Neuropediatrics
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Case Reports
Usefulness of addition of CT perfusion to CT angiography for brain death diagnosis in a child.
CT perfusion is a new technique that is rapid, available and minimally invasive which provides functional vascular information and can be made after conventional CT and CT angiography at the same imaging session. CT perfusion applications have focused on ischemic stroke with only a short series of applications to brain death diagnosis. Instead, CT angiography is frequently performed as a confirmatory test of brain death, but it has not been completely validated yet. ⋯ We present the case of a 12-year-old child with clinical criteria for brain death who required a confirmatory test. CT angiography and CT perfusion were performed. Both revealed the absence of any intracranial blood flow which supported the clinical diagnosis of brain death.
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The simultaneous appearance of congenital infiltrating lipomatosis of the face that causes facial hemihypertrophy and ipsilateral hemimegalencephaly is extremely rare. We report a 4-year-old boy with congenital facial asymmetry and infantile-onset epilepsy. Magnetic resonance imaging (MRI) results led to the diagnosis of infiltrating lipomatosis of the face; the diagnosis was confirmed on the basis of the results of pathological examinations. ⋯ His seizures were so intractable that they necessitated functional hemispherectomy. The lipomatous lesion was successfully resected without relapse. Psychomotor delay and left hemiplegia were observed at the last follow-up.
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Given the increasing incidence of deformational plagiocephaly due to infants' supine sleeping position to prevent sudden infant death syndrome, reliable anthropometric diagnostics are needed. Besides the traditional method of measuring landmarks with callipers, three-dimensional (3D) photography has great potential. In this investigation the accuracy of 3D photogrammetry is studied. ⋯ 3D photogrammetry is potentially a reliable tool for treatment planning and follow-up of abnormal head shapes in infancy.
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Moyamoya disease (MMD) is an uncommon cerebrovascular disorder characterized by progressive stenosis of the terminal portion of the internal carotid artery and its main branches. Direct and indirect bypass techniques have been devised with the aim of promoting neoangiogenesis. The current study aimed to investigate the role of multiple cranial burr hole (MCBH) operations in the prevention of cerebral ischemic attacks in children with MMD. ⋯ Postoperative BI was statistically significantly improved (P=0.02). This report suggests that MCBH for revascularization in MMD is a simple procedure with a relatively low risk of complications and effective for preventing cerebral ischemic attacks in children. In addition, MCBH may be placed as an adjunct to other treatments for MMD.