Ultrasonographic measurement of subarachnoid space and frontal horn width in healthy Iranian infants

Ultrasonography is among the most general evaluating methods for central nervous system [CNS] assessment, especially for detecting extra axial collection via anterior fontanel. There are few studies showing values of this technique in normal developing infants for detection of subarachnoid space width. Association between age and sex and cerebrospinal fluid [CSF] spaces are controversial. Therefore, we conducted this study to evaluate the relationship between subarachnoid space and sex and age in Iranian infants. We used ultrasonography with a 7.5 MHZ linear probe to evaluate 74 healthy infants who were referred to our departments for other reason.s sinocortical width [SCW], craniocortical width [CCW], interhemispheric width [IHW] and frontal horn width [FHW] were evaluated. Data was collected an analyzed using STAT 9.1 software. Fifty four percent of the patients were male and 45% were female. Mean age of cases was 71 days. Mean SCW was 2.8 +/- 1.33 mm [5% and 95% were 1.1 and 5.8]. Mean CCW was 2.52 +/- 1.37mm [5% and 95% were 1.2-5.8]. Mean CCW was 2.52 +/- 1.37 mm [5% and 95% were 1.1 and 5.2mm, respectively] and mean IHW was 4.39 +/- 2mm [5% and 95% were 1.7 and 8mm, respectively]. Mean FHW was 2.9 +/- 1.09 mm in females and 3.52 +/- 1.34mm in males [5% and 95% were 1.4 and 5mm in females and 1.7 and 5.8 mm in males, respectively]. There was no significant difference in subarachnoid space width between boys and girls except for FHW which was wider in males than females. All spaces diameter correlated with age and were wider in older infants. Although our sample size was rather small for accurate conclusion, we found a normal range which was wider than western countries but similar studies conducted in China. Delayed maturation of arachnoid villi is one of the most important reasons of subarachnoid space widening in infants younger than one year which seems occur later in Iranian infants

Risk factors and prognosis of epilepsy in children with hemiparetic cerebral palsy

Epilepsy is reported in 15-90% of the children with Cerebral Palsy [CP] but its clinical course is not well defined. We conducted a retrospective study on children with hemiparetic CP who were referred to Pediatric Neurology Department of Mofid Hospital. The aim of our study was to evaluate the risk factors and prognosis of epilepsy in children with hemiparetic CP. We evaluated 64 children with hemiparetic CP who were referred to Pediatric Neurology Department of Mofid Hospital 2006 and 2008. according to our protocol, patients were divided into two roups: 34 children in the case group [hemiparetic patients with epilepsy] and 30 children in the control group [hemiparetic patients without epilepsy]. Prenatal, perinatal and postnatal events, maternal age at the time of delivery, socioeconomic status of the family, familial history of epilepsy, neuroimaging findings, side of the hemiparesia and age at diagnosis of hemiparesis were not considered as risk factors for epilepsy in hemiparetic children, but microcephaly, severity of hemiparetic CP and mental retardation were significantly associated with an increased risk of epilepsy in children with hemiparetic CP. Our study showed that microcephaly, severity of hemiparesis and mental retardation were risk factors for developing epilepsy in children with hemiparetic CP; furthermore, they had negative effects on rehabilitation outcome in these patients

CNS involvement by novel influenza virus type A [H1N1], the first report from Iran

This is the first report of CNS involvement by the new influenza virus [influenza A [H1N1] in Iran. The patient was a 10-year-old boy with chief complaints of fever, malaise, and cranial nerve involvement, resulting in respiratory muscle paralysis and intubation. This shows that the new influenza virus, as well as the seasonal flu, can cause neurologic complications; however, the severity of the signs and symptoms is less and the disease may resolve without complications in the case of seasonal flu. Therefore, in each patient with neurological involvement and typical influenza signs and symptoms or a flu-like syndrome, diagnostic tests for H1N1 flu virus should be considered, especially during epidemics, and treatment with oseltamivir should be started