Nöraksisin kalsifiye psödoneoplazmaları (CAPNON), santral sinir sisteminin nonneoplastik ve nadir görülen lezyonlarıdır. Etiyolojisi belirsizdir ve cerrahi olarak çıkarılması genellikle küratiftir. Radyografik özellikleri, bilgisayarlı beyin tomografide belirgin kalsifikasyonlar ve manyetik rezonans (MR) görüntülemede değişken kontrastlanma gösteren, T1 ve T2 ağırlıklı görüntülerde hipointensite görülmesiyle tanımlanmıştır. Erişkinlerde de sık rastlanmayan CAPNON, çocuklarda ise çok nadir görülmektedir. Bildirilen CAPNON tümörlerinin büyük çoğunluğu intrakraniyal olmakla birlikte, spinal kord da bulunabilir. Asemptomatik olabildiği gibi semptom gösterdiğinde de baş ağrıları, nöbet ve fokal nörolojik defisitler ile presente olabilir. Literatürde çok nadir bildirilen, değişken bilincin eşlik ettiği fokal nöbet epizodları ile başvuran ve CAPNON tanısı alan opere olmadan takip edilen 12 yaşında çocuk olguyu sunuyoruz.
Background and aims:The peripheral nerve blocks (PNB) is an effective technique for a better management of the postoperative analgesia, reduces morbidity due to the general anaesthesia. Aims: Evaluate the practices, the efficiency and complications related to the PNB. Methods: From January 2012 to June 2013, children of age 1 to 16 years who benefited from the PNB technique were included in this study. The collected data: demographic characteristics, type of surgery and PNB practiced. The results were stated in average with extremes and in percentage. Results: In general 1829 acts of paediatric anaesthesia were performed in planned surgery and emergency. 75,7 % of the PNB were associated with general anaesthesias and 24,3 % of them with sedation. The incidence of the PNB practice was 5,85 % i.e. 107 peripheral nerve blocks. The patient average age was 9 years (1-16 years), the average weight was 32 Kg (10-80 Kg). 52,3 % were operated for the upper limb and 47,7% for the lower limb. PNB performed in emergency surgery and planned surgery were respectively at 37 % and 63 %. The PNB accounting for 40% were axillary, 11 % of infraclavicular, 28 % femoral, 20 % lateral sciatic popliteal blocks, and 1 % parascalene block. Local anaesthetics used was only Bupivacaine 2,5 mg/ml. We have accounted 11 (10 %) cases of failure. Conclusions:The practice of PNB is lower in comparison to other countries. Complications are minor and low. Large use of PNB must be encouraged.
Idiopathic intracranial hypertension or pseudotumor cerebri syndrome (PTCS) is defined as an increase in intracranial pressure (ICP) without an identifiable and/or structural cause or abnormal cerebrospinal fluid content. The most common symptoms of PTCS include headache, vomiting, pulsatile tinnitus, blurred vision, and diplopia. In 2 to 3% of PTCS patients, severe and rapidly progressive vision loss may develop within 1 month since symptoms begin; this clinical condition is usually defined as fulminant idiopathic intracranial hypertension (FIIH). This study presented a patient admitted to the hospital with headache and blurred vision, who also had high severe acute respiratory syndrome coronavirus 2 infections total antibody level and was treated with a lumboperitoneal shunt due to medical treatment-resistant increased ICP. We also reviewed similar cases previously reported in the literature. To the best of our knowledge, no children affected with coronavirus 2019 related to FIIH and requiring surgical treatment have been yet reported in the literature.
There are concerns on exposure to radiation especially in pediatric population, as magnetic resonance imaging (MRI) can be used in emergency departments and provides an imaging without radiation; its utilization has recently increased. This study aimed to evaluate MRI utilization trends in patients who underwent a MRI in a pediatric emergency department within a period of five years. Examination data of the patients admitted to pediatric emergency department between 2014 and 2018 were obtained from database of the hospital with the approval of Clinical Research Ethical Committee. Rate of MRI utilization in patients admitted to pediatric emergency department was 0.88%. There was a statistically significant increase in MRI utilization within five years (p<0.001). The rate of male patients (1.24%) who underwent MRI was significantly higher than that of female patients (0.65%) (p<0.0001). There was a statistically significant decrease in MRI utilization by age in all categories (p<0.0001). Neuroradiology imaging was the most common. Complaints at presentation and pre-diagnoses were analyzed. The results of MRI were evaluated by radiologists and 53.9% of the results were normal. The highest rate (46.1%) of MRI utilization was between 4 pm and 12 am in a day. The highest rate of MRI utilization was on Friday and the lowest rate was on Sunday. While MRI utilization has increased in pediatric patients, neuroradiology imaging is the most common type. MRI utilization in pediatric emergency department is higher in male patients and in the early ages.
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