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Abstract Objective: Suspicion of early anterior fontanel (AF) closure is a common reason for referral to a pediatric neurosurgeon because of the suspected increased risk of developing craniosynostosis (CS) in spite of the absence of evidence in the literature. The aim of this study was to analyze the association between AF closure and the diagnosis of non-syndromic CS in Brazilian children. Methods: An observational and case-cohort study was conducted to compare the incidence of closed AF between healthy children (group 1) and children diagnosed with non-syndromic CS (group 2) at a pediatric neurosurgery referral center. The accuracies of completely closed AF and diagnosis of CS were assessed. Results: High-resolution three-dimensional reconstruction computed tomography scans were obtained for 140 children aged < 13 months, of whom 62.9% were boys and 37.1% were girls (p < 0.001). The most common types of non-syndromic CS were trigonocephaly (34, 48%) and scaphocephaly (25, 35.7%). Closed fontanel (27, 38.6%) was observed in both groups, and a sensitivity of 36.1%, specificity of 72%, the positive predictive value of 59%, and negative predictive value of 51% were observed in the patients diagnosed with CS when AF closure occurred before the age of 6 months. Conclusion: The results of this comparative study of AF closure and CS diagnosis suggest that early AF closure does not imply a diagnosis of CS. Pediatricians should be aware of the risk of misdiagnosis of CS in cases with a widely open AF in spite of the presence of CS.
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O objetivo deste trabalho foi relatar um caso raro de hidrocefalia em um felino doméstico, da raça Persa, de 30 dias de idade. O animal foi atendido com histórico de impossibilidade de manter-se em estação, incoordenação motora, inabilidade para se alimentar sozinho e sustentar o peso da cabeça. No exame clínico, foi observada presença de fontanela aberta, aumento de calota craniana, ataxia, estrabismo unilateral e secreção ocular. A realização de ultrassonografia do crânio levou à confirmação do diagnóstico de hidrocefalia. O paciente permaneceu internado, sendo o protocolo de tratamento empregado constituído de corticosteroide, diurético e protetor gástrico em alta dose, além de alimentação por via oral e fluidoterapia. O animal veio a óbito após 24 horas, sendo encaminhado para realização de necropsia.(AU)
The objective of this work was to report a rare case of hydrocephalus in a domestic Persian feline, 30 days old. The animal was attended with a history of inability to keep in season, incoordination of the motor, inability to feed itself and support the weight of the head. In the clinical examination, the presence of an open fontanelle, an increase in the skull cap, ataxia, unilateral strabismus and ocular secretion were observed. The ultrasound examination of the skull led to confirmation of the diagnosis of hydrocephalus. The patient remained hospitalized, and the treatment protocol consisted of a corticosteroid, diuretic and gastric protector in high dose, besides oral feeding and fluid therapy. The animal died after 24 hours, being referred for necropsy.(AU)
Subject(s)
Animals , Cats , Cats/abnormalities , Hydrocephalus/classification , Hydrocephalus/diagnosis , Cerebrospinal FluidABSTRACT
Objective To understand the children′s development status of deciduous teeth erupt,fontanel closure,expressive language and gross motor in Zhengzhou.Methods According to random cluster sampling,the children health care clinic in three hospitals in Zhengzhou were investigated,all the data was gathered from the chil-dren health care management information system.4 230 healthy children aged 0-3 years old birth from 2000 to 2010 were investigated(2 141 boys and 2 089 girls),We collected the following information about birth situation,the dynamic physical growth,deciduous tooth occurrence,language and motor development.Results (1 )The children's weight,height has been persistent and significantly improved during the past 10 years in Zhengzhou.(2)There was a significant difference between the sexes in deciduous teeth erupt and the fontanel closure time.(3 )With the time, infant motor development and fontanelle closed slightly ahead of time.Conclusion The children's weight,height growth shows a long-term trend in Zhengzhou,with normal condition in neuropsychological development,and presents a slightly ahead of the trend.
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Background: Dermoid cysts are rare and benign tumors originating from failure of the normal embryologic development. Congenital inclusion dermoid cysts are usually located over the anterior fontanel. Surgical treatment is curative and provides good aesthetic results. The authors present a rare case of congenital inclusion dermoid cyst over the posterior fontanel and discuss the location, differential diagnosis, treatment and prognosis of this unusual pathological entity. Case description: A two-year old boy presented with a lesion on the posterior aspect of the head which had dated since birth. Imaging studies revealed an extracranial lesion over the posterior fontanel without intracranial extension. Surgical removal was performed and the histopathological examination confirmed the diagnosis of a dermoid cyst. The patient was discharged free of any medical complications. Conclusion: Although congenital inclusion dermoid cysts are more common over the anterior fontanel, they can occur over the posterior fontanel as well. Surgical treatment is curative in both locations with favorable aesthetic results.