William A. Wagle

Intraspinal air: An unusual manifestation of blunt chest trauma

A case of intraspinal air following traumatic bronchial laceration is demonstrated by computed tomography.

Development of Object Vision in Infants With Permanent Cortical Visual Impairment

We examined 30 infants in whom cortical visual impairment was diagnosed during their first year of life to ascertain prognostic factors for the development of object vision, defined as the ability to recognize faces or hand-held toys. All patients were followed up for a minimum of 12 months. The most common causes of cortical visual impairment in the 30 infants were hydrocephalus in nine infants (30.0%), birth asphyxia or neonatal hypoxia in eight infants (26.7%), intracranial hemorrhage with or without hydrocephalus in seven infants (23.3%), and meningitis in five infants (16.7%). Lack of development of object vision was associated only with hypoxia (P = .013). Findings on ophthalmic examination, an abnormality in the visual pathway on computed tomographic or magnetic resonance scan, and seizures, hydrocephalus, intracranial hemorrhage, meningitis, cerebral palsy, developmental delay, prematurity, microcephaly, and hearing deficit, did not appear to be risk factors for the lack of development of object vision.

Longitudinal analysis of olfactory deficits in HIV infection

The presence and degree of odor identification deficits in 55 HIV-infected (30 asymptomatic, 25 symptomatic) and 29 HIV-negative at-risk control volunteers were examined longitudinally using the University of Pennsylvania Smell Identification Test (UPSIT). Factors other than HIV infection that could account for olfactory loss (i.e., sinusitis or upper respiratory infection) were also considered by obtaining MRI scans of the nasal passages and information from an olfaction questionnaire. No differences were found among groups at the first administration of the UPSIT, with significant differences among groups emerging at the 1-year and 2-year follow-ups. The symptomatic group showed a significant decline in odor identification scores across time, while means for the asymptomatic and control groups remained stable. The presence of sinusitis or an upper respiratory infection appeared to have no effect on odor identification. The implications for these findings in relationship to cognitive decline in neurodegenerative diseases are discussed.

Development of Object Vision in Infants With Permanent Cortical Visual Impairment: Reply

We examined 30 infants in whom cortical visual impairment was diagnosed during their first year of life to ascertain prognostic factors for the development of object vision, defined as the ability to recognize faces or hand-held toys. All patients were followed up for a minimum of 12 months. The most common causes of cortical visual impairment in the 30 infants were hydrocephalus in nine infants (30.0%), birth asphyxia or neonatal hypoxia in eight infants (26.7%), intracranial hemorrhage with or without hydrocephalus in seven infants (23.3%), and meningitis in five infants (16.7%). Lack of development of object vision was associated only with hypoxia (P = .013). Findings on ophthalmic examination, an abnormality in the visual pathway on computed tomographic or magnetic resonance scan, and seizures, hydrocephalus, intracranial hemorrhage, meningitis, cerebral palsy, developmental delay, prematurity, microcephaly, and hearing deficit, did not appear to be risk factors for the lack of development of object vision.