Vegetative evoked potentials and cardiorespiratory correlations in children with cerebelare tumors

În articol sunt prezentate datele studiului neuropsihologic şi electrofiziologic la 36 copii, cu vârsta de la 7 ani până la 16 ani, cu tumori cerebelare (5 – afectarea emisferei stângi; 10 – afectarea emisferei drepte; 11 – afectarea vermisului). S-a demonstrat că în localizarea tumorii în vermisul cerebelar are loc un deficit generalizat de influenţă periferică simpaticotonică şi micşorarea vitezei de conducere a impulsurilor nervoase prin căile vegetative; în afectarea tumorală a emisferelor cerebelare deficitul influenţelor periferice simpaticotonice se manifestă preponderent homolateral cu emisfera lezată. Nivelul dereglărilor reglării vegetative se află într-o corelare strânsă cu dereglările sferei emoţionale şi cognitive. La copiii cu tumori cerebelare, în 77,8% cazuri, este prezentă desincronizarea ritmului cardiac şi respirator.Summary. In the article are presented data of neuropsychological and electrophysiological study of 36 children aged from 7 to 16 years with tumors of the cerebellum (5 - defeat of the left hemisphere, 10 - defeat of the right hemisphere, 11 - defeat the worm). It is shown the generalized deficit of peripheral sympathetic-tonic effects and decrease of the rate of pulses in the vegetative filaments; the deficiency of peripheral sympathetic-tonic that is situated in tumor of cerebellar hemisphere mainly manifest homolateral affected hemisphere of the cerebellum. Degree of impairment of vegetative regulation is closely linked to disturbances in emotional and cognitive domain. In children with tumors of the cerebellum in 77,8% of cases there is a desynchronization of respiration and heart rate.Universitatea de Stat de Medicina şi Farmacie „Nicolae Testemiţanu”, Institutul de Fiziologie şi Sanocreatologie al AŞM, Institutul de Cercetări Ştiinţifice în Domeniul Ocrotirii Sănătăţii Mamei şi Copilulu

Congenital malformations of central nervous system, spinal neural axis and osseous cranial system: diagnostic and treatment management

Congenital malformations of the central nervous system, of the neural spinal axis and of the cranial skeletal system are a more and more actual pathology. Its incidence increases year by year by more and more severely forms and associations. One of the most actual and most common congenital anomaly is: hydrocephalus (3-4 cases per 1.000 newborns), which puts us a lot of problems in solving it. The hydrocephalus of the newborn allegedly an increase of the volume of the skull due to the increase of the amount of cerebrospinal fluid and its accumulation under pressure in the fluid compartments that has as result the expansion of these cavities on account of the brain substance. The treatment of hydrocephalus requires a variety of methods, which are selected depending on the form and severity of the disease. A complex of anomalies of the neural spinal axis are disrafie thorns: Congenital malformations caused by the incomplete development of the neural tube during the fetal embryogenesis (approximately on the 20-th day). Their frequency is 4-5 cases per 1.000 newborns. The treatment is exclusively surgical and requires a great skill in tissue of the tissue defects. The cranial malformations include craniostenosises, which are affections characterized by premature, primitive closure of one or more skull sutures that may cause an increase of the intracranial pressure and cosmetic deformities. Their incidence is about 1 at 1.000 newborns. The indications for surgical treatment are functional, cosmetic, psychological, endocrine. The correct management in the diagnosis and treatment of congenital malformations allows children with these abnormalities the possibility to reduce completely or partially the neurological and esthetic difficulty

Tumorile unghiului pontocerebelos: diagnosticul și tactica de tratament chirurgical

Autorii prezintă un caz clinic a unui copil cu tumoră cerebrală în care sunt elucidate particularitățile evoluției clinice și unele aspecte de diagnostic imagistic și tratament, rezultatele obținute fiind confruntate cu datele literaturii. În lucrare se menționează că în cazul tumorilor cerebrale la copii, managementul este bazat exclusiv pe lucrul în echipă în care diferiți membri trebuie să fie familiarizați în amănunte cu toate aspectele patologiei date, precum și prezența unei experiențe de lucru, impunându-se necesitatea unui studiu continuu a problemei abordate. Autorii conchid că recurența tumorilor cerebrale la copii este determinată de rezecția incompletă, subtipul histologic fiind un factor important.The authors present a clinical case of a child with brain tumor in which are related the particularities of the clinical evolution and some aspects of imaging diagnosis and treatment, the results being confronted with literature data. The paper mentions that in the case of brain tumors in children, management is based exclusively on teamwork in which different members need to be familiar with all aspects of the pathology as well as the presence of a work experience, which implies the need for a continuous study of a problem addressed. The authors conclude that the recurrence of childhood brain tumors is due to incomplete resection, the histological subtype being an important factor

Возможности и лимитирование хирургического лечения тяжелых врожденных пороков развития у новорожденных детей

IMSP Institutul Mamei şi Copilului, Centrul Naţional Ştiinţifico-Practic de Chirurgie Pediatrică „Natalia Gheorghiu”The study clinical and paraclinical evaluation multimodal results of 1306 newborns with major CM assisted in our institution during of a period of time 2006-2015 highlights the possibilities and limits in the diagnosis and medical-surgical treatment. Obtained information shows that positive prenatal diagnosis was established occasionally in a few cases of major CM. Their postnatal diagnosis in 56.2% of cases was established late. In 98.2% of the major CM were associated with complications of basic pathology. As a result, lethality exceeded 50-60% of cases. The inoperable contingent of major CM depends on the anatomical defect and consists between 7-10% of total cases. Medical and surgical treatment optimization in major CM provides pre- and recently postnatal diagnosis, combating complications, and providing effective anesthetic-resuscitative support at all stages of care.Анализ результатов клинико-параклинического обследования 1306 новорожденных с различными тяжелыми пороками развития, которые находились на лечении в нашей клинике с 2006 по 2015 гг. выявил возможности и лимитирование их хирургической коррекции. Согласно полученным данным, внутриутробный диагноз тяжелых пороков развития, как правило, не устанавливался вовсе или выявлялся в поздние сроки беременности. В 56,2% случаев запаздывала постнатальная диагностика. Как следствие, летальность среди новорожденных с тяжелыми пороками развития достигала 50-60%. Пациенты с неоперабельными пороками составляли 7-10% от общего числа обследованных детей. Улучшение эффективности лечения этого контингента больных было бы возможно при оптимизации внутриутробной и ранней постнатальной диагностики, профилактики осложнений и оказание соответствующей реанимационной, анестезиологической и хирургической помощи на всех этапах медицинского обеспечения

Клиническое наблюдение анапластической эпендимомы у младенца, случайно выявленный на фоне острой респираторной инфекции

Department of Pediatrics, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Municipal Clinical Hospital of Children No 1, Chisinau, Republic of Moldova, Department of Neurosurgery, Research Institute for Maternal and Child HealthcareIn this article is dusscused the clinical case of an infant of 4.5 months with brain tumor, admitted in the hospital with clinical signs of acute respiratory infection, manifested by cough, noisy breathing (stridor at rest), rapid breathing, vomiting and liquid stool, which was reluctant to standard therapy, applied in cases of laryngeal edema, developing a swallow reflex disorder with it’s complete abolition afterwards, so that a brain stem tumor was suspected and later confirmed. В данной статье представлен редкий клинический случай опухоли мозга у 4,5 месячного ребенка, поступившего в клинику с признаками острой респираторной инфекции, проявлявшейся кашлем, затрудненным стридорозным дыханием, рвотой и жидким стулом. Состояние продолжало ухудшаться на фоне проводимой стандартной терапии стенозирующего ларингита, с нарушением до полного исчезновения глотательного рефлекса, как проявление бульбарного синдрома, что позволило заподозрить и, в последующем подтвердить, опухоль ствола мозга, гистологически представленную анапластической эпендимомой