Infantile pseudotumor cerebri related to viral illness.

Pseudotumor cerebri (PTC) presents with varied spectrum of manifestations, association with diverse pathological conditions and variable outcome. A preliminary observation on children presenting with PTC is being presented because of certain peculiarities, not observed earlier, like occurring in clusters during particular season, all were infants having close relationship with viral illness and all had extremely benign outcome. Children presenting with raised ICP were hospitalised and evaluated. The relevant investigations carried out included lumbar puncture, cranial ultrasonography, CT Scan and culture studies. Fifteen children, all in infancy with male-female ratio of 2:3 presented in clusters of 11 (73.3%) cases during late summer and early fall presented with bulging fontanelle, vomiting 11, fever 12, respiratory infection 5, diarrhea 5, lateral deviation of eye balls 4 and skin rashes 5 cases. Contact with viral illness in the family was found in 10 cases. Lumbar puncture showed high opening high CSF pressure in all. Results of this study suggest peculiar and perhaps different form of PTC seen recently which affected only the infants. These were closely related to viral illness and had benign outcome.

The dying child and overt parental behavior.

In order to study the immediate grief reaction in parents of children dying in the hospital each parental reaction was scored on a 'grief reaction and intervention' (GRI) scale (minimum 0; maximum 4). The death events of 73 children comprised the study. The GRI score was 0 in 10 (13.7%), 1 in 19 (26.1%), 2 in 21 (28.7%), 3 in 15 (20.5%) and 4 in 8 (11%) cases; the mean (+/- SD) score was 1.89 (+/- 1.20). Crying, weeping spells, hostility, restlessness, denial of death, mutism, impulsivity and destructive behavior were observed. A significantly higher grief reaction was observed among parents of grown up children and those from an urban background. An intense reaction was also seen in cases when the course of illness was acute and death was not anticipated. Parents of male children of the first and second birth order also had higher GRI scores. Our findings suggest that socio-cultural factors may influence the intensity of the parental grief reaction.