ABSTRACT
PURPOSE: Headache is a common disorder in childhood and adolescence and frequently associated with emotional or psychological problems. In this study we studied behavioral and psychological characteristics of recurrent headache patients. METHODS: We evaluated 120 patients over 9 years old with headache who visited Kangnam Sacred Heart Hospital. 33 patients who didn't have headache were included in the control group. Diagnosis was confirmed according to ICHD-2 classification and KCBCL, TAIC, CDI, and SAIC were conducted in all participants. RESULTS: Male to female ratio was 0.7:1 in the study group and 1.1:1 in the control group and the mean age was 11.5+/-2.1 and 12.6+/-2.0 years old respectively. 73.3% of patients were migraine and 26.7% were tension type headache. The mean of KCBCL total scores was 56.2 in the migraine group, 54.0 in the tension type headache group, and 38.3 in the control group and the score was higher in the headache group(P<0.001). The means of internalizing and externalizing scores were 59.8 and 54.1 in the migraine group, 57.4 and 51.3 in the tension headache group, and 40.1 and 42.4 in the control group respectively and the scores were higher in the headache group(P<0.001). The mean scores of SAIC and TAIC were 36.3 and 33.6 in the migraine group, 36.3 and 34.6 in the tension type headache group, and 25.3 and 26.9 in the control group respectively and the scores were higher in the headache group(P<0.001). The mean scores of CDI were 14.9 in the migraine group, 14.5 in the tension type headache group, and 9.1 in the control group and the scores were higher in the headache group(P=0.002). CONCLUSION: The patients with recurrent headache showed statistically significant higher scores in CBCL total, internalizing, and externalizing scores, SAIC, TAIC, and CDI in comparison with the control group.
Subject(s)
Adolescent , Child , Female , Humans , Male , Headache , Heart , Migraine Disorders , Stress, Psychological , Tension-Type HeadacheABSTRACT
Bacterial meningitis after head trauma is a rare complication, but the cerebrospinal fluid(CSF) leakage after head trauma greatly increases the risk of bacterial meningitis. Most of the infections passes through the defects in the basal skull fracture, and Streptococcus pneumoniae is the most common organism. MRI, coronal thin sections of cranial CT and radioiosotope cisternography are considered to diagnose the CSF fistulae. We report a case of a 14-year-old girl with pneumococcal meningitis complicated by CSF rhinorrhea following an asymptomatic period of 3 years after head trauma. We found a bone defect of the cribrium of the skull base by means of paranasal sinus CT scanning and MRI.
Subject(s)
Adolescent , Female , Humans , Cerebrospinal Fluid Rhinorrhea , Cerebrospinal Fluid , Craniocerebral Trauma , Fistula , Magnetic Resonance Imaging , Meningitis, Bacterial , Meningitis, Pneumococcal , Skull Base , Skull Fractures , Streptococcus pneumoniae , Tomography, X-Ray ComputedABSTRACT
Ataxia-telangiectasia is an autosomal recessive disorders characterized by cerebellar ataxis, oculocutaneous telangiectasia and frequent respiratory infections due to immunoincompetence. Ataxia usually appear by age of 2 years with most patients need wheelchairs for morbility by early teenage. Speech and eye movements are also affected. Other important features are immunodeficiency, a high level of serum alpha-fetoprotein concentration, growth retardation, telangiectasia and a very high risk of a lymphoid tumor. Patients also show an increased sensitivity to ionizing radiation. We report a case of a 7-year-old girl who had ataxic gate, conjunctival telangiectasia, and frequent upper respiratory infection. Her alpha-fetoprotein was elevated and the serum IgA was decreased. The brain MRI showed prominent cerebellar atrophy. From the 1 st year of life to death, the level of serum gamma- GTP became steadily elevated up to 10 times of a normal level.
Subject(s)
Child , Female , Humans , alpha-Fetoproteins , Ataxia , Ataxia Telangiectasia , Atrophy , Brain , Eye Movements , Guanosine Triphosphate , Immunoglobulin A , Magnetic Resonance Imaging , Radiation, Ionizing , Respiratory Tract Infections , Telangiectasis , WheelchairsABSTRACT
PURPOSE:The aim of this study was to determine whether postnatal sepsis is a risk factor for developing bronchopulmonary dysplasia (BPD) in premature infants. METHODS:Premature infants of less than 32 weeks of gestation or birth weight under 1,500 g who admitted at Kangnam Sacred Heart Hospital of Hallym University during 1997-2005 were investigated. Among them, infants born at other hospitals or died within 4 weeks of life and infants who got sepsis after neonatal period were all excluded. Total 268 cases were included in this study. They were divided into those with respiratory distress syndrome (RDS) (n=77) and without RDS (n=191) and each was subdivided into groups with sepsis and without sepsis. Based on the medical records, the incidence of BPD and its correlation with sepsis were analyzed. RESULTS:Incidence of typical BPD was 63.0% in group with sepsis and 26% in group without sepsis. In case of atypical BPD, incidence was 20.5% in group with sepsis and 1.3% in group without sepsis. When logistic regression analysis was performed for correcting the confounding factors, sepsis was found to be statistically significant for BPD de development (OR 3.159, 95% CI=1.241-8.039, P<0.05). RDS, birth weight were also independently significant. Other perinatal factors such as gestational age, 1 min & 5 min Apgar score, total duration of assisted ventilation, total duration of O2 administration, PDA, ROP, and IVH were found to be significant risk factors for developing BPD. We could not find any statistically significant maternal risk factors for BPD occurrence. CONCLUSION:For premature infants under 1,500 g of birth weight or 32 week of gestational age and less, sepsis during the first 4 weeks of age was a significant risk factor for developing both typical and atypical BPD.
Subject(s)
Humans , Infant , Infant, Newborn , Pregnancy , Apgar Score , Birth Weight , Bronchopulmonary Dysplasia , Gestational Age , Heart , Incidence , Infant, Premature , Logistic Models , Medical Records , Risk Factors , Sepsis , VentilationABSTRACT
Kikuchi-Fujimoto disease(KFD), also known as histiocytic necrotizing lymphadenitis, is a self-limited systemic illness and it has the pathognomonic histological appearance of lymph nodes. KFD is rarely associated with systemic lupus erythematosus (SLE). The diagnosis of KFD can precede, postdate or coincide with the diagnosis of SLE. Our case describes a young woman, originally diagnosed as having Kikuchi's disease by lymph node histology, who subsequently developed SLE with constitutional symptoms, skin rash, hematologic and immunologic disorder and high titer of antinuclear antibody. This raises consideration for the proposal that KFD may reflect a SLE-like auto-immune condition. Patients with KFD should be kept under observation for several years for the development of SLE. And KFD should be ruled out in SLE flare-up accompanied by lymphadenopathy.