ABSTRACT
ABSTRACT: An 81-year-old man with a history of metastatic melanoma presented with sudden onset of painless, binocular vertical diplopia. The clinical examination was consistent with a right fourth nerve palsy. An MRI of the head revealed a mass dorsal to the right tectum at the level of the inferior colliculus. An MRI just 4 months prior did not show a lesion in that location. An MRA of the head did not show an aneurysm. This is a rare case of an isolated fourth nerve palsy believed to be due to metastatic melanoma compressing the nerve along the dorsal midbrain.
Subject(s)
Brain Neoplasms/secondary , Melanoma, Amelanotic/secondary , Nerve Compression Syndromes/etiology , Skin Neoplasms/pathology , Trochlear Nerve Diseases/etiology , Aged, 80 and over , Brain Neoplasms/radiotherapy , Diplopia/diagnosis , Diplopia/etiology , Humans , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Male , Melanoma, Amelanotic/radiotherapy , Nerve Compression Syndromes/diagnostic imaging , Radiosurgery , Skin Neoplasms/surgery , Trochlear Nerve Diseases/diagnostic imagingABSTRACT
In the spring of 2017, a full-term infant with microcephaly was delivered in South Florida. During first trimester, the mother presented with fever, nausea, and vomiting. She reported no foreign travel for herself or her partner. The infant's neurologic, ophthalmologic, neuroradiologic, and audiologic findings were highly suggestive of congenital Zika syndrome (CZS), confirmed by IgM antibodies and plaque reduction neutralization test. New observations, including peripheral temporal retinal avascularity and peripapillary retinal nerve fiber layer thinning, are presented from this first known case of non-travel-associated CZS in the United States. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e93-e98.].
Subject(s)
Corneal Dystrophies, Hereditary/diagnosis , Eye Infections, Viral/diagnosis , Microcephaly/diagnosis , Optic Nerve Diseases/diagnosis , Pregnancy Complications, Infectious , Zika Virus Infection/diagnosis , Female , Gestational Age , Humans , Infant, Newborn , Pregnancy , RNA, Viral/genetics , Real-Time Polymerase Chain Reaction , Ultrasonography, Prenatal , United States , Young Adult , Zika Virus/genetics , Zika Virus Infection/congenitalABSTRACT
Aneurysms are rare in children. Causes include congenital, traumatic, inflammatory, and infectious etiologies. When and how to best surgically treat arterial aneurysms in a child remain unclear. We present the case of a 3-month-old child with an aneurysm of the left common iliac artery, which was first detected on abdominal ultrasound and was successfully repaired with a cadaveric vein graft.
Subject(s)
Aneurysm, Infected/surgery , Iliac Aneurysm/surgery , Postoperative Complications/surgery , Staphylococcal Infections/surgery , Vascular Grafting , Aneurysm, Infected/diagnosis , Aneurysm, Infected/etiology , Catheterization, Peripheral , Female , Humans , Iliac Aneurysm/diagnosis , Iliac Aneurysm/etiology , Infant , Postoperative Complications/diagnosis , Staphylococcal Infections/diagnosis , Staphylococcal Infections/etiology , Umbilical ArteriesABSTRACT
Approximately 22 million children in the United States sustain traumatic injuries every year, the etiologies of which vary with age as well as social and environmental factors. If not managed properly, these injuries can have a significant impact on future growth and development. Evaluation of facial injuries presents a unique diagnostic challenge in this population, as differences from adult anatomy and physiology can result in vastly different injury profiles. The increased ratio of the cranial mass relative to the body leaves younger patients more vulnerable to craniofacial trauma. It is essential that the treating physician be aware of these variations to properly assess and treat this susceptible and fragile patient population and ensure optimal outcomes. This article reviews the proper emergency department assessment and treatment of facial fractures in the pediatric population as well as any associated injuries, with particular emphasis on initial patient stabilization, radiological evaluation, and therapeutic options.
