scholarly journals Moyamoya disease in a child

2017 ◽  
Vol 10 (2) ◽  
pp. 101
Author(s):  
Shohela Akhter ◽  
Rumana Riaaz ◽  
Roushan Jahan ◽  
Shahana A. Rahman
Keyword(s):  
Moyamoya Disease ◽  
Collateral Circulation ◽  
Bypass Surgery ◽  
Pediatric Patients ◽  
Cerebral Stroke ◽  
Radiological Evaluation ◽  
One Year ◽  
The Right

<p class="Abstract">A 6 year old boy presented with sign symptoms of cerebral stroke. After clinical and radiological evaluation, a diagnosis of bilateral moyamoya disease was made. An indirect bypass surgery encephaloduroateriosynangiosis was done on the right side at first then on the left side.  Patient was partially improved. At one year follow-up, there was the evidence of occlusion of collateral circulation on the right side and the patient became symptomatic again. It is noted that, although the early indirect bypass surgery is indicated in the pediatric patients for preventing the stroke but the outcome is difficult to judge.</p>

scholarly journals Case of de novo cerebral microbleeds in ischemic-type pediatric moyamoya disease

2021 ◽  
Vol 12 ◽  
pp. 284
Author(s):  
Kohei Inoue ◽  
Akihiko Momozaki ◽  
Takashi Furukawa ◽  
Fumitaka Yoshioka ◽  
Atsushi Ogata ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Pediatric Patients ◽  
De Novo ◽  
Cerebral Microbleeds ◽  
Left Middle Cerebral Artery ◽  
Current Case ◽  
Motor Weakness ◽  
The Right ◽  
Revascularization Surgery

Background: Studies on pediatric patients with moyamoya disease who presented with de novo cerebral microbleeds (CMBs) are extremely rare. Case Description: Herein, we report a 7-year-old boy with moyamoya disease who had de novo CMBs during treatment. He presented with transient left-side motor weakness and was diagnosed with moyamoya disease. He underwent revascularization surgery on the right cerebral hemisphere. Six months after the surgery, he presented with transient right-side motor weakness and MRA revealed progression of stenosis in the left middle cerebral artery. After another 3 months, three de novo CMBs were identified. He underwent revascularization surgery on the left side. The symptom disappeared completely after surgery and no additional de novo CMBs were identified 1 year after surgery. Conclusion: This is the first report on de novo CMBs in pediatric patients. Although the significance of de novo CMBs in pediatric patients is completely unknown, attention should be paid to not only ischemic stroke but also hemorrhagic stroke. Although the short-term course is good in the current case, follow-up period is too short to assess for rebleeding and long-term follow-up is still important. Further, more cases should be collected.

scholarly journals Recovery from Transient Global Amnesia Following Restoration of Hippocampal and Fronto–Cingulate Perfusion

2010 ◽  
Vol 22 (3-4) ◽  
pp. 131-139 ◽  
Author(s):  
Paolo Caffarra ◽  
Letizia Concari ◽  
Simona Gardini ◽  
Sabrina Spaggiari ◽  
Francesca Dieci ◽  
...  
Keyword(s):  
Acute Phase ◽  
Neuropsychological Testing ◽  
Transient Global Amnesia ◽  
Normal Limits ◽  
Global Amnesia ◽  
One Year ◽  
The Right ◽  
Rcbf Spect ◽  
Subject Comparison

A patient who suffered a transient global amnesia (TGA) attack underwent regional cerebral blood flow (rCBF) SPECT imaging and neuropsychological testing in the acute phase, after one month and after one year. Neuropsychological testing in the acute phase showed a pattern of anterograde and retrograde amnesia, whereas memory was within age normal limits at follow up. SPECT data were analysed with a within subject comparison and also compared with those of a group of healthy controls. Within subject comparison between the one month follow up and the acute phase detected increases in rCBF in the hippocampus bilaterally; further rCBF increases in the right hippocampus were detected after one year. Compared to controls, significant hypoperfusion was found in the right precentral, cingulate and medial frontal gyri in the acute phase; after one month significant hypoperfusion was detected in the right precentral and cingulate gyri and the left postcentral gyrus; after one year no significant hypoperfusion appeared. The restoration of memory was paralleled by rCBF increases in the hippocampus and fronto-limbic-parietal cortex; after one year neither significant rCBF differences nor cognitive deficits were detectable. In conclusion, these data indicate that TGA had no long lasting cognitive and neural alterations in this patient.

Transcatheter closure of defects within the oval fossa using the Amplatzer® Septal Occluder

2002 ◽  
Vol 12 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Haifa Abdul Latiff ◽  
Mazeni Alwi ◽  
Hasri Samion ◽  
Geetha Kandhavel
Keyword(s):  
Transcatheter Closure ◽  
Standard Procedure ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Term Outcome ◽  
Long Term Follow Up ◽  
One Year ◽  
The Right

This study reviewed the short-term outcome of transcatheter closure of the defects within the oval fossa using an Amplatzer® Septal Occluder. From January 1997 to December 2000, 210 patients with defects within the oval fossa underwent successful transcatheter closure. We reviewed a total of 190 patients with left-to-right shunts, assessing the patients for possible complications and the presence of residual shunts using transthoracic echocardiogram at 24 h, 1 month, 3 months and one year. Their median age was 10 years, with a range from 2 to 64 years, and their median weight was 23.9 kg, with a range from 8.9 to 79 kg. In 5 patients, a patent arterial duct was closed, and in 2 pulmonary balloon valvoplasty performed, at the same sitting. The median size of the Amplatzer® device used was 20 mm, with a range from 9 to 36 mm. The median times for the procedure and fluoroscopy were 95 min, with a range from 30 to 210 min, and 18.4 min, with a range from 5 to 144 min, respectively. Mean follow-up was 20.8 ± 12.4 months. Complete occlusion was obtained in 168 of 190 (88%) patients at 24 h, 128 of 133 (96.2%) at 3 months, and 103 of 104 (99%) at one year. Complications occurred in 4 (2.1%) patients. In one, the device became detached, in the second the device embolized into the right ventricular outflow tract, the lower end of the device straddled in the third, and the final patient had significant bleeding from the site of venupuncture. There were no major complications noted on follow-up. We conclude that transcatheter closure of defects within the oval fossa using the Amplatzer® Septal Occluder is safe and effective. Long-term follow-up is required, nonetheless, before it is recommended as a standard procedure.

AVASCULAR NECROSIS OF THE TRIQUETRUM: A CASE REPORT

Hand Surgery ◽  
2005 ◽  
Vol 10 (01) ◽  
pp. 91-94 ◽  
Author(s):  
Y. C. POR ◽  
W. Y. CHEW ◽  
I. Y. Y. TSOU
Keyword(s):  
Case Report ◽  
Avascular Necrosis ◽  
Total Ischemia ◽  
One Year ◽  
The Right

A case of total ischemia of the triquetrum after a crushing injury to the right wrist by a dumbbell is reported. He was treated conservatively with splinting and analgesia. There was complete clinical and radiological recovery after a follow-up of one year.

Abstract WP171: Surgical Strategy And Results Of Additional Bypass For Patients With Moyamoya Disease Refractory To Previous Surgery

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Satoshi Kuroda ◽  
Naoki Akioka ◽  
Daina Kashiwazaki ◽  
Hideo Hamada ◽  
Naoya Kuwayama ◽  
...  
Keyword(s):  
Disease Progression ◽  
Moyamoya Disease ◽  
Bypass Surgery ◽  
Posterior Cerebral Artery ◽  
Cerebral Hemodynamics ◽  
Surgical Revascularization ◽  
Surgical Strategies ◽  
Cerebrovascular Events ◽  
Before And After

Introduction —It is well known that surgical revascularization can improve cerebral hemodynamics and prevent further ischemic cerebrovascular events in moyamoya disease. However, a certain subgroup of patients repeats ischemic attacks even after surgery because of insufficient surgery or disease progression during follow-up periods. Hypothesis —Relevant designs and techniques in additional bypass surgery can resolve ischemic cerebrovascular events in patients with moyamoya disease refractory to previous bypass surgery. Methods —This study included totally 7 patients (9 hemispheres) with moyamoya disease refractory to previous bypass surgery. There were 5 children and 2 adults. They underwent previous bypass surgery in Japan and Europe 6 to 240 months before admission. Based on precise clinical and radiological analysis, cerebrovascular events were considered to occur because of insufficient bypass surgery in 5 patients and disease progression in the ipsilateral posterior cerebral artery in 2. Surgical strategies included wide craniotomy to cover the area where cerebral hemodynamics is still impaired and appropriate bypass procedures such as STA-MCA anastomosis, OA-PCA anastomosis, and indirect bypass. Using [123]I-IMP SPECT or [15]O-gas PET, cerebral hemodynamics was precisely examined before and after surgery Results —Postoperative course was uneventful and cerebral hemodynamics significantly improved in all 7 patients. Postoperative cerebral angiography revealed that additional bypass provided collateral blood flow to ischemic area before surgery. Ischemic cerebrovascular events rapidly resolved in 5 patients and gradually decreased in 2. Conclusion —This study strongly suggests adequate surgical design and procedures can resolve ischemic cerebrovascular events in patients with moyamoya disease refractory to previous bypass surgery.

scholarly journals Peritonea-vaginal canal pathologies at Regional Hospital Center of Lomé-Commune (Togo): Epidemiological, anatomoclinical and therapeutic aspects

2017 ◽  
Vol 3 (3) ◽  
pp. 10
Author(s):  
Simlawo Kpatékana ◽  
Tchangaï B ◽  
Kanassoua K ◽  
Boumé MA ◽  
Sakye A ◽  
...  
Keyword(s):  
Study Data ◽  
Regional Hospital ◽  
Average Hospital ◽  
Scrotal Hematoma ◽  
Scrotal Swelling ◽  
Vaginal Canal ◽  
One Year ◽  
The Right ◽  
Hospital Center

Objective: To describe epidemiological, anatomo-clinical and therapeutic aspects of peritoneo-vaginal canal pathologies (PVCP).Methods: We performed a retrospective and descriptive study on the files of PVCP cases operated in Lomé-Commune Regional Hospital (Togo). The study data concerned: the age, the occuring mode, anatomo-clinical classification, the side and treatment outcomes.Results: 107 files were collected from January 2011 to December 2015. The average age was 9.2 ± 8 years with a range from 16 months to 47 years. Twelve patients were less than 2 years and 14 patients were adults. The main consultation motive was an intermittent and painless inguinal or inguino-scrotal swelling in 89 cases (83.18%). The PVCP was in the right side in 66 patients (61.68%) and bilateral in 8 patients (7.47%). Concerning anatomo-clinical types, inguinal or inguino-scrotal hernia were more frequent (62.6%). The treatment was surgical in all cases and the average hospital stay was 2.1 days. The operative follow up was satisfactory in 94.3%. However, we noticed 4 cases of scrotal hematoma and 2 cases of parietal suppuration. The mortality rate after surgery was zero. One year back, we noticed two cases of testicular atrophy.Conclusions: Pathologies of the peritoneo-vaginal canal are frequent in our urological practice. Inguinal hernia and inguinoscrotal hernia are more represented. The surgical treatment results are successful.

scholarly journals Utility of uroflowmetry during the follow-up of children affected by balanitis xerotica obliterans (BXO)

2018 ◽  
Vol 90 (2) ◽  
pp. 123 ◽  
Author(s):  
Salvatore Arena ◽  
Tiziana Russo ◽  
Pietro Impellizzeri ◽  
Saveria Parisi ◽  
Patrizia Perrone ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Voiding Dysfunction ◽  
Clobetasol Propionate ◽  
Histological Diagnosis ◽  
Balanitis Xerotica Obliterans ◽  
Urethral Stenosis ◽  
Urethral Dilatation ◽  
One Year

Introduction: To evaluate the outcome of circumcised patients with balanitis xerotica obliterans (BXO) using uroflowmetry (UF). Methods: Between 2011 and 2013, 180 children underwent a circumcision for phimosis. The foreskin was examined on microscopy. Patients with an histological diagnosis of BXO were included in the study. Patients with BXO underwent UF two weeks after surgery and treatment with clobetasol propionate ointment. Patients were re-evaluated at 6, 12, 18 and 24 months postoperatively clinically and using UF. Results: 75 of 180 circumcised patients (41.6%) were included. At two weeks, Thirtytwo of 75 patients (42.7%) displayed a pathological UF. At six months, 15 patients (20%) had pathological UF and a new cycle of clobetasol was prescribed. At one year, 10 patients (13.3%) displayed patholgocial UF and underwent progressive urethral dilatation or meatoplasty. At 18 months, 71 patients (94.7%) displayed regular UF, 3 underwent a meatoplasty and one a staged urethroplasty for a severe urethral stenosis. At two years, UF was normal in 74 out of 75 (98.7%). Conclusions: We recommend to send for hystological examination all foreskins excised after circumcision. We believe that a clinical and uroflowmetric follow-up of pediatric patients with BXO is mandatory for a prompt identification of post-voiding dysfunction.

scholarly journals Ipsilateral Pediatric Supracondyar Humerus Fracture and Radial Head Dislocation

2018 ◽  
Vol 1 (1-3) ◽  
pp. 62-66
Author(s):  
Daniel C. Kim ◽  
Adam J. Handwerger ◽  
John T. Riehl
Keyword(s):  
Radial Head ◽  
Closed Reduction ◽  
Pediatric Patients ◽  
Humerus Fracture ◽  
Radial Head Dislocation ◽  
Supracondylar Humerus Fracture ◽  
Left Elbow ◽  
One Year

Case: A 5-year-old boy presented with left elbow pain after a fall. Radiographs revealed a radial head dislocation without ulnar involvement which was treated with closed reduction in the emergency department. Two-week follow-up radiographs revealed a periosteal reaction along the medial epicondyle at the supracondylar region, consistent with a type 1 supracondylar humerus fracture. The elbow was treated with closed reduction and casting for 2 weeks. One year after injury, the patient had full painless range of motion. Conclusion: This case report highlights an injury pattern not previously described in the literature, and no previous recommendations exist regarding treatment. Although rare, radial head dislocation with simultaneous supracondylar humerus fracture can occur in pediatric patients. Our patient obtained a good result without surgical treatment.

Laparoscopic Treatment of Hydrocele of the Canal of Nuck in Pediatric Patients

2017 ◽  
Vol 28 (04) ◽  
pp. 378-382 ◽  
Author(s):  
Sung Lee
Keyword(s):  
Pediatric Patients ◽  
Inguinal Canal ◽  
Abdominal Cavity ◽  
Operating Time ◽  
High Ligation ◽  
Canal Of Nuck ◽  
The Mean ◽  
The Right ◽  
Short Operating Time

Introduction Hydrocele of the canal of Nuck (HCN) causes an inguinal swelling in pediatric females similar to that observed in case of inguinal hernia. HCN should be considered in the differential diagnosis of hernia in such children. Although laparoscopic operations have been reported in several cases for the treatment of HCN in adults, they have not been reported for the treatment in pediatrics. This study aimed to evaluate the outcomes of laparoscopic intracorporeal hydrocelectomy with high ligation as a treatment for HCN in pediatrics. Materials and Methods I retrospectively reviewed the charts of 26 pediatric females aged ≤10 years who underwent laparoscopic hydrocelectomy with high ligation at Damsoyu Hospital, Seoul, Republic of Korea from September 2012 to December 2016. Results The mean age was 3.31 (1–10) years. HCN was on the right in 11 patients and on the left in 15. The presenting symptom in all cases was inguinal swelling. HCN was of the hourglass type inside the inguinal canal in 17 patients and in the abdominal cavity outside the inguinal canal in 9. All patients were treated with laparoscopic hydrocelectomy with high ligation. The mean operating time was 17.8 minute (15–30). The wounds were scarcely visible immediately after surgery. There were no postoperative complications and no recurrences on follow-up. Conclusion Laparoscopic intracorporeal hydrocelectomy with high ligation is effective for HCN in pediatrics owing to its short operating time, excellent cosmesis, and no recurrence.

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