hemorrhoids were randomized to receive treatment with either infrared photocoagulation (IRPC) or a bipolar diathermy probe (BD). There was no significant difference in complications, number of treatments required (IRPC 1.7 [0.9], BD 1.6 [0.8]). Third-degree hemorrhoids required more treatments than smaller piles. BD has some practical advantages over IRPC but results are similar.