ABSTRACT
BACKGROUND: Cerebral venous sinus thrombosis (CVST) in children is associated with a high incidence of serious morbidity and mortality. The presenting features are variable. It can be diagnostically challenging and the optimal treatment is uncertain. AIM: To describe the features of a series of children with CVST treated in a single paediatric neurology centre and to discuss the role of local thrombolysis. METHODS: Electronic databases were searched using diagnostic labels and International Classification of Diseases (ICD) codes to identify children aged 1 month to under 17 years with CVST. Their records were reviewed. RESULTS: 21 children were identified over a period of 8.25 years with a median age of 7.1 years. The presenting symptoms included headache (15 children), vomiting (14 children) and visual disturbance (eight children). Signs found included papilloedema (16 children), fever (six children) and sixth nerve palsy (six children). The most common underlying condition was middle ear infection (13 children). All cases received unfractionated heparin and four severe cases received local pharmacological thrombolysis. 48% of cases had an adverse outcome (death, chronic intracranial hypertension, residual hemiparesis or sixth nerve palsy). DISCUSSION: CVST has non-specific presenting features and a high risk of significant morbidity. CVST is typically found in association with a predisposing condition. Although heparin is the mainstay of treatment, thrombolysis may reverse deterioration as seen in three cases in this series. However, there is insufficient evidence to recommend the routine use of thrombolysis at present.
Subject(s)
Sinus Thrombosis, Intracranial/diagnosis , Sinus Thrombosis, Intracranial/drug therapy , Thrombolytic Therapy/methods , Adolescent , Anticoagulants/therapeutic use , Child , Child, Preschool , Female , Fibrinolytic Agents/therapeutic use , Follow-Up Studies , Headache Disorders, Secondary/etiology , Heparin/therapeutic use , Humans , Infant , Male , Risk Factors , Sinus Thrombosis, Intracranial/complications , Thrombophilia/complications , Thrombophilia/diagnosis , Time Factors , Tissue Plasminogen Activator/therapeutic use , Treatment Outcome , Vision Disorders/etiology , Vomiting/etiologyABSTRACT
The tropical ocean plays a major role in global climate. It is therefore crucial to establish the precise phase between tropical and high-latitude climate variability during past abrupt climate events in order to gain insight into the mechanisms of global climate change. Here we present alkenone sea surface temperature (SST) records from the tropical South China Sea that show an abrupt temperature increase of at least 1 degrees C at the end of the last glacial period. Within the recognized dating uncertainties, this SST increase is synchronous with the Bølling warming observed at 14.6 thousand years ago in the Greenland Ice Sheet Project 2 ice core.
Subject(s)
Climate , Geologic Sediments , Plankton , Animals , China , Eukaryota , Greenland , Oceans and Seas , Oxygen Isotopes , Temperature , TimeABSTRACT
The microcystin cyanobacterial hepatotoxins represent an increasingly severe global health hazard. Since microcystins are found world wide in drinking water reservoirs concern about the impact on human health has prompted investigations into remedial water treatment methods. This preliminary study investigates the scavenging from water of microcystin-LR by fine-grained particles known to have a high concentration of the clay minerals kaolinite and montmorillonite. The results show that more than 81% of microcystin-LR can be removed from water by clay material. Thus, microcystin-LR is indeed scavenged from water bodies by fine-grained particles and that this property may offer an effective method of stripping these toxins from drinking water supplies.
