Anterior Spinal Artery Syndrome in 13-year Old boy:A Case Report

We herein report a rare case of a child patient with anterior spinal artery syndrome. The patient presentedwith mobility impairment in the lower limbs after suffering from a common cold. Temperature perceptionand pain perception were lost in both sides below the level of the fourth thoracic spine. In a thoracicspine MRI, abnormal signals were detected in the ventral side of the spinal cord below the Th3 level, thusleading to our diagnosis of anterior spinal artery syndrome. Gamma globulin therapy and steroid pulse therapywere applied concomitantly but no obvious effects were obtained. Continuing treatment with rehabilitationstarted for one month. Four months later, he was able to maintain a standing position and walk using awalking stick. The loss of temperature perception and pain perception in both sides below the Th4 remained.In the present case, movements in daily life became possible through the effects of rehabilitation. However,an impairment in the patient\u27s temperature and pain perception remained, and thus close attention is requiredfor various disorders and in daily life

Image Analysis with the Brain Easy Analysis Tool (BEAT) Method in Cases of Encephalomalacia Following Shaken Baby Syndrome

Brain easy analysis tool( BEAT) is newly released software to calculate composite images both MRI andSPECT on computer graphics. At first, we herein report two cases with shaken baby syndrome associatedwith multicystic encephalomalasia diagnosed based on MRI. Next, we created fusion MRI-SPECT imagesusing BEAT. The result of composited images was not only well recognized in anatomical visually but alsoeasy to explain data to patients. This report is the second case report with this software called BEAT

Three Cases of Shaken Baby Syndrome without a History of Shaking

Three cases of Shaken Baby Syndrome (SBS) without a history of abusive shaking have been reported.The reason why SBS without intentional shaking as follows;case 1was throwing, case 2 was dropping, case3 was unknown. For all 3 reported cases, attending physicians suspected the SBS from the presence of subduralhematoma and fundus hemorrhage. All 3 cases occurred at home, and the parents had no knowledgeof SBS. After a detailed interview, the diagnosis of SBS without a history of intentional shaking was made.Although the mechanism in detail was unclear in 3 cases, these SBS may happen by the difference betweenacceleration and the deceleration during the throwing and dropping movement;similar to intentional shakingthat causes of common SBS.For subdural hematoma and fundus hemorrhage of unknown cause, it is important to conduct an interviewwith the possibility of unintentional SBS in mind, without the occurrence of abusive shaking. In addition,attention should be paid to both pediatrician and parents about the risk of SBS in the care of infant inthe everyday life

シンシンショウ ト シンダン サ レテ イタ TOLOSA - HUNT ショウコウグン ノ 15 サイ ジョシ

Tolosa-Hunt症候群(THS)は先行する片側眼窩部痛と眼球運動障害を生じ,病態は海綿静脈洞の非特異的炎症性肉芽腫病変と推測されている.発症は年間100万人あたり1人前後で,40歳台の成人に多く小児例は稀である.今回,1カ月続く右眼をえぐられる様な頭痛を主訴とした15歳のTHSを報告する.発症後,各種頭痛薬で改善がなく,各種検査を施行し異常がないため心身症に伴う反復する片頭痛と診断された.当院で脳MRIを施行し右内頸動脈の狭窄を認めTHSと確定診断した.プレドニゾロン(PSL)1?mg/kg/dayを朝1回開始し,翌日頭痛は改善した.以降,半年かけてPSLを漸減し再発はない.Tolosa-Hunt syndrome(THS)is characterized by periorbital pain accompanying opthalmoplegia. The pathogenesis is considered to involve non-specific granulomatous inflammation in the cavernous sinus, and the frequency is around one case per year per million people. Symptoms usually develop in adulthood, and pediatric cases are rare. We report herein a case of THS in a 15-year-old girl whose headache was diagnosed as psychosomatic disease in the early stage of the clinical course. Her chief compliant was headache with strong pain in the right eye, continuing for 1 month. Although several medications were trialed to alleviate headaches, no improvement was achieved. Various physical examinations proved uninformative. Headache was therefore tentatively diagnosed as psychosomatic disease associated with migraine. Brain magnetic resonance imaging in our university hospital revealed strangulation of the internal carotid artery, and headache was diagnosed as confirmed THS. Oral administration of prednisolone was started at 1 mg/kg/day, given once in the morning. Headache improved from the next day. Oral therapy with prednisolone was tapered over the course of 6 months and headache did not recur

ヨード ゾウエイ ザイ ニヨル アナフィラキシー ショック ノ 3レイ : ブンケンテキ コウサツ

造影CT検査は悪性腫瘍の質的診断や病期診断,解離性動脈瘤の診断に欠かせない.しかし,ヨード造影剤で重篤な副作用が生じる危険性がある.気管支喘息など危険因子はいわれているものの,実際,副作用発現は予測不能である.今回,我々は,ここ8ヶ月の間にヨード造影剤による重篤なアナフィラキシーショックを生じた3例を経験したので文献的考察を加えて報告する.Recently, iodinated contrast media are necessary for CT examinations and they occupy an important position in the radiological diagnosis. Nonionic contrast media significantly reduce the prevalence of all degree of adverse reaction to contrast media rather than ionic contrast media. So, generally, iodinated contrast media are safe and widely used, but adverse reaction after intravenous iodinated contrast media are not uncommon. Severe and potentially life-threatening reaction occur by using the iodinated contrast media practically. Patients at risk must be identified before the contrast media study, and all possible measures must be taken to deal effectively with spontaneous anaphylactic reactions. We report three cases of anaphylactic reactions by iodinated contrast media on CT

A Comprehensive Review of Pediatric Acute Encephalopathy

Acute encephalopathy typically affects previously healthy children and often results in death or severe neurological sequelae. Acute encephalopathy is a group of multiple syndromes characterized by various clinical symptoms, such as loss of consciousness, motor and sensory impairments, and status convulsions. However, there is not only localized encephalopathy but also progression from localized to secondary extensive encephalopathy and to encephalopathy, resulting in a heterogeneous clinical picture. Acute encephalopathy diagnosis has advanced over the years as a result of various causes such as infections, epilepsy, cerebrovascular disorders, electrolyte abnormalities, and medication use, and new types of acute encephalopathies have been identified. In recent years, various tools, including neuroradiological diagnosis, have been developed as methods for analyzing heterogeneous acute encephalopathy. Encephalopathy caused by genetic abnormalities such as CPT2 and SCN1A is also being studied. Researchers were able not only to classify acute encephalopathy from image diagnosis to typology by adjusting the diffusion-weighted imaging/ADC value in magnetic resonance imaging diffusion-weighted images but also fully comprehend the pathogenesis of vascular and cellular edema. Acute encephalopathy is known as a very devastating disease both medically and socially because there are many cases where lifesaving is sometimes difficult. The overall picture of childhood acute encephalopathy is becoming clearer with the emergence of the new acute encephalopathies. Treatment methods such as steroid pulse therapy, immunotherapy, brain hypothermia, and temperature control therapy have also advanced. Acute encephalopathy in children is the result of our predecessor’s zealous pursuit of knowledge. It is reasonable to say that it is a field that has advanced dramatically over the years. We would like to provide a comprehensive review of a pediatric acute encephalopathy, highlighting advancements in diagnosis and treatment based on changing disease classification scenarios from the most recent clinical data