Pediatric emergency care
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Pediatric emergency care · Feb 2014
Case ReportsAcute posterior fossa epidural hematoma in a newborn infant with menkes disease.
Epidural hematoma (EDH) in newborn infants is rare compared with other types of intracranial hemorrhages. Furthermore, posterior fossa EDH is extremely rare. We present a case of posterior fossa EDH in an infant with Menkes disease with accessory bones in the occiput. ⋯ The hematoma gradually resolved, and his tremor did not recur. We suggest the following mechanism of posterior fossa EDH development in our patient: (1) external force was applied to the occiput inside the birth canal during delivery, resulting in diastasis; (2) a communicated fracture occurred, and a bone fragment displaced toward the inside (linear fracture was caused indirectly by the force); (3) a transverse sinus was injured by the fragment; and (4) EDH developed in both the posterior fossa and supratentorial region. Copper deficiency can also cause fragility of connective tissues, vessels, and bones.
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Traumatic asphyxia is a rare condition in children that usually occurs after severe compression to the chest or abdomen. We report 3 cases in patients 18, 20, and 36 months of age who presented signs and symptoms of traumatic asphyxia after car accidents. ⋯ In children, the number of clinical manifestations that should be evident to diagnose traumatic asphyxia has not been ascertained. However, in any history of trauma with compression of the chest or abdomen and signs of increased intravenous craniocervical pressure, traumatic asphyxia should be suspected.
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Pediatric emergency care · Feb 2014
Case ReportsAn unexpected clinical course in a 29-day-old infant with ethanol exposure.
Ethanol exposure can affect all pediatric age groups but occurs most commonly in ambulatory children and adolescents. Infants are less likely to ingest ethanol because they have limited ability to explore their environments. However, ethanol exposures in infants can occur. ⋯ This case demonstrates that the ethanol-exposed infant may lack typical or clear symptoms of acute intoxication. Therefore, the clinician must have a low threshold for pursuing blood alcohol testing in infants and young children with altered mental status. A prompt diagnosis of ethanol exposure is important for ensuring the health and safety of the child.
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Pediatric emergency care · Feb 2014
Presenting Symptoms of Pediatric Brain Tumors Diagnosed in the Emergency Department.
The primary objective of this study is to categorize the symptoms associated with brain tumors as diagnosed in the emergency department (ED). The secondary objective is to detail the specific characteristics of these headaches via a subgroup analysis. ⋯ Brain tumors diagnosed in the ED most commonly present with headache, hydrocephalus, nausea/vomiting, and gate disturbances. The headaches are described as progressively worsening and diffuse most commonly occurring in the morning and night.
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Pediatric emergency care · Feb 2014
Case ReportsPosttraumatic superior ophthalmic vein thrombosis in a 2 year old.
Superior ophthalmic vein thrombosis (SOVT) usually results from inflammatory, infectious, or malignant causes. This case describes a 2-year-old boy with severe prolapsing chemosis and proptosis due to thrombosis of the right superior ophthalmic vein resulting from midfacial and right orbital fractures 1 week after the initial trauma. Magnetic resonance imaging and internal carotid artery angiogram are essential in the diagnosis of SOVT. The literature on issues surrounding this case was reviewed with emphasis on the diagnostic evaluation, differential diagnoses, and management of posttraumatic SOVT.