Dandy Walker and Extreme Macrocephaly Caused by Enormous Occipital Encephalocele

2016 ◽  
Vol 70 (3) ◽  
pp. 158-162
Author(s):  
Vladimir Mirchevski ◽  
Elizabeta Zogovska ◽  
Aleksandar Chaparoski ◽  
Milenko Kostov ◽  
Michun Micunovic ◽  
...  
Keyword(s):  
Motor Development ◽  
Early Recognition ◽  
Cyst Formation ◽  
Psychomotor Development ◽  
Occipital Encephalocele ◽  
Shunt Procedure ◽  
Congenital Brain Malformation ◽  
Associated Malformations ◽  
The Right

Abstract Introduction. Dandy-Walker syndrome is a congenital brain malformation involving cerebellum with partial and complete vermian agenesis, enlargement of the fourth ventricle and surrounding fluid spaces, cyst formation in posterior cranial fosse pushing tentorium upward [1,2]. Hydrocephalus or an increase in the pressure of the fluid spaces may also be present or other malformation as corpus calosum hypoplasia or agenesia, occipital encephalocele, malformation of the heart, face, limbs fingers and toes [3-5]. The symptoms often occur in early infancy and include slow motor development and progressive enlargement of the skull. The diagnostic is done by ultrasound, CT and MRI [6-11]. The treatment of this syndrome may be complex and sometimes includes various experts such as pediatrician, pediatric neurosurgeon, physiatrist, psychologist, sociologist or others. The treatment consists of treating the associated problems such as hydrocephaly [12-15]. Prognosis of Dandy-Walker syndrome is variable and the morbidity and mortality depends on severity of the syndrome and associated malformations [16]. Aim. The aim of this paper was to demonstrate how severe spontaneous evolution of Dandy-Walker syndrome may be expressed and the problems and dilemmas which may appear related to its treatment. Case report. A six-year-old boy was referred to the neurosurgeon because of the excessive growth of the skull in anteroposterior axis caused by a wide base occipital encephalocele. Although the psychological development was near the low limit of the IQ, the enormous head had not allowed verticalization of the child and further progress of his psychomotor development. The head was so heavy that could not be supported by the child’s neck. Surgical procedure. We performed a cranial skull reduction with primary cranioplasty assisted by a plastic surgeon and Pudentz shunt procedure. Result. The follow-up period lasted two years. The child started to walk, hypotonia and Babinski signs disappeared, communication and his IQ improved. The esthetic results are quite acceptable allowing him better development. Conclusion. The early recognition of anomalies such as Dandy-Walker syndrome with occipital encephalocele using ultrasound may suggest interruption of the pregnancy on time [6-9]. However, the right diagnostic procedure for detecting deformities of the newborn and infant’s head at birth is MRI, and the adequate surgical treatment can prevent abnormal and excessive growth of the skull and disorders in the psychomotor development during child’s growth. A multidisciplinary approach may prevent new disabled individuals in the society.

scholarly journals SENTUHAN KASIH IBU, UPAYA STIMULASI TUMBUH KEMBANG ANAK DENGAN PIJAT BAYI PADA ANAK USIA 0-3 TAHUN DI DESA SELEBUNG KETANGGA, KECAMATAN KERUAK KABUPATEN LOMBOK TIMUR

2020 ◽  
Vol 4 (1) ◽  
pp. 356
Author(s):  
Catur Esty Pamungkas ◽  
Aulia Amini ◽  
Cyntiya Rahmawati
Keyword(s):  
Community Service ◽  
Motor Development ◽  
Blood Circulation ◽  
Infant Massage ◽  
Post Test ◽  
Good Productivity ◽  
The Right ◽  
The Brain ◽  
Stimulation Of

ABSTRAKBayi dapat tumbuh dan berkembang dengan baik jika kebutuhan dasarnya terpenuhi, yaitu  asah, asih dan asuh. Kebutuhan asah adalah kebutuhan akan stimulasi dini. Pemberian stimulasi dini yang sesuai akan memungkinkan terbentuknya etika, kepribadian yang baik, kecerdasan, kemandirian, keterampilan dan produktivitas yang baik. Efektifitas pijat bayi memberikan manfaat pada perkembangan motorik sangat baik pada anak usia 8-28 hari dibandingkan dengan anak yang tidak diberikan stimulasi pijat bayi (Rizki, 2017). Melalui pemijatan peredaran darah akan lancar, Salah satu zat penting yang dibawa adalah oksigen. Terpenuhinya oksigen diotak secara cukup membuat konsentrasi dan kesiagaan bayi semakin baik(Sembiring, 2017). Solusi permasalahan yang ditawarkan yaitu “Sentuhan Kasih Ibu” Upaya Stimulasi Tumbuh Kembang anak dengan Pijat Bayi yang dilakukan Pada Anak Usia 0-3 Tahun di Desa Selebung Ketangga di Kecamatan Keruak Kabupaten Lombok Timur. Tujuan pengabdian ini memberikan informasi bagi masyarakat terutama orang tua mengenai manfaat setiap langkah dari pijat bayi. Tim PKMS akan memberikan pelatihan langsung kepada ibu yang akan dipraktikkan oleh narasumber yang berpengalaman, memiliki bidang ilmu yang sesuai dan telah mendapatkan pelatihan pijat bayi sebelumnya, sehingga setiap informasi diberikan oleh orang yang tepat. Setelah diberikan pelatihan pijat bayi tersebut, diharapkan ibu dapat mempraktikan sendiri pijat bayi di rumah.Jumlah responden yang mengikuti kegiatan ini sebanyak 32 balita. Hasil pengadian didapatkan terbanyak responden 12-24 sebanyak 19 balita (59,4%). Hasil pre test didapatkan 23 responden memiliki pengetahuan kurang dan post test sebagian besar pengetahuan cukup sebanyak 18 responden. Hasil follow up kemampuan pijat bayi didapatkan 24 reponden mampu melakukan pijat bayi dengan benar. Kata kunci: stimulasi tumbuh kembang; bayi; pijat bayi. ABSTRACTBabies can grow and develop well if their basic needs, which are teasers, love and foster. The need for sharpening is the need for early stimulation. Providing first inspiration appropriate will enable the formation of ethics, a good personality, intelligence, independence, skills and good productivity. The effectiveness of baby massage provides benefits to motor development is very good in children aged 8-28 days compared with children who do not give stimulation of baby massage (Rizki, 2017). Through massage, the blood circulation will be smooth. One of them the essential substance carried is oxygen. Fulfilment of oxygen in the brain is sufficient to make the baby's concentration and alertness are getting better (Sembiring, 2017). The solution to the problem offered is the "Touch of Mother's Love" Efforts to Stimulate Child Development with Infant Massage which was carried out on children aged 0-3 years in Selebung Ketangga Village in Keruak District East Lombok Regency. The purpose of this service is to provide information for the community, especially parents, regarding the benefits of every step of baby massage. The Stimulus Community Service Team (PKMS) will provide training directly to the mother who will be practised by experienced speakers who have fields science according to the training and baby massage before, so every information given by the right person. After being given the baby massage training, it is hoped that the mother can practicing baby massage at home on their own. The number of respondents who participated in this activity was 32 toddler. The results obtained were the most respondents 12-24 as many as 19 toddlers (59.4%). Pre results test found 23 respondents have less knowledge and most of the post-test sufficient knowledge of 18 respondents. The follow-up results of the infant massage ability were obtained 24 respondents are able to massage the baby properly. Keywords: growth and development stimulation; baby; baby massage.

scholarly journals Evaluation of psycho-motor development in children with West syndrome

2012 ◽  
Vol 140 (5-6) ◽  
pp. 278-284 ◽  
Author(s):  
Dimitrije Nikolic ◽  
Petar Ivanovski ◽  
Dragana Bogicevic ◽  
Nikola Dimitrijevic ◽  
Ivan Milovanovic ◽  
...  
Keyword(s):  
Motor Development ◽  
Epileptic Encephalopathy ◽  
West Syndrome ◽  
Psychomotor Development ◽  
Seizure Type ◽  
Age Related ◽  
Psychological Examination ◽  
Developmental Index ◽  
Age Range

Introduction. West Syndrome (WS) is age-related epileptic encephalopathy characterised by a triad of symptoms: specific seizure type, pathognomonic electroencephalographic (EEG) pattern - hypsarrhythmia and delay and/or regression in psychomotor development (PMD). Aetiologically, it occurs in three forms: symptomatic, cryptogenic and idiopathic. Objective. Estimation of PMD in children with WS according to aetiology. Methods. The observed group consisted of 65 children. Age range was between 6 and 30 months. The patients were divided into three groups according to aetiology. All patients underwent psychological examination with Brunet-Lesine test, as well as PMD evaluation based on achieved developmental milestones for the corresponding age. Results. Statistically significant better values in the Human Developmental Index (HDI) had patients with idiopathic compared to other forms of WS, at testing after 12 months (93.0?8.1 vs. 46.8?6.1 vs. 45.6?3.8), as well as after 24 months (93.9?7.7 vs. 51.9?5.5 vs. 50.9?4.4). The best values of HDI after 24 months had patients with improvement in PMD with the average of 66.2?4.4, which was statistically significant compared to those with unchanged PMD (41.5?5.3) and with further regression in PMD (28.3?4.4). Significant correlation was obtained between PMD after 12 and 24 months (r=0.477), as well as a considerable improvement in HDI from the 12th to 24th month (49.4?4.0 vs. 53.7?3.9). Conclusion. The patients with idiopathic WS accomplished the best PMD. Improvement in PMD after 12 and 24 months of treatment was associated with improved HDI. Improvement in PMD was observed in all patients after 2 years of follow-up.

CASE REPORT: SURGICAL MANAGEMENT OF LUMBAR COMPRESSION FRACTURE

2019 ◽  
Vol 1 (4) ◽  
Author(s):  
Yustinus Robby Budiman Gondowardojo ◽  
Tjokorda Gde Bagus Mahadewa
Keyword(s):  
Spinal Cord ◽  
Left Lung ◽  
Lumbar Vertebrae ◽  
Compression Fracture ◽  
High Mobility ◽  
Early Mobilization ◽  
Cord Injury ◽  
Cardiothoracic Surgeon ◽  
The Right

The lumbar vertebrae are the most common site for fracture incident because of its high mobility. The spinal cord injury usually happened as a result of a direct traumatic blow to the spine causing fractured and compressed spinal cord. A 38-year-old man presented with lumbar spine’s compression fracture at L2 level. In this patient, decompression laminectomy, stabilization, and fusion were done by posterior approach. The operation was successful, according to the X-Ray and patient’s early mobilization. Pneumothorax of the right lung and pleural effusion of the left lung occurred in this patient, so consultation was made to a cardiothoracic surgeon. Chest tube and WSD insertion were performed to treat the comorbidities. Although the patient had multiple trauma that threat a patient’s life, the management was done quickly, so the problems could be solved thus saving the patient’s life. After two months follow up, the patient could already walk and do daily activities independently.

Upper instrumented vertebra to the right of the lowest instrumented vertebra as a predictor of an increase in the main thoracic curve after selective posterior fusion for the thoracolumbar/lumbar curve in Lenke type 5C adolescent idiopathic scoliosis: multicenter study on the relationship between fusion area and surgical outcome

2019 ◽  
Vol 31 (6) ◽  
pp. 857-864 ◽  
Author(s):  
Hiroki Oba ◽  
Jun Takahashi ◽  
Sho Kobayashi ◽  
Tetsuro Ohba ◽  
Shota Ikegami ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Posterior Fusion ◽  
Main Thoracic ◽  
Lowest Instrumented Vertebra ◽  
Line Tilt ◽  
The Right ◽  
Upper Instrumented Vertebra

OBJECTIVEUnfused main thoracic (MT) curvatures occasionally increase after selective thoracolumbar/lumbar (TL/L) fusion. This study sought to identify the predictors of an unacceptable increase in MT curve (UIMT) after selective posterior fusion (SPF) of the TL/L curve in patients with Lenke type 5C adolescent idiopathic scoliosis (AIS).METHODSForty-eight consecutive patients (44 females and 4 males, mean age 15.7 ± 2.5 years, range 13–24 years) with Lenke type 5C AIS who underwent SPF of the TL/L curve were analyzed. The novel “Shinshu line” (S-line) was defined as a line connecting the centers of the concave-side pedicles of the upper instrumented vertebra (UIV) and lowest instrumented vertebra (LIV) on preoperative radiographs. The authors established an S-line tilt to the right as S-line positive (S-line+, i.e., the UIV being to the right of the LIV) and compared S-line+ and S-line− groups for thoracic apical vertebral translation (T-AVT) and MT Cobb angle preoperatively, early postoperatively, and at final follow-up. The predictors for T-AVT > 20 mm at final follow-up were evaluated as well. T-AVT > 20 mm was defined as a UIMT.RESULTSAmong the 48 consecutively treated patients, 26 were S-line+ and 22 were S-line−. At preoperative, early postoperative, and final follow-up a minimum of 2 years later, the mean T-AVT was 12.8 mm (range −9.3 to 32.8 mm), 19.6 mm (range −13.0 to 41.0 mm), and 22.8 mm (range −1.9 to 68.7 mm) in the S-line+ group, and 10.8 mm (range −5.1 to 27.3 mm), 16.2 mm (range −11.7 to 42.1 mm), and 11.0 mm (range −6.3 to 26.9 mm) in the S-line− group, respectively. T-AVT in S-line+ patients was significantly larger than that in S-line− patients at the final follow-up. Multivariate analysis revealed S-line+ (odds ratio [OR] 23.8, p = 0.003) and preoperative MT Cobb angle (OR 7.9, p = 0.001) to be predictors of a UIMT.CONCLUSIONSS-line+ was defined as the UIV being to the right of the LIV. T-AVT in the S-line+ group was significantly larger than in the S-line− group at the final follow-up. S-line+ status and larger preoperative MT Cobb angle were independent predictors of a UIMT after SPF for the TL/L curve in patients with Lenke type 5C AIS. Surgeons should consider changing the UIV and/or LIV in patients exhibiting S-line+ during preoperative planning to avoid a possible increase in MT curve and revision surgery.

Persistent Apical Periodontitis: Bacterial Taxonomic Analysis and Treatment Through Intentional Replantation

2020 ◽  
Author(s):  
Fernando Eduardo Coria-Valdiosera
Keyword(s):  
Antibiotic Therapy ◽  
Root Canal ◽  
Resistance Mechanisms ◽  
Apical Periodontitis ◽  
Infectious Process ◽  
Identification Of Bacteria ◽  
The Right ◽  
Apical Lesions ◽  
Endodontic Retreatment

Introduction: The microorganisms own different resistance mechanisms that allow them to resist the chemo-mechanical cleanliness of root canal and antibiotic therapies causing the persistence of apical lesions. Methods: This clinical case describes a male patient diagnosed with pulp necrosis in the right lower central incisor due to trauma, which developed apical periodontitis manifesting itself extra orally. Root canal treatment along with antibiotic therapy was performed, but because the infectious process persisted, endodontic retreatment and a new antibiotic therapy were carried out, however, the clinical evolution was not favorable. For this reason, the intentional replantation was chosen as the outright treatment, performing apicectomy and curettage of the periapical lesion, from which the isolation and taxonomic study of microorganisms were carried out, with the respective antibiogram. Results: In the 10-day clinical follow-up, the extraoral infectious process disappeared almost completely and 6 months later, a complete repair of the bone tissue was observed on the tomography. Conclusion: A better understanding of the persistence of apical periodontitis was achieved by taxonomic identification of bacteria and the intentional replantation allowed to remove the apical biofilm gaining an excellent wound healing.

Adenoid cystic carcinoma of the labium oris with rare metastasis to the pleural cavity

2021 ◽  
Vol 14 (1) ◽  
pp. e237622
Author(s):  
Osama Mosalem ◽  
Anas Alsara ◽  
Fawzi Abu Rous ◽  
Borys Hrinczenko
Keyword(s):  
Side Effects ◽  
Adenoid Cystic Carcinoma ◽  
Pleural Cavity ◽  
Epigastric Pain ◽  
Asian Woman ◽  
Upper Lip ◽  
Adenoid Cystic ◽  
History Of ◽  
The Right

A 57-year-old Southeast Asian woman with a remote history of adenoid cystic carcinoma (ACC) of the right labium superius oris (upper lip) presented to the hospital with vague epigastric pain. On workup, she was found to have multiple pleural nodules. Histopathology confirmed the diagnosis of metastatic ACC. After 8 months of active surveillance, evidence of disease progression was found and the patient was started on pembrolizumab. Follow-up after starting pembrolizumab showed stable disease with no significant side effects.

Hypogastric Artery Stenting for Chronic Intermittent Spinal Cord Ischemia After Thoracic Endovascular Aortic Repair

2020 ◽  
Vol 27 (5) ◽  
pp. 801-804
Author(s):  
Catharina Gronert ◽  
Nikolaos Tsilimparis ◽  
Giuseppe Panuccio ◽  
Ahmed Eleshra ◽  
Fiona Rohlffs ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Ischemia ◽  
Thoracic Endovascular Aortic Repair ◽  
Neurological Symptoms ◽  
Endovascular Aortic Repair ◽  
Hypogastric Artery ◽  
Lower Extremity Weakness ◽  
Aortic Repair ◽  
The Right

Purpose: To report a case of chronic intermittent spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR) and its successful treatment using hypogastric artery stenting. Case Report: A 79-year-old patient presented in May 2013 with a thoracic aortic aneurysm (TAA) and a contained rupture. He urgently underwent TEVAR that covered 274 mm of descending thoracic aorta without immediate postoperative signs of acute SCI. At 3-month follow-up, he reported repeating incidents of sudden lower extremity weakness leading to a fall with a humerus fracture. A neurological consultation revealed the tentative diagnosis of intermittent SCI caused by TEVAR and initially recommended a conservative approach. During the following year there was no clinical improvement of the symptoms. Computed tomography angiography showed a high-grade stenosis of the right hypogastric artery, which was stented in November 2014 to improve the collateral network of spinal cord perfusion. Following treatment, the patient had no further neurological symptoms; at 32 months after the reintervention, the imaging follow-up documented a patent stent and continued exclusion of the TAA. Conclusion: Intermittent neurological symptoms after TEVAR should be suspected as chronic intermittent SCI. The improvement of collateral networks of the spinal cord by revascularization of the hypogastric artery is a viable treatment option.

scholarly journals Early recognition of PIMS-TS: a single centre retrospective review

2021 ◽  
Vol 5 (1) ◽  
pp. e001011
Author(s):  
Roshni Mistry ◽  
Nicola Scanlon ◽  
James Hibberd ◽  
Fionnghuala Fuller
Keyword(s):  
Early Recognition ◽  
Febrile Illness ◽  
Final Diagnosis ◽  
University Hospital ◽  
Single Centre ◽  
Retrospective Case ◽  
Reactive Protein ◽  
Review Reports ◽  
Specific Symptoms

IntroductionResearch into paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) has focused on tertiary level management. This review reports on symptoms and investigations at presentation.MethodsSingle centre retrospective case note analysis of patients fulfilling PIMS-TS diagnostic criteria from March to May 2020 in a London district level university hospital.ResultsSix patients presented in the week prior to their final diagnosis with fever and non-specific symptoms. Raised C-reactive protein (CRP), lymphopenia and hyponatraemia were noted. Kawasaki-like symptoms were under-represented in all patients.InterpretationThe results suggest that a proportion of children with early PIMS-TS present with a non-specific febrile illness and abnormal blood results. Further research is needed to determine the most appropriate identification and follow-up of these children.

scholarly journals MAPPING AND ENHANCING DESIGN STUDIES WITH PSI META-THEORETIC DESIGN FRAMEWORK

2021 ◽  
Vol 1 ◽  
pp. 2007-2016
Author(s):  
Yoram Reich ◽  
Eswaran Subrahmanian
Keyword(s):  
Design Research ◽  
The Other ◽  
Design Studies ◽  
Abstraction Level ◽  
Follow Up Studies ◽  
The One ◽  
The Right ◽  
Abstract Framework ◽  
Tools And Methods

AbstractDesign research as a field has been studied from diverse perspectives starting from product inception to their disposal. The product of these studies includes knowledge, tools, methods, processes, frameworks, approaches, and theories. The contexts of these studies are innumerable. The unit of these studies varies from individuals to organizations, using a variety of theoretical tools and methods that have fragmented the field, making it difficult to understand the map of this corpus of knowledge across this diversity.In this paper, we propose a model-based approach that on the one hand, does not delve into the details of the design object itself, but on the other hand, unifies the description of design problem at another abstraction level. The use of this abstract framework allows for describing and comparing underlying models of published design studies using the same language to place them in the right context in which design takes place and to enable to inter-relate them, to understand the wholes and the parts of design studies.Patterns of successful studies could be generated and used by researchers to improve the design of new studies, understand the outcome of existing studies, and plan follow-up studies.

Sign in / Sign up

Export Citation Format

Share Document