scholarly journals Moyamoya disease in pediatric patients: outcomes of neurosurgical interventions

2008 ◽  
Vol 24 (2) ◽  
pp. E16 ◽  
Author(s):  
Anand Veeravagu ◽  
Raphael Guzman ◽  
Chirag G. Patil ◽  
Lewis C. Hou ◽  
Marco Lee ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Moyamoya Disease ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Small Populations ◽  
Age Group ◽  
Radiological Findings ◽  
Advantages And Disadvantages ◽  
Pediatric Age Group ◽  
Revascularization Procedures

✓Neurosurgical interventions for moyamoya disease (MMD) in pediatric patients include direct, indirect, and combined revascularization procedures. Each technique has shown efficacy in the treatment of pediatric MMD; however, no single study has demonstrated the superiority of one technique over another. In this review, the authors explore the various studies focused on the use of these techniques for MMD in the pediatric population. They summarize the results of each study to clearly depict the clinical outcomes achieved at each institution that had utilized direct, indirect, or combined techniques. In certain studies, multiple techniques were used, and the clinical or radiological outcomes were compared accordingly. Direct techniques have been shown to aid a reduction in perioperative strokes and provide immediate revascularization to ischemic areas; however, these procedures are technically challenging, and not all pediatric patients are appropriate candidates. Indirect techniques have also shown efficacy in the pediatric population but may require a longer period for revascularization to occur and perfusion deficits to be reversed. The authors concluded that the clinical efficacy of one technique over another is still unclear, as most studies have had small populations and the same outcome measures have not been applied. Authors who compared direct and indirect techniques noted approximately equal clinical outcomes with differences in radiological findings. Additional, larger studies are needed to determine the advantages and disadvantages of the different techniques for the pediatric age group.

scholarly journals Etiopathological study of pediatric neck masses in a rural population

2018 ◽  
Vol 4 (5) ◽  
pp. 1206
Author(s):  
Mudassar A. Shariff
Keyword(s):  
Pediatric Patients ◽  
Histopathological Examination ◽  
Pediatric Population ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Age Group ◽  
Medical College ◽  
Pediatric Age Group ◽  
Neck Masses ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Neck mass in pediatric age group is a common clinical condition encountered by an ENT Specialist. Detailed clinical examination and knowledge of the common neck masses in children, which differ from those in adults is vital in early diagnosis and treatment. Diagnostic modalities such as Ultrasonography, Computerised Tomography, Fine needle aspiration cytology (FNAC) and histopathological examination aids in the diagnosis of superficial neck masses. The majority of neck masses in the pediatric population are congenital or inflammatory in origin and some are neoplastic. This study was conducted to establish the various causes of neck masses and the site of origin of neck masses in pediatric patients attending ENT OPD.</p><p class="abstract"><strong>Methods:</strong> 50 patients in the age group of 1 month to 18 years presenting with neck masses to the ENT OPD of Vinayaka Mission’s Medical College and Hospital, Karaikal were included in the study. This was a prospective study conducted for a period of 2 years. All the cases underwent FNAC. Biopsy and histopathological examination was done in cases where the cytological diagnosis was inconclusive.  </p><p class="abstract"><strong>Results:</strong> Of the 50 cases clinically evaluated, 24 were lymph node swellings, 7 were thyroid swellings, 8 were salivary gland swellings, 10 were congenital neck swellings, with 1 swelling being due to other cause.</p><p class="abstract"><strong>Conclusions:</strong> Inflammatory swelling arising from the Lymph nodes were the commonest cause of neck swelling in pediatric patients. Neck swellings were located most commonly in the Submandibular triangle in the study.</p>

scholarly journals Paranasal Mass in a Healthy Male Toddler

2021 ◽  
pp. 014556132110079
Author(s):  
Melonie Anne Phillips ◽  
Meredith Lind ◽  
Gerd McGwire ◽  
Diana Rodriguez ◽  
Suzanna Logan
Keyword(s):  
Differential Diagnosis ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Age Group ◽  
Significant Morbidity ◽  
Healthy Male ◽  
Neck Tumors ◽  
Complete Surgical Resection ◽  
Maxilla And Mandible ◽  
Benign Mass

Head and neck tumors are rare in pediatric patients but should be kept in the differential when a patient presents with a new swelling or mass. One of these tumors is a myxoma, which is an insidiously growing, benign mass originating from the mesenchyme. They most commonly arise in the myocardium but can also develop in facial structures, particularly in the maxilla and mandible. When arising in facial structures, ocular, respiratory, and digestive systems can be affected based on local invasion. Complete surgical resection is curative but can lead to significant morbidity as well. Here, we present a case of a 15-month-old toddler presenting with a paranasal mass, which was ultimately diagnosed as a maxillary myxoma. This tumor is very rare in the pediatric population, especially in the toddler age-group, reminding clinicians to broaden the differential diagnosis when a patient’s course is atypical.

scholarly journals Current treatment of post-tonsillectomy pain: a review

2021 ◽  
Vol 7 (10) ◽  
pp. 1708
Author(s):  
Santosh Kumar Swain
Keyword(s):  
Pediatric Patients ◽  
Hospital Staff ◽  
Current Treatment ◽  
Review Article ◽  
Age Group ◽  
Throat Pain ◽  
Pediatric Age Group ◽  
Post Operative Pain ◽  
Active Research ◽  
Pain Analgesics

<p class="abstract">Tonsillectomy is one of the most common surgical procedures performed by an otorhinolaryngologist. This surgery is done more in the pediatric age group. Although tonsillectomy is safe and effective surgery, it is usually associated with significant post-operative pain. Analgesics used for post-tonsillectomy pain is often inadequate. Severe throat pain following tonsillectomy has been documented for decades. Patients or parents/caretakers often worry about such severe pain in the home. The pain following tonsillectomy is usually intense and long-lasting. The severe post-tonsillectomy pain often overstrains the patient, family, and hospital staff. Regular changes in the analgesic armamentarium, particularly in pediatric patients are making the treatment of post-tonsillectomy pain more challenging. Pain following the tonsillectomy period continues to be a highly debated issue and an area of active research. Throat pain in the post-tonsillectomy period can result in significant morbidity among patients. There are different analgesics available; each one has its risk profile and side effects when used for controlling post-tonsillectomy pain. This review article discusses on recent management of post-tonsillectomy pain. This article reviews the epidemiology, pathophysiology, impact of post-tonsillectomy pain, and details of medications used for controlling post-tonsillectomy pain.</p>

scholarly journals Neurological manifestation of Vitamin D deficiency

2021 ◽  
pp. 430-432
Author(s):  
Saniya Sroa ◽  
Shweta Nair ◽  
Fehmida N ◽  
Amit Vatkar
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Pediatric Population ◽  
Pseudotumor Cerebri ◽  
Neurological Manifestation ◽  
Age Group ◽  
Pediatric Age Group ◽  
Pressure Headache ◽  
Common Deficiency ◽  
Visual Disturbances

Idiopathic intracranial hypertension, also known as pseudotumor cerebri, is a disorder with raised intracranial pressure, headache, papilledema, visual disturbances with a normal cerebrospinal fluid examination, and normal neuroimaging. It is rare in the pediatric population and may occur as a manifestation of underlying disorders. Vitamin D deficiency is a common deficiency in the pediatric age group. However, neurological manifestations are rare. Here, we present the case of a 5-year-old male child who presented with headache, vomiting, and hypertension; however, the neurological examination was normal but the neuroimaging was suggestive of pseudotumor cerebri. Appropriate investigations were done. The most likely cause of pseudotumor cerebri in this patient was the deficiency of Vitamin D. We have reported this case as pseudotumor cerebri is a rare neurological manifestation of Vitamin D deficiency.

scholarly journals Post-tonsillectomy pain management in pediatric patients-a review

2021 ◽  
Vol 8 (9) ◽  
pp. 1637
Author(s):  
Santosh Kumar Swain
Keyword(s):  
Pediatric Patients ◽  
Hospital Staff ◽  
Risk Profile ◽  
Review Article ◽  
Age Group ◽  
Pediatric Age ◽  
Clinical Issue ◽  
Pediatric Age Group ◽  
Post Operative Pain ◽  
Active Research

Tonsillectomy is a common surgical procedure performed in the pediatric age group. Although tonsillectomy is a safe surgery, it is associated with significant post-operative pain. Analgesia after tonsillectomy is often inadequate. Severe post-tonsillectomy throat pain has been described for more than a decade. Parents often worry for handling the pain of their children in home. Post-tonsillectomy pain is often considered as a long lasting and intense in nature. Post-tonsillectomy pain in children is an important problem which overstrains the patient, family and hospital staff. Post-tonsillectomy pain in children is an important problem which overstrains the patient, family and hospital staff. Regulatory alteration in the analgesic armamentarium, particularly in pediatric patients are making the treatment of post-tonsillectomy pain more difficult. Post-tonsillectomy pain in pediatric patients continues to be highly debated clinical issue and also an area of active research. Post-tonsillectomy pain can result in significant morbidity among pediatric patients. There are several analgesics available; each one has its own risk profile and unique side effects when used in pediatric age group in post-tonsillectomy period. This review article provides an update on recent management of post-tonsillectomy pain in pediatric patients. This article reviews the epidemiology, pathophysiology, impact of post-tonsillectomy pain in children and details of medications used for controlling post-tonsillectomy pain. 

Surgery for Moyamoya Disease in Children

2019 ◽  
Vol 34 (9) ◽  
pp. 517-529 ◽  
Author(s):  
Ramana Appireddy ◽  
Manish Ranjan ◽  
Bryce A. Durafourt ◽  
Jay Riva-Cambrin ◽  
Walter J. Hader ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Hemorrhagic Stroke ◽  
Pediatric Population ◽  
Surgical Revascularization ◽  
Surgical Options ◽  
Revascularization Procedures ◽  
Cerebrovascular Occlusive Disease ◽  
The Brain ◽  
Internal Carotid Arteries ◽  
Selection Of

Moyamoya disease is a chronic progressive cerebrovascular occlusive disease of the terminal portion of the internal carotid arteries associated with an acquired abnormal vascular network at the base of the brain, often leading to ischemic or hemorrhagic stroke. Moyamoya disease is a relatively common cause of pediatric stroke with a specific racial and well-identified clinical and imaging phenotype. Moyamoya disease is more prevalent in East Asian countries compared with other geographic regions with a higher incidence of familial cases and clinically more aggressive form. Moyamoya disease is one of the few causes of stroke that is amenable to effective surgical revascularization treatment. There are various surgical options available for revascularization, including the direct, indirect, or combined bypass techniques, each with variable responses. However, due to the heterogeneity of the diseases, different clinical course, geographical variables associated with the disease, and availability of a wide variety of surgical revascularization procedures, optimal selection of a surgical candidate and the surgical technique becomes challenging, particularly in the pediatric population. This brief review presents pertinent literature of clinical options for the diagnosis and surgical treatment of moyamoya disease in children.

scholarly journals Imaging of COVID-19 pneumonia in children

2020 ◽  
Vol 93 (1113) ◽  
pp. 20200647 ◽  
Author(s):  
Figen Palabiyik ◽  
Suna Ors Kokurcan ◽  
Nevin Hatipoglu ◽  
Sinem Oral Cebeci ◽  
Ercan Inci
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Chest Ct ◽  
Ground Glass ◽  
Pathologic Finding ◽  
Radiological Findings ◽  
X Ray ◽  
Ct Findings ◽  
Chest X Ray ◽  
Single Lesion

Objective: Literature related to the imaging of COVID-19 pneumonia, its findings and contribution to diagnosis and its differences from adults are limited in pediatric patients. The aim of this study was to evaluate chest X-ray and chest CT findings in children with COVID-19 pneumonia. Methods: Chest X-ray findings of 59 pediatric patients and chest CT findings of 22 patients with a confirmed diagnosis of COVID-19 pneumonia were evaluated retrospectively. Results: COVID-19 pneumonia was most commonly observed unilaterally and in lower zones of lungs in chest X-ray examinations. Bilateral and multifocal involvement (55%) was the most observed involvement in the CT examinations, as well as, single lesion and single lobe (27%) involvement were also detected. Pure ground-glass appearance was observed in 41%, ground-glass appearance and consolidation together was in 36%. While peripheral and central co-distribution of the lesions (55%) were frequently observed, the involvement of the lower lobes (69%) was significant. In four cases,the coexistence of multiple rounded multifocal ground-glass appearance and rounded consolidation were observed. Conclusion: COVID-19 pneumonia imaging findings may differ in the pediatric population from adults. In diagnosis, chest X-ray should be preferred, CT should be requested if there is a pathologic finding on radiography that merits further evaluation and if clinically indicated. Advances in knowledge: Radiological findings of COVID-19 observed in children may differ from adults. Chest X-ray should often be sufficient in children avoiding additional irradiation, chest CT needs only be done in cases of clinical necessity.

scholarly journals Opioid Prescribing Patterns for Low Back Pain Among Commercially Insured Children

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Tej D Azad ◽  
Michael D Harries ◽  
Daniel Vail ◽  
Yi Jonathan Zhang ◽  
John K Ratliff
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Prescribing Patterns ◽  
Low Back ◽  
Age Group ◽  
Newly Diagnosed ◽  
Opioid Prescription ◽  
Opioid Prescribing

Abstract INTRODUCTION Low back pain (LBP) may affect up to 20% of the pediatric population. No specific guidelines exist regarding pharmacotherapy for acute LBP in the pediatric population. Given this observation and the lack of data available regarding pharmacotherapy for pediatric LBP, we sought to characterize patterns of opioid prescribing in the pediatric population. METHODS We used a national database to identify pediatric patients (age 5-17) with newly diagnosed with LBP between 2008 and 2015 who did not have a red flag diagnosis, had not received an opioid prescription in the 6 mo prior to diagnosis, and had 12-mo of continuous enrollment after diagnosis. We used logistic regression to model the association between sex, geographic region, categorical age, and our primary outcome, receipt of an opioid prescription in the year following diagnosis. RESULTS Our sample included 268 228 opioid-naïve pediatric patients diagnosed with LBP between 2008 and 2015. We observed that 47 631 (17.8%) patients received physical therapy, 29 903 (11.2%) patients received chiropractic manipulative therapy, 658 (0.25%) patients received epidural steroid injection, and 281 (0.10%) patients received surgery. A total of 35 274 (13.2%) pediatric LBP patients were prescribed opioids within 12 mo from their diagnosis. Opioid prescribing decreased in all age groups over the study period age group 5 to 9 decreased from 4.2% to 2.7%, age group 10 to 14 decreased from 10.3% to 7.7%, and age group 15 to 18 yr decreased from 20.9% to 17.1%. Female pediatric patients were more likely than male patients to receive an opioid prescription (OR, 1.12, P < .0001). Patients ages 10 to 14 (OR, 2.89, P < .0001) and 15 to 18 (OR, 6.98, P < .0001) were significantly more likely to be prescribed opioids compared to patients in the youngest age group. CONCLUSION To our knowledge, we report the first observational cohort study of opioids and LBP in the pediatric population. Our findings indicate that opioids are being used for newly diagnosed LBP and receipt of opioids are associated with patient demographic factors.

Analysis of Warfarin Therapy in Pediatric Patients: A Prospective Cohort Study of 319 Patients

Blood ◽  
1999 ◽  
Vol 94 (9) ◽  
pp. 3007-3014 ◽  
Author(s):  
W. Streif ◽  
M. Andrew ◽  
V. Marzinotto ◽  
P. Massicotte ◽  
A.K.C. Chan ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Warfarin Therapy ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
International Normalized Ratio ◽  
Target Range ◽  
Age Group ◽  
Older Children ◽  
Effect Of Age ◽  
Fontan Patients

Abstract This study details warfarin use in a large pediatric population followed in a central anticoagulation clinic. A prospective, consecutive cohort of nonselected children were studied. Patients were divided into groups by age, target international normalized ratio (INR) range, disease, medications, and vitamin K supplemented enteral nutrition use. Groups were analyzed on multiple aspects of warfarin therapy using multivariate methods. A total of 319 patients received 352 warfarin courses representing 391 treatment years. Age independently influenced all aspects of therapy. When compared with all older children, the ≤1 year of age group required increased warfarin doses, longer overlap with heparin, longer time to achieve target INR ranges, more frequent INR testing and dose adjustments, and fewer INR values in the target range. Although significantly different than children ≤1 year, children 1 to 6 years of age showed the same findings when compared with 7- to 18-year-olds. Fontan patients required 25% decreased dosage as compared with other congenital heart disease patients. Children on corticosteroids had less INRs in the target range and children on phenobarbital/carbamazepine required increased maintenance dosages of warfarin. Also, patients receiving enteral nutrition required increased dosages of warfarin. Serious bleeding occurred in 2 children (0.5% per patient year). Recurrent thromboembolic events (TEs) occurred in 8 children. Two children had recurrences while receiving warfarin (1.3% per patient year). This study outlines the profound effect of age and relative complexity of clinical management of warfarin therapy in children.

A Prospective Evaluation of Pediatric Patients With Syncope

1994 ◽  
Vol 33 (2) ◽  
pp. 66-70 ◽  
Author(s):  
Tally Lerman-Sagie ◽  
Pinchas Lerman ◽  
Masza Mukamel ◽  
Leonard Blieden ◽  
Marc Mimouni
Keyword(s):  
Pediatric Patients ◽  
Tilt Test ◽  
Breath Holding ◽  
Age Group ◽  
Single Episode ◽  
Pediatric Age Group ◽  
History Of ◽  
Head Up Tilt ◽  
Head Up Tilt Test ◽  
Multiple Episodes

Fifty-eight children with syncope were evaluated prospectively to determine the characteristics of syncope in the pediatric age group and the yield of various diagnostic tests. The age at first syncope ranged from 0.5 to 15 years. Twenty-five children presented after a single episode and 33 after multiple episodes. Ten had a history of breath-holding spells. Nineteen had a family history of syncope. A diagnosis was established in 53 patients (91%): vasodepressor (31), cardioinhibitory (13), tussive (3), hyperventilation (2), and mixed syncope (4). In five patients (9%), the cause remained unknown. The diagnosis was established from the history in 45 cases, by a positive oculocardiac reflex in 11, and by the head-up tilt test in four. We conclude that the cause of most cases of pediatric syncope is vasodepressor or cardioinhibitory and can be diagnosed by good history-taking. Costly evaluations are rarely necessary.

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