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Severe Cerebral Vasospasm and Childhood Arterial Ischemic Stroke After Intrathecal Cytarabine
We report on 2 patients who developed widespread cerebral vasospasm and arterial ischemic strokes (AIS) after application of intrathecal (IT) cytarabine. In a 3-year-old child with acute lymphoblastic leukemia (ALL), left leg weakness, hyperreflexia, and clonus were noted 4 days after her first dose of IT cytarabine during the induction phase of her chemotherapy. Cerebral MRI revealed multiple acute cerebral ischemic infarcts and widespread cerebral vasospasm. A 5-year-old girl complained of right arm and leg pain and began limping 11 days after IT cytarabine. Symptoms progressed to right dense hemiplegia, left gaze deviat...
Source: PEDIATRICS - February 1, 2016 Category: Pediatrics Authors: Tibussek, D., Natesirinilkul, R., Sun, L. R., Wasserman, B. A., Brandao, L. R., deVeber, G. Tags: Hematology/Oncology, Cancer/Neoplastic, Neurology, Neurologic Disorders Case Report Source Type: research

Lyme Neuroborreliosis: A Potentially Preventable Cause of Stroke
A 15-year-old boy presented with multiple cranial nerve palsies including bilateral facial nerve palsy, right-sided limb weakness, and cerebellar signs. Nine months previously, after a trip to the Scottish Highlands where he reported a discrete scalp rash, he began experiencing lethargy, anorexia, arthromyalgia, and headache. He attended his general practitioner 4 months into the course of this illness and was treated with a short course of oral azithromycin, following which symptoms transiently improved.
Source: The Journal of Pediatrics - January 6, 2016 Category: Pediatrics Authors: Nicholas M. Allen, Heinz Jungbluth Tags: Insights and Images Source Type: research

Paediatric cerebral sinovenous thrombosis: findings of the International Paediatric Stroke Study
Conclusions Our study extends the observations of previously published smaller studies in children with CSVT that this is a morbid disease with diverse underlying causes and risk factors. Divergent treatment practices among highly specialised centres as well as limited data on treatment efficacy and safety suggest that further study of this condition is warranted.
Source: Archives of Disease in Childhood - January 20, 2015 Category: Pediatrics Authors: Ichord, R. N., Benedict, S. L., Chan, A. K., Kirkham, F. J., Nowak-Gottl, U., Ashwal, deVeber, Ferriero, Fullerton, Ichord, Kirkham, Lynch, O'Callaghan, Pavlakis, Sebire, Willan, Kirton, Moharir, Sofronas, Nowak-Gottl, During, Krumpel, Dowling, Plumb, Jou Tags: Epidemiologic studies, Drugs: cardiovascular system, Epilepsy and seizures, Headache (including migraine), Pain (neurology), Stroke, Child health, Memory disorders (psychiatry) Original article Source Type: research

Twin surgeries bring this family a stroke of luck
Ryan Earle is outgoing and upbeat, goofing around in his neurosurgeon’s office. He’s had two strokes, but he’s recovering steadily, a testament to the resilience of children’s brains. His twin brother Tyler, with him at the visit, has avoided a likely stroke altogether. Both Ryan and Tyler, 8, have a rare brain disorder called moyamoya disease, in which the internal carotid arteries become narrowed, slowing the flow of blood to their brains. Without surgery, moyamoya poses a five-year stroke risk of 60 to 90 percent. The boys’ moyamoya symptoms were subtle: “They would have a mild headache, then they’d throw ...
Source: Thrive, Children's Hospital Boston - December 29, 2014 Category: Pediatrics Authors: Lisa Fratt Source Type: news

Hyperbaric oxygen for neurologic indications. Action plan for multicenter trials in: stroke, traumatic brain injury, radiation encephalopathy and status migrainosus
Publication date: September–October 2012 Source:Pediatria Polska, Volume 87, Issue 5 Author(s): Harry T. Whelan , Ann K. Helms Introduction: There is great interest in using hyperbaric oxygen (HBO) to treat neurological disease. The exquisite sensitivity of neural tissue to hypoxia makes increased oxygenation attractive as a therapy for disease processes that induce ischemia, edema, and, more recently, apoptosis. Four things specifically exist as targets for future projects and clinical trials: (1) stroke (2) traumatic brain injury (3) radiation induced necrosis and (4) status migrainosus. Methods: Specific aims: Strok...
Source: Pediatria Polska - November 6, 2014 Category: Pediatrics Source Type: research

Pharmacological interventions for hypertension in children
Abstract BackgroundHypertension is a major risk factor for stroke, coronary artery disease and kidney damage in adults. There is a paucity of data on the long‐term sequelae of persistent hypertension in children, but it is known that children with hypertension have evidence of end organ damage and are at risk of hypertension into adulthood. The prevalence of hypertension in children is rising, most likely due to a concurrent rise in obesity rates. In children with hypertension, non‐pharmacological measures are often recommended as first‐line therapy, but a significant proportion of children will eventually require ph...
Source: Evidence-Based Child Health: A Cochrane Review Journal - September 19, 2014 Category: Pediatrics Authors: Swasti Chaturvedi, Deborah H Lipszyc, Christoph Licht, Jonathan C Craig, Rulan Parekh Tags: Intervention Review Source Type: research

Childhood cerebral vasculitis.
Abstract Central nervous system vasculitides are defined as the invasion of the vascular wall by blood-borne inflammatory cells. In childhood, they may be classified according to their trigger event (infectious vs. non-infectious), their temporal course (time-limited vs. chronic), and the size of the affected vessel. Diseases apparently confined to the central nervous system are also distinguished from secondary forms, associated with infection or rheumatic or systemic inflammatory disorders. Large-vessel vasculitis, the most frequent form, causes stroke and presents with acute focal deficits. MR, or more seldom c...
Source: Archives de Pediatrie - July 3, 2014 Category: Pediatrics Authors: Chabrier S, Darteyre S, Mazzola L, Stéphan JL Tags: Arch Pediatr Source Type: research

Headache does not equal stroke in sickle cell
Headache is a common complaint in children with sickle cell disease. Dowling et al conducted a planned secondary analysis from the Silent Infarct Transfusion Trial to determine whether recurrent headache or, more specifically, migraine were predictive of silent cerebral infarction in children with sickle cell disease. In a cross-sectional study of 872 children, about one-third had headaches and 15% had migraines. Asymptomatic cerebral infarcts were not more likely in patients with recurrent headaches or migraine. As a take-home point, the authors note that neuroimaging may not be needed for children with sickle cell diseas...
Source: The Journal of Pediatrics - April 16, 2014 Category: Pediatrics Authors: Paul G. Fisher Tags: The Editors' Perspectives Source Type: research

Headache and Migraine in Children with Sickle Cell Disease Are Associated with Lower Hemoglobin and Higher Pain Event Rates But Not Silent Cerebral Infarction
Objective: To identify risk factors for headache and migraine in children with sickle cell disease and test the hypothesis that either or both are independently associated with silent cerebral infarcts.Study design: In this cross-sectional study, we evaluated the health history, laboratory values, and brain magnetic resonance imaging findings of participants with sickle cell disease (hemoglobinSS or hemoglobinSβ°-thalassemia) with no history of overt stroke or seizures. Participants characterized headache severity and quality. Migraine was defined by International Headache Society criteria modified for increased sensitiv...
Source: The Journal of Pediatrics - February 19, 2014 Category: Pediatrics Authors: Michael M. Dowling, Michael J. Noetzel, Mark J. Rodeghier, Charles T. Quinn, Deborah G. Hirtz, Rebecca N. Ichord, Janet L. Kwiatkowski, E. Steven Roach, Fenella J. Kirkham, James F. Casella, Michael R. DeBaun Tags: Original Articles Source Type: research

Malignant Paraganglioma Presenting With Hemorrhagic Stroke in a Child
We report here the case of a 12-year-old boy with malignant sympathetic paraganglioma presenting with hemorrhagic stroke. Severe hypertension was found and the patient evolved into a coma. Brain computed tomography scan showed right thalamus hemorrhage with intraventricular extension. After clinical improvement, further investigation revealed elevated catecholamine and metanephrine levels, and 2 abdominal tumors were identified by computed tomography. Resection of both lesions was performed, and histologic findings were consistent with paraganglioma. Multiple metastatic involvement of bones and soft tissues appeared severa...
Source: PEDIATRICS - December 2, 2013 Category: Pediatrics Authors: Luiz, H. V., da Silva, T. N., Pereira, B. D., Santos, J. G., Goncalves, D., Manita, I., Portugal, J. Tags: Case Report Source Type: research

Heat stroke related to the use of topiramate. The importance of prevention.
We present the case of a patient who developed heat stroke due to physical exercise while under topiramate treatment. PMID: 24290155 [PubMed - as supplied by publisher]
Source: Anales de Pediatria - November 27, 2013 Category: Pediatrics Authors: Rosich Del Cacho M, Pareja Grande J, Martínez Jiménez MD, Latorre Latorre JF, Bejarano Ramírez N, López-Menchero Oliva C Tags: An Pediatr (Barc) Source Type: research

Subconcussive blows and soccer: what’s the headache?
As the fall sports ramps up, teen athletes across the country are donning shin guards and cleats, prepping to return to their beloved sport—soccer. A handful, however, are foregoing the ritual. One child sitting on the sidelines is the 13-year old daughter of Ken Reed, sports policy director of the League of Fans. Reed and his wife decided the risk of short- and long-term brain damage from subconcussive blows to the head outweighed the benefits of the sport. They pulled their daughter from the field, a decision Reed shared on this recent Huffington Post blog. Thriving checked with William Meehan, MD, director of Boston C...
Source: Thrive, Children's Hospital Boston - September 25, 2013 Category: Pediatrics Authors: Lisa Fratt Tags: All posts Concussions Orthopedics Sports & exercise athlete and concussion Bill Meehan soccer injuries Sports Concussion Clinic Source Type: news

Fifteen minute consultation: headache in children under 5 years of age
Headache occurring in children under the age of 5 years may cause a high level of anxiety in both parents and medical professionals. Crucial to a consultation about this problem will be to actively seek out clues to sinister pathologies, and investigate or reassure as appropriate. Making a positive diagnosis of a primary headache disorder where one exists is also important; however, in young children, headache does not always conform to well-established diagnostic criteria. This short guide provides a practical overview using the scenario of a new referral to the outpatient clinic.
Source: Archives of Disease in Childhood - Education and Practice - September 5, 2013 Category: Pediatrics Authors: McCrea, N., Howells, R. Tags: Headache (including migraine), Pain (neurology), Stroke, Child health Best practice Source Type: research

Idiopathic intracranial hypertension associated with iron-deficiency anaemia
A 12-year-old Nigerian girl presented to the Emergency Department with headache, dizziness and diplopia. She had a history of menorrhagia. Mild dyspnoea, tachycardia, left sixth cranial nerve palsy and papilloedema (figures 1 and 2) were noted. Body mass index was normal. Full blood count revealed haemoglobin of 4.8 g/dl. The red cells were hypochromic and mircocytic. A CT scan of the brain with venous contrast was normal. A lumbar puncture showed opening and closing pressures of 35 and 33.5 cm H2O, respectively. The diagnosis of idiopathic intracranial hypertension secondary to iron-deficiency anaemia was made. ...
Source: Archives of Disease in Childhood - May 9, 2013 Category: Pediatrics Authors: Forman, E. B., O'Byrne, J. J., Capra, L., McElnea, E., King, M. D. Tags: Miscellanea Source Type: research

Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicentre European study
Conclusions Pain in young people with CP is highly prevalent. Because pain causes immediate distress and is associated with lower subjective well-being and reduced participation, clinicians should routinely assess pain. Clinical interventions to reduce pain should be implemented and evaluated. The efficacy of medical and therapeutic interventions causing pain should be re-examined to establish if their benefit justifies the pain and fear of pain that accompany them.
Source: Archives of Disease in Childhood - May 9, 2013 Category: Pediatrics Authors: Parkinson, K. N., Dickinson, H. O., Arnaud, C., Lyons, A., Colver, A., on behalf of the SPARCLE group, Beckung, Parkes, Fauconnier, Lyons, Michelsen, Marcelli, Arnaud, Thyen, Rapp Tags: Cerebral palsy, Open access, Headache (including migraine), Pain (neurology), Stroke, Child health, Physiotherapy, Physiotherapy Original article Source Type: research

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