Pediatric emergency care
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Pediatric emergency care · Feb 2012
Case ReportsNon-operative treated spontaneous spinal epidural hematoma in a 12-year-old boy.
Spontaneous spinal epidural hematoma (SSEH) has been reported as a rare condition especially in childhood. Because its symptoms are atypical, it is not easy to diagnose the onset of SSEH. However, with wider use of magnetic resonance imaging (MRI), several SSEH cases, especially not requiring surgical intervention, have been reported. ⋯ Because of bleeding tendencies in these cases the spinal cord was not pressed by the hematoma; this contributed conclusively to the prognosis. On the contrary, the 12-year-old boy, not having bleeding tendency, had the larger lesion of SSEH and recovered spontaneously without surgical intervention. Evaluation of MRI findings and neurological deficits in SSEH cases is important for deciding the indication of surgical intervention.
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The authors created a computer-based, interactive atlas of pediatric chest radiographs to facilitate (1) understanding of normal variants and (2) interpretation of pediatric chest radiographs in the acute setting. ⋯ Improved interpretation of pediatric chest radiographs in the acute setting may be facilitated by a comprehensive, computer-based, pediatric chest atlas.
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Pediatric emergency care · Feb 2012
Case ReportsThrombolytic therapy for acute stroke in a teenager.
The importance of thrombolytic therapy within the first 3 hours of onset of symptoms of an acute stroke has been stressed, and in consequence, the diagnosis is most commonly made based on clinical grounds. Intracranial hemorrhage is the major life-threatening complication with the use of thrombolytic therapy. Because of the very small time window before administering thrombolytics, it is often not possible to investigate the unusual causes of a stroke that occurs most often in children. ⋯ Thrombolytic therapy is effective in acute ischemic strokes; however, in children, one must consider and exclude stroke mimickers and recognize that potentially life-threatening bleeding complicates the use of these medications.