scholarly journals Clinical and Radiological Characteristics of Non-Benign Pineal Cyst Lesions in Children

2021 ◽  
Vol 12 ◽  
Author(s):  
Ula Arkar ◽  
Rok Kučan ◽  
Mirjana Perković Benedik ◽  
Tadeja Hostnik ◽  
Tina Vipotnik Vesnaver ◽  
...  
Keyword(s):  
Brain Imaging ◽  
Pediatric Population ◽  
Clinical Signs ◽  
Malignant Neoplasm ◽  
Signs And Symptoms ◽  
Pineal Region ◽  
Common Finding ◽  
Pineal Cyst ◽  
Radiological Features ◽  
Increased Icp

Background: With the increasing availability and advances in brain imaging, pineal cyst lesions (PCL) are becoming a common finding in the pediatric population. In the absence of evidence-based guidelines, optimal diagnostic and therapeutic approaches have not been established, and there is a risk of under- or overtreatment of these patients.Objectives: The aim of our study was to evaluate the clinical presentation and radiological features of PCL in a cohort of pediatric patients and to identify clinical parameters more commonly associated with neoplasms in the pineal region. In addition, the prevalence of PCL in the pediatric population of Slovenia was estimated.Methods: In this observational, cohort study, children treated at University Children's Hospital, Ljubljana, Slovenia in the period 1997–2016 were included if PCL was found on brain imaging. We analyzed indications for referral to a neurologist, clinical signs and symptoms, radiological features, treatment and outcome.Results: The cohort consisted of 143 children with PCL. Pineocytoma was suspected in 31 children (21.7%). Six children underwent surgery – pineocytoma was confirmed in two cases and germinoma in one (2/3 of these children had signs of increased intracranial pressure (ICP), while PCL was benign in the remaining 4 cases. Only 2 PCL enlarged during the study period, both <2mm, none of these children developed neoplasm. Two children had PCL >20mm in diameter; both showed signs of increased ICP, one patient was found to have a germinoma of the pineal region, while the other had no neoplasm.Conclusions: Most PCL do not change their features during radiological follow-up and even atypical PCL are very rarely associated with a malignant neoplasm of the pineal region. A PCL larger than 20 mm and signs of increased ICP were identified as potential markers for selecting patients at risk.

scholarly journals ATRT-10. ATYPICAL TERATOID/RHABDOID TUMOR OF THE PINEAL REGION IN A PEDIATRIC PATIENT

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii277-iii277
Author(s):  
Carlos Almeida ◽  
Bruna Minniti Mançano ◽  
Marcus Matsushita ◽  
Stephanie Previdelli ◽  
Marina Lopes Lamim ◽  
...  
Keyword(s):  
Pediatric Patient ◽  
Pediatric Population ◽  
Obstructive Hydrocephalus ◽  
Malignant Neoplasm ◽  
Pineal Region ◽  
Rhabdoid Tumor ◽  
Atypical Teratoid Rhabdoid Tumor ◽  
Atypical Teratoid ◽  
Magnetic Resonance Imaging Mri ◽  
One Year

Abstract BACKGROUND Atypical teratoid/rhabdoid tumor (ATRT) is a malignant neoplasm of the central nervous system and corresponds to 1.5% of all intracranial tumors. Mainly affects children under three years of age and shows aggressive behavior (most pediatric patients succumb to their disease within a year after the initial diagnosis, despite the treatment performed). Its place of occurrence in children is preferably in the posterior fossa, and it is rare to appear in other regions. There are only seven patients with ATRT reported on literature; all of them are adults. We present the case of a pediatric patient with a tumor in the pineal region diagnosed as ATRT. CASE REPORT: Three-year-old female patient admitted with occipital headache, vomiting, and seizure. Magnetic resonance imaging (MRI) showed obstructive hydrocephalus secondary to a solid-cystic lesion located at the pineal region that was 3.0 x 3.0 x 3.5 cm in size. Spine MRI did not reveal leptomeningeal spreading. We performed an occipital transtentorial approach to achieve the best safe resection possible, and a ventriculoperitoneal shunt. Histological examination revealed ATRT. The patient received adjuvant treatment with radiotherapy and chemotherapy according to the “Head Start” protocol. One year after the surgery, MRI did not identify any remaining lesion. CONCLUSION ATRT is an aggressive and rare neoplasm whose clinical picture depends on the location of the tumor; however, it must be considered in the differential diagnosis of tumors of the pineal region in the pediatric population.

scholarly journals Reexpansion pulmonary edema in children

2013 ◽  
Vol 31 (3) ◽  
pp. 411-415 ◽  
Author(s):  
Antonio Lucas L. Rodrigues ◽  
Carlos Eduardo Lopes ◽  
Mariana Tresoldi das N. Romaneli ◽  
Andrea de Melo A. Fraga ◽  
Ricardo Mendes Pereira ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pulmonary Edema ◽  
Case Reports ◽  
Pediatric Population ◽  
Clinical Signs ◽  
Fatal Disease ◽  
Radiological Features ◽  
Acute Respiratory Insufficiency ◽  
Disease Case ◽  
Reexpansion Pulmonary Edema

OBJECTIVE To present a case of a patient with clinical and radiological features of reexpansion pulmonary edema, a rare and potentially fatal disease. CASE DESCRIPTION An 11-year-old boy presenting fever, clinical signs and radiological features of large pleural effusion initially treated as a parapneumonic process. Due to clinical deterioration he underwent tube thoracostomy, with evacuation of 3,000 mL of fluid; he shortly presented acute respiratory insufficiency and needed mechanical ventilation. He had an atypical evolution (extubated twice with no satisfactory response). Computerized tomography findings matched those of reexpansion edema. He recovered satisfactorily after intensive care, and pleural tuberculosis was diagnosed afterwards. COMMENTS Despite its rareness in the pediatric population (only five case reports gathered), the knowledge of this pathology and its prevention is very important, due to high mortality rates. It is recommended, among other measures, slow evacuation of the pleural effusion, not removing more than 1,500 mL of fluid at once.

ACUTE HEMATOGENOUS OSTEOMYELITIS

PEDIATRICS ◽  
1956 ◽  
Vol 17 (3) ◽  
pp. 368-382
Author(s):  
Morris Green ◽  
William L. Nyhan ◽  
Mildred D. Fousek
Keyword(s):  
Age Groups ◽  
Clinical Signs ◽  
Extended Period ◽  
Signs And Symptoms ◽  
Etiologic Agent ◽  
Common Finding ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
Clinical Records ◽  
Time Of Admission

The clinical records of 99 infants and children admitted to the Grace-New Haven Community Hospital with acute hematogenous osteomyelitis are reviewed. The presenting symptomatology and physical findings are discussed. Detection of localized tenderness is the most significant early clinical sign. This was not, however, a common finding at the time of admission. The diagnoses entertained in these patients at the time of admission are reviewed and the differential diagnosis is discussed. The distribution of the bony lesions was similar to that noted by other authors. However, attention is called to the frequent involvement of the bony pelvis. A specific bacteriologic diagnosis was made in 87 per cent of the patients. In 63 per cent staphylococcus was the etiologic agent. Beta-hemolytic streptococcus was considered the etiologic agent in 18 per cent. Staphylococcus was the most frequent offender in all age groups. In infants less than 2 years of age osteomyelitis was streptococcal in 27 per cent. The average interval from the onset of symptoms to the development of positive roentgenographic signs was 10 days. The range was 3 to 17 days. In treatment of patients suspected of having osteomyelitis, vigorous antibiotic therapy should be continued until at least 3 weeks have elapsed since the onset of symptoms. If at the end of that period roentgenograms remain normal and clinical signs and symptoms have been absent for at least 1 week, it would seem safe to discontinue treatment. A detailed program for medical therapy is Presented and the indications for surgery are considered. Emphasis is placed on vigorous search for the infecting organism. The necessity for intensive treatment given over an extended period of time is stressed.

scholarly journals Gastric Outlet Obstruction and Sigmoid Volvulus in a Patient with Pneumatosis intestinalis: An Etiology or a Complication

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Osama Shaheen ◽  
Wassim Ahmad ◽  
Najm Aldin Mhammad
Keyword(s):  
Gastric Outlet Obstruction ◽  
Incidental Finding ◽  
Clinical Signs ◽  
Radiographic Finding ◽  
Outlet Obstruction ◽  
Pneumatosis Intestinalis ◽  
Signs And Symptoms ◽  
Sigmoid Volvulus ◽  
Radiological Features ◽  
Clinical Signs And Symptoms

Pneumatosis intestinalis (PI) is a radiographic finding which refers to the presence of gas within the wall of any part of the gastrointestinal tract. While in some cases it is an incidental finding which usually represent its benign nonischemic etiology, it may indicate a catastrophic intra-abdominal condition and distinctly characteristic of ischemic enterocolitis. Herein, we discuss the clinical signs and symptoms, the radiological features, the surgical management and outcome of an extremely rare concurrent triad of PI, gastric outlet obstruction, and the sigmoid volvulus based on a case of a patient who underwent surgery in our hospital, which, we think, can emphasize the mysterious concept of PI’s mechanical etiology.

Prevalence of pineal cysts in children and young adults

2009 ◽  
Vol 4 (3) ◽  
pp. 230-236 ◽  
Author(s):  
Wajd N. Al-Holou ◽  
Hugh J. L. Garton ◽  
Karin M. Muraszko ◽  
Mohannad Ibrahim ◽  
Cormac O. Maher
Keyword(s):  
Older Patients ◽  
Incidental Finding ◽  
Pediatric Population ◽  
Mass Effect ◽  
Patient Characteristics ◽  
Pineal Region ◽  
Consecutive Series ◽  
Cyst Size ◽  
Pineal Cyst ◽  
Age And Sex

Object Pineal cysts are a frequent incidental finding on intracranial imaging. In adults, the prevalence of pineal cysts is estimated to be 1.1–4.3%. However, the prevalence is not well established in younger patients. Methods The authors retrospectively reviewed a consecutive series of 14,516 patients 25 years of age and younger, who underwent brain MR imaging at a single institution over an 11-year period. In patients identified with pineal cysts, the authors analyzed the images according to cyst size, signal characteristics, enhancement pattern, and evidence of local mass effect. Patient characteristics including demographics and other intracranial diagnoses were collected in the pineal cyst population and compared with a randomly selected age- and sex-matched control patient population. The data were evaluated using univariate and multivariate logistic regression, linear regression, and ANOVA. Results The authors identified 288 pineal region cysts (2.0%). The prevalence of pineal cysts was higher in female (2.4%) than in male patients (1.5%; p < 0.001). Pineal cysts were identified in patients of all ages, with an increased prevalence found in older patients (p < 0.001). Pineal cyst size was similar for all age and sex groups. Conclusions Pineal cysts are common in the pediatric population, with an increased prevalence in girls and in older patients.

scholarly journals The biology of schizophrenia

2000 ◽  
Vol 2 (4) ◽  
pp. 339-348 ◽  
Keyword(s):  
Brain Imaging ◽  
Imaging Techniques ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Neural Systems ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
Clinical Signs And Symptoms ◽  
Human Postmortem Tissue ◽  
And Function

Schizophrenia is an illness where the clinical signs and symptoms, course, and cognitive characteristics are well described. Successful pharmacological treatments do exist, even though they are likely palliative. However, this broad knowledge base has not yet led to the identification of its pathophysiology or etiology The risk factors for schizophrenia are most prominently genetic and scientists anticipate that contributions from the new genetic information in the human genome will help progress towards discovering a disease mechanism. Brain-imaging techniques have opened up the schizophrenic brain for direct inquiries, in terms of structure, neurochemisiry, and function. New proposals for diagnosis include grouping schizophrenia together with schizophrenia-related personality disorders into the same disease entity, and calling this schizophrenia spectrum disorder. New hypotheses of pathophysiology do not overlook dopamine as playing a major role, but do emphasize the participation of integrative neural systems in the expression of the illness and of the limbic system in generating symptoms. Critical observations for future discovery are likely to arise from molecular genetics, combined with hypothesis-generating experiments using brain imaging and human postmortem tissue.

Pneumoperitoneum Post-Fluoroscopic Percutaneous Gastrojejunostomy Insertion: Computed Tomography and Clinical Evaluation

2012 ◽  
Vol 63 (3_suppl) ◽  
pp. S33-S36
Author(s):  
Grant Stoneham ◽  
Brent Burbridge ◽  
Jaime Pinilla ◽  
Andrea Gourgaris ◽  
Valerie Astrope ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Blood Cell ◽  
Cell Count ◽  
Clinical Evaluation ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Tube Placement ◽  
Common Finding ◽  
Blood Cell Count ◽  
Tube Insertion

Introduction To assess the incidence and clinical significance of pneumoperitoneum after radiologic percutaneous gastrojejunostomy (PGJ) tube insertion. Methods Sixteen subjects were prospectively assessed after imaging-guided PGJ tube insertion to discern the incidence of pneumoperitoneum related to specific clinical signs and symptoms. Computed tomography of the abdomen and the pelvis was performed immediately after PGJ insertion. A clinical evaluation, including history, general and abdominal physical examination, temperature, complete blood cell count, abdominal pain, and abdominal tension, was performed on days 1 and 3, and at the discretion of the nutritional support team on day 7 after PGJ insertion. Results Fifteen of the 16 subjects demonstrated imaging findings of pneumoperitoneum after the PGJ-tube insertion. Only a small amount of pneumoperitoneum was demonstrated in 10 of the subjects, whereas a large volume of gas was detected in 2 of the subjects. The only altered clinical findings encountered were increased white blood cell count and fever. These abnormal clinical data were most frequently seen immediately after feeding-tube placement. Discussion Pneumoperitoneum was a common finding after PGJ-tube placement in our study population. There were no statistically significant abnormal clinical parameters, in the presence or absence of pneumoperitoneum, for any of the subjects after PGJ-tube insertion. Conservative management of pneumoperitoneum after PGJ is warranted.

scholarly journals Blood biomarkers differentiating viral versus bacterial pneumonia aetiology: a literature review

2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Jithin Thomas ◽  
Aiste Pociute ◽  
Rimantas Kevalas ◽  
Mantas Malinauskas ◽  
Lina Jankauskaite
Keyword(s):  
Literature Review ◽  
Bacterial Pneumonia ◽  
Pediatric Population ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Detection Methods ◽  
Clinical Settings ◽  
Clinical Environment ◽  
Specificity And Sensitivity ◽  
Marker Combination

Abstract Background and objectives The goal of this literature review is to compare current studies regarding the accuracy of different serum markers in differentiating viral from bacterial pneumonia in the pediatric population with what is employed in the medical settings at present. Currently there is still a lack of significant research, that would give us evaluation on biomarkers benefits towards getting a definite diagnosis of pneumonia. Finding out the potential of biomarkers to differentiate between viral and bacterial pneumonia is also important because knowing the exact pathogen would prevent irrational use of antibiotics. At present, irrational, broad-spectrum antibiotic use and increasing antibiotic resistance in microorganisms are still one of the greatest challenges in clinical settings. The use of biomarkers in clinical practice would not only facilitate accurate diagnosis, but would also help to reduce the amount of antibiotics overuse. Materials and methods Literature search conducted on Medline and Google Scholar using a combination of terms. Articles that were in English and within ten years of the search date were manually sorted according to inclusion and exclusion criteria. Results: Initial search returned n = 13,408. After activating filters, n = 140 were identified of which n = 12 included for literature review. Conclusions Rise or drop in the concentration of a single marker is not accurate enough for predicting viral/bacterial community acquired pneumonia. This is because there is overlapping to a varying extent depending on the marker cut-off values, detection methods, analyses, the desired specificity, and sensitivity. Furthermore, the presence of mixed infection makes almost all markers suboptimal to be used universally. New markers such as MxA1 and HMGB1 gave promising results. However, to replicate a similar testing condition in a clinical environment may not be practical. Another approach is to make use of more than one marker and combine with clinical signs and symptoms. This may not be cost-effective in many clinical settings; nevertheless, in many studies, marker combination greatly improved the predictive power.

scholarly journals Intestinal Obstruction in a Patient with Sclerosing Encapsulating Peritonitis

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Oday Obaid ◽  
Dawood Alhalabi ◽  
Mohamed Ghonami
Keyword(s):  
Small Bowel ◽  
Surgical Management ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Bowel Ischemia ◽  
Radiological Features ◽  
Sclerosing Encapsulating Peritonitis ◽  
Abdominal Symptoms ◽  
Clinical Signs And Symptoms ◽  
Encapsulating Peritonitis

Sclerosing encapsulating peritonitis (SEP) is a rare disorder that is characterized by encapsulation of bowel loops by thick fibrinogenous case. Most patients present with vague abdominal symptoms. It is challenging to diagnose the condition preoperatively. Surgical management is preserved for patients with small bowel obstruction with no improvement on conservative measures or for those with signs of bowel ischemia (Li et al., 2014; Habib et al. 2011). Herein, we discuss the clinical signs and symptoms, the radiological features, the surgical management, and outcome of SEP based on a patient who underwent surgery in our hospital.

Sign in / Sign up

Export Citation Format

Share Document