RESUMO
Stroke is a thrombohemorrhagic disorder of the central nervous system, with a fairly good outcome in pediatric age group except for the infancy period. In children ischemic type is more common than hemorrhagic type. Though it is difficult to distinguish between thrombotic and embolic phenomenon but it is largely due to cardiovascular lesions, at times it may be the first symptom to appear. The signs and symptoms also appear to be vague in children, hence difficult to pinpoint the etiology. The treatment of stroke is largely for stabilization of the patient, but it is very important to know the cause to prevent future strokes. Use of heparin in ischemic stroke is very promising and thrombolytic therapy is under trial.
Assuntos
Adolescente , Anticoagulantes/uso terapêutico , Anticonvulsivantes/uso terapêutico , Isquemia Encefálica/diagnóstico , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Recém-Nascido , Hemorragias Intracranianas/etiologia , Masculino , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Terapia Trombolítica/métodosRESUMO
Acute headaches in a child evoke anxiety in parents, of a possible catastrophic underlying intracranial pathology. Headaches constitute up to 2 to 6% of all emergency room visit. The prevalence of migraine is increasing. The majority of children have migraine without aura, and about one fifth have migraine with aura. Complicated migraine presents with dramatic neurologic signs and remains a diagnosis of exclusion. Children with migraine require reassurance, modification of life style and food habits, combined with judicious use of simple abortive medications and antiemetics. Prophylaxis in migraine is recommended for frequent or severe attacks and in complicated migraine.
Assuntos
Adolescente , Anti-Inflamatórios não Esteroides/uso terapêutico , Antieméticos/uso terapêutico , Antipsicóticos/uso terapêutico , Criança , Hospitalização , Humanos , Transtornos de Enxaqueca/diagnóstico , Prevalência , Agonistas do Receptor de Serotonina/uso terapêuticoRESUMO
We report three patients who lapsed into coma and subsequently manifested hypersomnolence, amnesia and vertical gaze paresis. Computed tomography revealed bilateral paramedian thalamic infarcts. This clinical symptomatology comprises the paramedian diencephalic syndrome.
Assuntos
Idoso , Infarto Cerebral/complicações , Coma/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome , Tálamo/irrigação sanguíneaRESUMO
We report a 25 year old male who suffered thalamic and multiple cerebellar infarctions during infrequent attacks of basilar artery migraine. Migraine-related infarcts at these sites are uncommon.
Assuntos
Adulto , Cerebelo/irrigação sanguínea , Infarto Cerebral/diagnóstico por imagem , Humanos , Masculino , Transtornos de Enxaqueca/diagnóstico por imagem , Tálamo/irrigação sanguínea , Tomografia Computadorizada por Raios X , Insuficiência Vertebrobasilar/diagnóstico por imagemRESUMO
Eight patients with hemiplegic migraine are described. Majority were in their second decade and suffered two or more episodes of dense hemiplegia outlasting the headache. Complete recovery was the rule.
Assuntos
Adolescente , Adulto , Criança , Feminino , Hemiplegia/etiologia , Humanos , Masculino , Transtornos de Enxaqueca/complicações , Recidiva , Fatores de RiscoRESUMO
Epilepsia partialis continua was the chief initial complaint in a young diabetic who was found to have hyperosmolar non ketotic hyperglycaemia. Such a presentation in a juvenile diabetic is rare. Literature relevant to this interesting neurologic disturbance has been briefly reviewed.
Assuntos
Adulto , Diabetes Mellitus Tipo 1/complicações , Epilepsias Parciais/etiologia , Feminino , Humanos , Hiperglicemia/complicações , Estado Epiléptico/etiologiaRESUMO
Fifteen patients presenting with visual, oculomotor and behavioural disturbances were diagnosed to be suffering from "top of the basilar" syndrome. Computed tomography confirmed the distribution of infarctions in the vascular territory of the rostral basilar artery. The clinical profile comprised cortical blindness and visual field defects, vertical gaze paresis, memory and behavioural disturbances and in one patient, the paramedian diencephalic syndrome.