Normal variations of the arteries and veins visualized during vertebral angiography of children were assessed by utilizihg measurements. The values were applied for evaluating dislocation and stretching of the vessels by brain tumors. Special emphasis has been placed on nodular and choroidal branches of the posterior inferior cerebellar artery, various measurements of the posterior fossa veins and the choroid vein of the lateral ventricle. These were considerably useful for the diagnosis of brain tumors in children. Because of minimal vascular changes associated with posterior fossa tumors, it has been emphasized that two or more findings should be evaluated together for arriving at a correct diagnosis.
Measurement of head circumference is one of the clinical parameters widely used as an index of brain growth and development. The study of normal head circumference for Negro, Japanese, Alaskan, Eskimo, and Russian has been reported by Nellhaus. The author has studied whether the Nellhaus' composite graph is useful for the Japanese infants or not. Measurements were made on 16 healthy newborn infants at Shiba, Minato-ku, Tokyo. All measurements were made every monthly by one observer, during the first year. The data lied within two standard deviations. Thus Nellhaus composite graph has been useful in Japanese infants. The serial measurements of the head circumference at periodic intervals should be routine part of the physical examination of infants and children. Borderline cases of normal or abnormal head circuniference are: 1) The measurement, which falls slightly outside or on two plus or minous standard deviations. 2) The serial head measurmeents which reflect an abnormal growth pattern, even though each individual measurement is well within normal limits. Evaluation of horde line case is best obtained by observation, palpation and use of skull roentgenograms (especially the cranial index of Cronqvist).
Head circumference (h. c.) of 108 children without mental deficiency whose height or weight were deviated more than 2 SD from the average, were measured. Five cases with hydrocephalus and 10 with microcephalus were also studied. Head circumference of 34 of 66 short children (51. 5%) were below the average minus 2 SD. Head circumference of 2 of 4 tall children (50%) were larger than the average plus 2 SD. Only 7 of 32 underweight children with normal height (21. 9%) and 3 of 13 obese children with normal height (23. 1%) had smaller or larger h. c. respectively than the average ±2 SD. When h. c. of the children with pituitary dwarfism, hypothyroidism, Turner's syndrome and malnutrition was compared with the h. c. corresponding to height age, the difference was smaller than that when compared wih the h. c. corresponding to chronological age. It was shown that thesmallness of the h. c. of children with constitution' dwarfism should be evaluated compareing with “h. c. corresponding to height” (=height measured × average h. c./average height) as the standard. Head circumference of some cases with hydrocephalus, microcephalus and low birth weight infant was followed up from birth till one year, and it was emphasized that the rate of growth was important indicator to judge normal or abnormal.
The changes of popliteal angle after delivery, appearance of stepping reflex and postural reflex at one month of age, motor development of prone position and possible causes of not supporting one's body weight after five month of age were studied. Immediately after delivery, popliteal angle was less than 100 degrees in 72.5% and arm recoil was positive in 83% of the 112 newborn infants. The change of patterns of popliteal angle after delivery was divided into four groups: group A, popliteal angle was constantly under 100: group B, popliteal angle was under 100 after delivery and became 100 and return to normal; group C, at first popliteal angle was over 100 and gradualy return to under 100; group D was others. The possible causes of popliteal angle over 100 after delivery were also discussed. The possible causes of not supporting one's body wieght after five month of age were as follows: 1) normal variation: shufflers, slow starters and others. 2) mental retardation 3) some form of cerebral palsy. 4) myopathy: benign congenital hypotonia.
This paper is to study abnormality in motor development of the children from the standpoint of clinician. Two major points are discussed. 1. Motor functions which are defined here as consisting of motility, manual faculty and speech are studied placing the emphasis on the correlation with the process of corticalization which manifests itself as the functional development from the reflex to the higher symbolic level according to Delacato-Domans's scale. Especially the developmental apractognosia and developmental retardation of speech are discussed in terms of this corticalization process. 2. Statistical analysis of the abnormal motor behavior against the normal control is not statisfactory because the developmental process is the dynamic process between biological and environmental factors. Above all, the development of children with brain damage is much more dependent upon the environmental factor than the normal children. This directly leads to the importance of the influence of therapist upon the children with brain damage. Thus, it is indispensable to grasp variations of motor development in the constellation of the total behavior of the children.
1. Four infantile cases of Subacute myelo-optico-neuropathy (SMON) were reported. Clinical characteristics of these cases are that sensory disturbances are not so severe as seen in adult cases and they tend to recover in relatively short period. Infantile cases of SMON have been considered to be very rare and only seven cases have been reported so far in Japan, but it is assumed that some cases of SMON are overlooked or misdiagnosed because of the different clinical features from those of adult cases. 2. How much doses of chinoform had been administered to children was investigated in a pediatric clinic of a medical college hospital. Though 244 cases were administered it, SMON did not appear. The dosage per kilogram was the same with adult cases, but duration of administration was less than 14 days in 94.3% of the cases.