A Challenge in Diagnosis of Cerebellar Hemangioblastoma.

Hemangioblastomas are benign neoplasms, which are highly vascularized and have a slow-growing rate that typically affect the central nervous system; they account for about 1-2.5% of all intracranial tumors and for approximately 2-3% of all intramedullary neoplasms. We present a clinical case of cerebellar hemangioblastoma with six years of evolution, which illustrates the diagnostic difficulties that often arise, especially when the clinical and imaging characteristics escape those usually described and when other clinical findings appear as confounding factors. A 17-year-old female was initially admitted to the emergency department (ED) with a holocranial headache, gait imbalance, and vomiting. A brain magnetic resonance imaging (MRI) was done and a rounded lesion was detected in the left cerebellar hemisphere, hypointense in T1 and hyperintense in T2, with annular contrast enhancement. Several hypotheses for diagnosis were made, and the patient was subjected to several therapies, with periods of remission of symptoms interleaved with periods of worsening. After imaging suggestive of hemangioblastoma on routine brain MRI, the tumor was excised surgically and the histopathology confirmed the diagnosis. In the control brain MRI exams performed six and 24 months after surgery, no evidence of tumor recurrence was detected, and the patient remained asymptomatic. In conclusion, although these are rare neoplasms, it is essential to always consider hemangioblastomas in the differential diagnosis of cases with compatible clinical and radiological findings. A wrong or late diagnosis may lead to the use of unnecessary and harmful therapies as well as the appearance of potentially preventable complications if these tumors are handled correctly and timely.

Saúde perinatal em Ribeiräo Preto, Brasil: distribuiçäo do perímetro craniano em recém-nascidos / Distribution of the head circunference measure of newborn in Ribeiräo Preto, Brazil

Dos 9048 recém-nascidos vivos, que representam 98% do universo de nascimentos em Ribeiräo Preto, Brasil, no período de 1 de junho de 1978 a 31 de maio de 1979, foi estudado o perímetro craniano de 4554 crianças, traçando-se as curvas de distribuiçäo para ambos os sexos e para cada sexo separadamente. Foi demonstrado que a variável apresentou distribuiçäo normal, sendo estabelecidos os limites de normalidade para sua aplicaçäo prática

Crescimento craniano na criança / Skull growth in children

Os autores fazem ampla revisäo dos estudos e pesquisas realizadas sobre crânio em recém-nascidos e lactentes, procurando analisar e correlacionar os dados antropométricos com os vários fatores biológicos e sociais maternos

Doenças neurológicas na criança: estudo epidemiológico / Neurologic diseases in children: epidemiological study

Foram estudadas 1200 crianças, atendidas durante o ano de 1980, no setor de Neurologia Infantil do Departamento de Neuropsiquiatria e Psicologia Médica do Hospital das Clínicas da Faculdade de Medicina de Ribeiräo Preto, Universidade de Säo Paulo. Na análise global de nossos casos pudemos verificar a incidência de diferentes patologias, segundo os sexos e as faixas etárias consideradas, na freqüência abaixo discriminada: epilepsia em 429 crianças (35,7%); distúrbios de comportamento em 118 (9,8%); retardo neuropsicomotor em 84 (7,0%); infecçöes do sistema nervoso central em 70 (5,8%); paralisia cerebral em 48 (4,0%); poliomielite anterior aguda em 47 (3,9%); traumatismos cranioencefálicos em 46 casos (3,8%); malformaçöes em 41 (3,4%); distúrbios do sono em 35 (2,9%); distúrbios de escolaridade em 33 (2,7%) e, outras anormalidades menos freqüentes, em 249 crianças (21%)