RESUMO
A 5-month-old infant had right Horner syndrome and left hemiplegia. Magnetic resonance imaging confirmed smaller cerebral hemisphere and magnetic resonance angiography showed reduced blood flow in the internal carotid artery on the right. A diagnosis of congenital hemiplegia and carotid occlusion secondary to maternal trauma during pregnancy was made.
Assuntos
Dissecação da Artéria Carótida Interna/complicações , Hemiplegia/congênito , Hemiplegia/etiologia , Síndrome de Horner/congênito , Síndrome de Horner/etiologia , Acidentes de Trânsito , Dissecação da Artéria Carótida Interna/diagnóstico , Dissecação da Artéria Carótida Interna/etiologia , Feminino , Humanos , Lactente , Angiografia por Ressonância Magnética , Imageamento por Ressonância Magnética , Gravidez , Complicações na GravidezRESUMO
PURPOSE: Meningococcal septicemia is associated with coagulopathy and hemorrhagic tendency. We carried out this study to determine the incidence of retinal hemorrhages in meningococcal septicemia. METHODS: This was a prospective study involving all children admitted to the Sheffield Children's Hospital, Sheffield, England, with a diagnosis of meningococcal septicemia. Confirmation of meningococcal infection was by blood culture or DNA analysis using polymerase chain reaction. The children underwent ocular examination including dilated fundus examination by direct and indirect ophthalmoscopy. Details of their coagulation status were also obtained. RESULTS: Twelve children (mean age, 4.5 years) with a confirmed diagnosis of meningococcal septicemia were included. All children had coagulopathy. Retinal hemorrhages were found in 5 children (42%). The disease was fatal in 3 children. Group C meningococcus was responsible for the infection in all those with retinal hemorrhages and those with fatal outcome. CONCLUSIONS: Retinal hemorrhage is a common feature in meningococcal septicemia. Ophthalmic evaluation should be part of the assessment of children with meningococcal septicemia. Future studies on meningococcal disease should include retinal hemorrhage as another parameter in the assessment. This should help us to understand the role of retinal hemorrhage in the prognosis of this serious disease.
Assuntos
Bacteriemia/complicações , Infecções Meningocócicas/complicações , Hemorragia Retiniana/etiologia , Pré-Escolar , DNA Bacteriano/análise , Humanos , Incidência , Neisseria meningitidis/genética , Neisseria meningitidis/isolamento & purificação , Oftalmoscopia , Reação em Cadeia da Polimerase , Estudos Prospectivos , Hemorragia Retiniana/diagnósticoRESUMO
Posner-Schlossman syndrome (glaucomatocyclitic crisis) is a condition of unknown etiology. Patients present with blurred vision, show minimal anterior chamber activity, and raised intraocular pressure (IOP). Corneal edema may cause colored halos. The condition tends to be recurrent, usually responding to a topical steroid and ocular hypotensives. The eyes appear normal between attacks. We present a patient who had bilateral Posner-Schlossman syndrome and underwent filtering surgery to control raised intraocular pressure in both eyes. During the follow up of more than 4 years, the control of IOP was good and he had no further attacks.
