Epidural blood patch for the treatment of liquor hypotension after intrathecal chemotherapy in a 10-year-old: case report.

BACKGROUND AND OBJECTIVES: An epidural blood patch is used to treat postdural puncture and liquor hypotension headache. We report the use of an epidural blood patch in a critical pediatric patient. CASE REPORT: A 10-year-old girl with acute leukemia developed venous cerebral thrombosis with hemorrhagic transformation one month after intrathecal chemotherapy. Given the unusual clinical and imagiological evolution even after decompressive craniectomy, we suspected cerebrospinal fluid hypotension. Spine imaging revealed signs of post-lumbar puncture fistula; we hence performed a blind blood patch. CONCLUSIONS: Recognizing cerebrospinal fluid hypotension in critical pediatric patients is important. Less-conventional life-saving measures, such as a blind blood patch, may be considered in such patients.

Effects of high temperature on body temperature and hormonal adjustments in piglets.

Effects of a high (33 degrees C) or thermoneutral (23 degrees C) temperature on body temperature and endocrine parameters were studied in weaned piglets. Rectal and skin temperatures were measured in four ad libitum fed animals per temperature during three weeks. After this acclimation period, 11 blood samples were withdrawn on a 24-h period. Over the acclimation period, rectal and skin temperatures were 0.6 and 2.9 degrees C higher, respectively, at 33 degrees C than at 23 degrees C (P < 0.01), this change occurring from the 1st day at 23 or 33 degrees C. A tendency of serum leptin concentrations to be lower after meals at 33 degrees C than at 23 degrees C was also displayed (P = 0.09). Plasmatic concentrations in Insulin-like growth factor I and thyroxine were decreased at 33 degrees C relative to 23 degrees C (P < 0.01 and P < 0.06, respectively), and triiodothyronine concentrations tended to be lower at 33 degrees C than at 23 degrees C (P = 0.1), which could account for the lower heat production and growth observed in pigs exposed to high temperatures.