Pediatric neurology
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Pediatric neurology · May 2006
Case ReportsHemorrhage predisposing to cerebral infarction in children with moyamoya disease.
Two children with a new diagnosis of hemorrhagic type moyamoya disease experienced cerebral infarction after intraventricular hemorrhage. The patients developed ischemia 15 and 2 days after the initial diagnosis of hemorrhage. ⋯ Increased intracranial pressure in the setting of hemorrhage may be a risk factor for ischemic complications in patients with moyamoya disease. The optimal acute management of these patients requires further study.
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Pediatric neurology · May 2006
Critical score of Glasgow Coma Scale for pediatric traumatic brain injury.
The aim of this study is to determine the predictive critical value of the Glasgow Coma Scale for use as a determinant of outcome for children with traumatic brain injuries. A total of 309 children, aged 2-10 years, were enrolled in this study. Each subject underwent the following assessments: Glasgow Coma Scale; clinical data; brain computed tomography; and Glasgow Outcome Scale assessments. ⋯ Of the factors analyzed, the score of the Glasgow Coma Scale was the most effective predictor for outcome in pediatric traumatic brain injury. Furthermore, the predictive critical score of the Glasgow Coma Scale should be set at 5 for pediatric traumatic brain injury. The computed tomographic findings also were important in determining injury severity and predicting outcome.
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Resting cerebral glucose metabolism was assessed by 18[F]-fluorodeoxyglucose in 11 Down syndrome patients. Standardized uptake values were determined on a pixel-by-pixel basis from the measured tissue-activity data. The results revealed a mean overall 18[F]-fluorodeoxyglucose uptake in the Down syndrome patients close to that observed in the control group, consisting of children and young adults. ⋯ Six regions (clusters) were found for which the glucose uptake was higher in the Down syndrome patients than in the control group. The anatomic localization of these clusters was based on magnetic resonance investigations and a brain-atlas technique. The localization of the identified clusters with an increased glucose metabolism in the Down syndrome patients suggests that these subjects have an enhanced resting neuronal activity in cortical areas involved in reasoning, cognition, and speech as compared with normal subjects.
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Pediatric neurology · Mar 2006
Case ReportsChronic paroxysmal hemicrania in a 3-year, 10-month-old female.
This is the report of a 3-year, 10-month-old female with classical symptoms of chronic paroxysmal hemicrania and favorable response to indomethacin therapy. The patient was admitted because of frequent episodes of severe unilateral headaches during the day and nighttime as well as agitation. ⋯ Initially, focal epileptic attack was diagnosed and during the following 10 months several antiepileptic drugs were used without effect. After 10 months, chronic paroxysmal hemicrania was diagnosed because of the typical symptoms along with a favorable response to indomethacin therapy.
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Pediatric neurology · Feb 2006
Case ReportsMagnetic resonance spectroscopy and electroencephalography in baclofen coma.
This report describes a 14-year-old female who presented with coma and seizures. Continuous electroencephalographic monitoring revealed suppression and semiperiodic sharp waves. ⋯ She was subsequently found to have elevated serum baclofen levels after an intentional overdose. At the time of her discharge from the pediatric intensive care unit, she manifested no neurologic deficits, and on telephone follow-up 2 years after the ingestion the patient had no complaints of any cognitive problems or neurologic dysfunction.