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Stroke
This 18-month-old girl developed left-sided focal seizures, left arm and leg weakness 3 days after an uncomplicated appendicectomy. She had been previously well, and the surgery was uneventful. An urgent cranial MR scan was performed under general anaesthetic within 12 h of the onset of symptoms. Look at the selected images from this study and answer the following questions. Read on to confirm the answers and learn more about the use of diffusion-weighted imaging (DWI) in this condition. Questions There is evidence of acute intracerebral haemorrhage. (True or false?) The abnormality is in the left middle cerebral...
Source: Archives of Disease in Childhood - Education and Practice - May 17, 2016 Category: Pediatrics Authors: Williams, H. Tags: Oncology, Illuminations, Epilepsy and seizures, Stroke, Child health, Other anaesthesia Source Type: research

Unusual case of stroke in childhood
You receive a prealert call from a paramedic team stating they are managing a 12-year-old girl with acute left-sided weakness. As you prepare for the patient’s arrival, you go through a list of potential differentials. Question 1 Which of the following is not part of the differential list? Haemorrhagic stroke. Hypoglycaemia. Bell’s palsy. Migraine. Todds’ paresis. Question 2 What is the recommended time to CT following this type of presentation to the emergency department? 15 min. 40 min. 60 min. 120 min. The time to CT is only applicable to adult patients. The family report intermittent frontal headaches...
Source: Archives of Disease in Childhood - Education and Practice - September 19, 2022 Category: Pediatrics Authors: Mawhinney, D. C., Mullen, S., Clarke, N. Tags: Epilogue Source Type: research

How to use... lupus anticoagulants
Introduction Lupus anticoagulants (LA) were first detected in patients with systemic lupus erythematosus (SLE) in 1952 by Conley and Hartmann.1 They identified patients in whom the activated partial thromboplastin time (APTT) was prolonged and which did not correct on the addition of normal plasma. Although Conley and Hartmann's original description was in association with a haemorrhagic disorder, subsequent reports from the 1960s highlighted patients with thrombotic events in the presence of LA.2 The term ‘lupus anticoagulant’ was introduced by Feinstein and Rapaport in 1972.3 It has, however, caused some conf...
Source: Archives of Disease in Childhood - Education and Practice - March 14, 2013 Category: Pediatrics Authors: Sen, E. S., Beresford, M. W., Avcin, T., Ramanan, A. V. Tags: Liver disease, Immunology (including allergy), Hepatitis and other GI infections, Travel medicine, Epilepsy and seizures, Headache (including migraine), Stroke, Pregnancy, Reproductive medicine, Rheumatology Interpretations Source Type: research

Answers to Illuminations questions
Answers (1) False, (2) False, (3) True, (4) False, (5) True, (6) False, (7) True, (8) True. This patient has an acute, non-haemorrhagic right middle cerebral territory infarct. There was involvement of the right precentral and postcentral gyri (motor and sensory areas) on other images. The axial T2-weighted image (figure 1) demonstrates high signal in swollen/oedematous ischaemic cortex with effacement of the sulci. There is also restricted diffusion in the affected area, with corresponding high/increased signal (bright) on DWI (figure 2), and low signal (dark) on the apparent diffusion coefficient (ADC) map (figure 3). In...
Source: Archives of Disease in Childhood - Education and Practice - May 17, 2016 Category: Pediatrics Authors: Williams, H. Tags: Oncology, Journalology, Echocardiography, Epilepsy and seizures, Headache (including migraine), Infection (neurology), Neurooncology, Stroke, Child health, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Competing interests (ethics) Illum Source Type: research