[Cerebral venous thrombosis complicating a severe dehydration in the infant about a case report]

Cerebral venous thrombosis [CVT] is a rare vascular pathology in the infant characterized by a clinical and etiologic diversity. We report the case of CVT secondary to a severe deshydratation. It is about a one month old infant without notable pathological antecedents which presented 5 days before its hospitalization a refusal of feeding, a disorder of behavior and somnolence. The initial assessment showed a urinary infection with negative gram bacillus and a functional renal insufficiency. In front of the non improvement under treatment and the aggravation of the renal insufficiency, the patient was transferred to our formation. At admission the examination found an apyretic, icteric and hypertonic infant with dehydration of more than 15%and a convex anterior fontanella. Transfontanellar echography showed signs of cerebral haemorrhage and the CT-scan revealed a wide cerebral thrombosis. In spite of the rehydration and the antibioc, the patient deceased following a bradycardia with haemodynamic instability non responding to vaso-active drugs. The TVC is an unusual complication of deshydration in the infant. Through this observation the authors discuss the mechanisms of the TVC

[ acute liver failure [ALF] in children - about 55 cases]

The acute liver failure [ALF] in children has multiple etiological factors.. In our context, the infectious, especially viruses, are in the first rank. In this study, the authors report 35 cases of ALF, diagnosed and treated in our unit, between January the 1st 2003 to february 28[th], 2006 for analyzing the clinical, biochemical characteristics, the evolution as well as the treatment. The age of the patients varies between 2 months to 14 years old. Clinically, the jaundice was noted at 57% of the patients, are bleeding 28%, a hepatomegaly 41% with cirrhotic once at 17% and a generalized edema at 34%. A hepatic encephalopathy was noted in 11% of the patients. On the biological parameters: the rate of prothrombin [RP] was lower than 50% in 82% of cases, the hepatic cytolysis was noted in 88% of cases, the hypoalbuminemia in 40% and low blood glucose in 43% of the patients. Concerning etiologies, the infectious origin accounts for 45%, followed by Wilson disease with a rate of 19%. The treatment is in all cases symptomatic; it was etiologie each time that a cause was identified. The death of 3 patients is deplored. The infectious origin remains the dominant cause in our department, represented primarily by hepatitis A and the leishmaniosis, followed by the Wilson's disease. The high mortality must encourage rapid evaluation and selection of the patients candidates to liver transplant