Hypoxic brain injury and cortical blindness in a victim of a Mozambican spitting cobra bite

Snakebite and the subsequent envenomation is a serious and potentially fatal illness, owing to the effects of the various toxins present in the venom. Cortical blindness following bites containing neurotoxin is a rare complication. We describe the clinical findings and imaging in a child who sustained significant brain injury following a bite from a Mozambican spitting cobra. We also discuss the venom composition, complications and appropriate management of such cases.http://www.sajs.org.za/index.php/sajsam201

Curved reformat of the paediatric brain MRI into a ‘flat-earth map’ — standardised method for demonstrating cortical surface atrophy resulting from hypoxic–ischaemic encephalopathy

Hypoxic–ischaemic encephalopathy is optimally imaged with brain MRI in the neonatal period. However neuroimaging is often also performed later in childhood (e.g., when parents seek compensation in cases of alleged birth asphyxia). We describe a standardised technique for creating two curved reconstructions of the cortical surface to show the characteristic surface changes of hypoxic–ischaemic encephalopathy in children imaged after the neonatal period. The technique was applied for 10 cases of hypoxic–ischaemic encephalopathy and also for age-matched healthy children to assess the visibility of characteristic features of hypoxic–ischaemic encephalopathy. In the abnormal brains, fissural or sulcal widening was seen in all cases and ulegyria was identifiable in 7/10. These images could be used as a visual aid for communicating MRI findings to clinicians and other interested parties

Hybrid lesion in a child presenting with cough, fever and haemoptysis

CITATION: Goussard, Pierre et al. 2020. Hybrid lesion in a child presenting with cough, fever and haemoptysis. BMJ Case Reports, 13(10):e238796, doi:10.1136/bcr-2020-238796.The original publication is availble at: https://casereports.bmj.comENGLISH ABSTRACT: A 10-year-old boy presented with minimal haemop-tysis after 1 week of cough and fever. He had a similar presentation 3 years earlier; the diagnosis at that stage was right lower lobe pneumonia. He is HIV uninfected and has no known tuberculosis exposure. Investigations revealed a raised white cell count of 19.0×109 /L, raised C reactive protein 217 mg/L, normal clotting studies and the GeneXpert MTB/RIF was negative.Publisher's versio

New imaging approaches for improving diagnosis of childhood tuberculosis

In South Africa (SA), childhood tuberculosis (TB) still accounts for considerable morbidity and mortality. The incidence of TB disease and risk of progression to severe or disseminated forms are especially high in young children or those with HIV infection. Childhood TB presents most commonly as primary TB, often with non specific signs and symptoms; TB may also present as acute pneumonia. The clinical diagnosis can therefore be challenging. Furthermore, due to difficulty in obtaining good-quality specimens and the paucibacillary nature of childhood TB, microbiological confirmation is only achieved in a minority of children, especially in settings where there is limited capacity for microbiological confirmation

Vascular cause for stridor in infants

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