Kawasaki disease is an acute vasculitis, that has a classic complication of acquired coronary artery aneurysm. Severe forms with multi‐organ involvement or neurological dysfunction are rare. Cerebral vascular involvement has been related to large‐vessel injury or cardioembolism, leading to focal brain infarction. A 4‐year‐old female presented with unusual, rapidly catastrophic Kawasaki disease with refractory shock, acute renal failure, and coma, requiring intensive haemodynamic management. The observation of diffuse micro‐haemorrhages (T2*‐weighted sequence) associated with white matter injury on brain magnetic resonance imaging (MRI) pointed towards lesions of the medium/small blood vessels. Cerebral vasculitis was suspected and the immunosuppressive treatment was increased Subsequently, the patient’s recovery was rapid. On follow‐up severe, bilateral vitritis was evident and surgery improved visual outcome. Early recognition of severe or unusual forms of Kawasaki disease could lead to more favourable outcome using appropriate treatment strategies. Diffuse cerebral micro‐haemorrhages on T2* brain MRI sequences might be a key sign for the diagnosis of medium or small cerebral vessel involvement.
Objective: To investigate presence of and factors associated with self-and parent-reported Fatigue seven years after severe childhood traumatic brain injury (TBI) in the prospective longitudinal study TGE (Traumatisme Grave de l'Enfant -severe childhood trauma). Method: Self-and/or parent-reports on the Multidimensional Fatigue Scale (MFS) were collected for 38 participants (ages 7-22 years) seven years after severe childhood TBI, and 33 controls matched for age, gender and parental educational level. The data collected included socio-demographic characteristics, age at injury and injury severity scores, overall disability (Glasgow Outcome Scale Extended, GOS-E), intellectual outcome (Wechsler scales) and questionnaires assessing executive functions, Health-Related Quality of Life (HRQoL), behavior and participation.Results: Fatigue levels were significantly worse in the TBI than in the control group, especially for cognitive fatigue. Correlations of reported fatigue with age at injury, gender, TBI severity and intellectual ability were moderate and often not significant. Fatigue was significantly associated with overall level of disability (GOS-E), and with all questionnaires completed by the same informant.
Conclusion:High levels of fatigue were reported by 30 to 50% of patients seven years after a severe childhood TBI. Reported fatigue explained more than 60% of the variance of reported HRQoL by the same informant (patient or parent).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.