Neonatal intracranial aneurysms are rare. Clinical presentation of subarachnoid haemorrhage in this age group is often non-specific. First-line investigation should start with transfontanelle cranial ultrasound, followed by MR angiography then CTA if necessary. Posterior circulation aneurysms and large or giant aneurysms are more frequent in neonates and children than in adults. Early diagnosis and treatment are important for improved outcome. Surgery is better tolerated than in adults.
Objectives.-The aim of this study is to evaluate the benefits of a rehabilitation program in terms of balance, gait and muscle strength in a population of patients with fascioscapulohumeral muscular dystrophy. Patients, material and method.-It is a retrospective analysis of a cross-section of patients with FSHD. The patients received a rehabilitation program in the outpatient unit (Rothschild hospital, Paris, France) between 2010 and 2013. Each patient benefited of 20 sessions alternating two and three half-day per week, with physiotherapy (muscle building, balance with unstable platform, endurance), hydrotherapy and occupation therapy. A clinical and instrumental evaluation was systematically proposed before and after the program. Balance was clinically assessed using three scales (BBS, FRT, and TUG) and instrumentally evaluated using a stabilometer. Gait parameters were analyzed with the Locometre 1 , the muscle strength was quantified on an isokinetic dynamometer at the speed of 608/s. Results.-Twenty-four patients (nine women and 15 men aged 21 to 70 years) were included in this study. After the rehabilitation program, there was a significant balance improvement validated by clinical tests: BBS (51.7 to 54.3 P = 0.001), FRT (17.9 to 24.7 cm P < 0.0001), TUG (9.58 to 7.91 s P < 0.0001), an improvement of the spontaneous gait speed (3.14 to 3.43 km/h P = 0.015) and of the muscle strength (Q min +29.7%, HM min +28.8% and HM max +6%, P < 0.05). No gain was observed for the stabilometric parameters, the fast gait speed and the quadriceps of the stronger limb.Discussion.-Intensive rehabilitation in patients suffering from fascioscapulohumeral muscular dystrophy improves their balance abilities, muscle strength and spontaneous gait speed. The long-term vision of this study would be to evaluate the maintenance on middle run of the achieved capabilities and the efficacy of the rehabilitation on the frequency of falls.
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