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• W1995931921 abstract "Based on a correlative clinico-neuropathological study of 891 necropsy cases with mental and neurological defects in infancy and early childhood (clinically manifest within the first 3 years of life), the possibilities and limitations of a nosological classification of infantile cerebral disorders are discussed. Without reference to the medical history, the clinical picture of the condition alone would have enabled a correct diagnosis to be reached in 15% of cases and by the addition of certain laboratory tests (pneumoencephalography, EEG, biochemical methods) recognition was possible in 24.2% of the sample. The greatest incidence of accurate diagnosis was in cases of cerebral malformation, representing 32% of the material, 62% of which could be recognised clinically. In 21% of the sample, exact medical records were lacking or were inadequate. However in 16.5% of all patients, obscure clinical syndromes could be clarified by the medical or family history. On the other hand, this information was of little value in almost 60% of cases and even misleading in 8.6% as compared with the necropsy findings. Neuropathological analysis alone enabled a correct nosological classification to be reached in about 80%, whereas combined clinical and morphological evaluation, including comprehensive medical records would have elucidated 90% of the material presented. The diagnostic difficulties of infantile cerebral disorders are particularly due to a frequent lack of correlation between the pathological findings in the CNS on the one hand and the clinical symptoms of the neurological disorders and the history on the other. This problem is discussed with special reference to cases of perinatal brain damage which represented about 26% of the material. In less than half the cases with reports of abnormal deliveries, was the morphological brain damage reasonably referable to birth injury. On the other hand, perinatal accidents were reported in one-third of all morphologically-confirmed cerebral malformations. Only in 54% of the patients with reported birth asphyxia, was respiratory distress considered to be the cause of the observed brain lesion. Perinatal distress, therefore, may be regarded not only as the cause but also as the result of organic brain damage in a considerable proportion of cases. In metabolic disorders which represented 6.7% of the sample, the accuracy of clinical diagnosis was 46.4% but this could have been considerably increased by accurate family histories and diagnostic biopsies." @default.
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• W1995931921 date "1968-11-01" @default.
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• W1995931921 title "Infantile cerebral disorders Clinical-neuropathological correlations to elucidate the aetiological factors" @default.
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• W1995931921 doi "https://doi.org/10.1016/0022-510x(68)90060-9" @default.
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