Double Ventricular Shift in a Case of Cerebral Hemiatrophy

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CEREBRAL hemiatrophy has always been an entity involving considerable controversy and confusion. Since its first introduction into the American literature by Dyke, Davidoff, and Masson1 in 1933, attempts have been made to standardize the terminology. The original 9 cases presented by these authors displayed atrophy of one cerebrum and homolateral skull changes associated with varying degrees of contralateral hemiplegia, Jacksonian seizures, and mental deficiency. In all but one of the cases the onset of the illness began during the first eighteen months of life. The etiology was variable and in several cases was unknown. Roentgenography revealed a homolateral thickening of the vault with over-development of the sinuses. Air studies demonstrated hemicortical atrophy and an enlargement of the ventricular system with a shift to the atrophic side. All of the cases presented had been examined several years after the original illness.

A similar series of 9 cases was presented a few years later by Casamajor and Laidlaw.2

Independently at the same time Alpers and Dear,3 in an effort to clarify the subject, suggested that the classification be broken down into primary and secondary on the basis of the age of the patient when the original illness developed. They considered it to be primary when the patient was under 3 years of age. The signs and symptoms in their 22 cases of primary hemiatrophy were essentially the same as those listed by Dyke, Davidoff, and Masson, and by Casamajor and Laidlaw.

Ross4 presented a group of 36 patients ranging in age from. . .



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