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What Causes Microcephaly?
Discussion Microcephaly is usually defined as an occipitofrontal head circumference (OFC) more than 2 standard deviations (SD) below the mean for sex, age and ethnicity. Severe microcephaly is used for OFC < 3 standard deviations. Rates of microcephaly range from 0.5-12 patients/10,000 live births. The OFC should be measured at every well child visit and at other opportunities and plotted on standard growth charts. The OFC is measured using a nonelastic tape measure around the largest part of the head with the tape measure held above the eyebrows and ears. It is a highly reproducible measurement. There are several diff...
Source: PediatricEducation.org - September 25, 2017 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Athletes at risk: Knowing the dangers of heat stroke
For many young athletes, fall sports practices have already started. Whether it’s football two-a-days, soccer practices on a sweltering turf field, or cross country training in the late summer sun, the threat of heat exhaustion and heat stroke is prevalent across all sports. It’s an important time for athletes and parents to be aware of the signs of heat illnesses, especially given that children and adolescents are more susceptible to heat stroke than adults. Younger athletes produce more heat during activity, sweat less, and adjust less rapidly to changes in environmental heat. Certain sports also carry unique risks f...
Source: Thrive, Children's Hospital Boston - September 5, 2017 Category: Pediatrics Authors: Connor Ertz Tags: Ask the Expert Division of Sports Medicine Dr. Michael Beasley football heat exposure Source Type: news

Full circle: From moyamoya patient to intern
It’s the last day of Justin Doo’s research internship in the Department of Neurology at Boston Children’s Hospital and he’s eager to join the team for a celebratory scoop of ice cream at JP Licks. Before he leaves, he meets with his supervisor, Dr. Laura Lehman — but they both know this isn’t a final goodbye. The 18-year-old will see Dr. Lehman again within the year, because he isn’t just her intern. He’s also her patient. Unlike most summer interns, Justin has already spent plenty of time at Boston Children’s — more than a decade, in fact. When he was 7 years old, his parents brought him to the hospita...
Source: Thrive, Children's Hospital Boston - August 29, 2017 Category: Pediatrics Authors: Jessica Cerretani Tags: Diseases & Conditions Our Patients’ Stories Dr. Darren Orbach Dr. Edward Smith Dr. Laura Lehman Dr. Michael Scott moyamoya Moyamoya Disease Program Pial Synangiosis Source Type: news

4 questions parents have about moyamoya disease
Last month, families from across the country gathered at Boston Children’s Hospital to celebrate World Moyamoya Day. The expert speakers at the Moyamoya Family Day Symposium shared the latest information about this rare but very serious condition with parents and patients alike. Moyamoya disease occurs when the walls of the internal carotid arteries — the vessels that supply blood to important areas of the brain — become thickened and narrowed. As a result, blood flow to the brain slows, making blood clots more likely. Kids with moyamoya disease are at significantly higher risk of having a stroke, as well as other co...
Source: Thrive, Children's Hospital Boston - June 13, 2017 Category: Pediatrics Authors: Jessica Cerretani Tags: Ask the Expert Diseases & Conditions Dr. Edward Smith moyamoya Moyamoya Disease Program Source Type: news

Keeping up with Amanda: Life after brain surgery
In most ways, Amanda LePage is just like any other rambunctious fourth grader. She loves school, dance class, playing basketball and keeping up with her twin sister Macy and older brother Nathan. Sometimes it just takes her a little longer to do these everyday things. That’s because Amanda has been through a lot in her short nine years. Amanda was just 5 months old when she was brought by helicopter to Boston Children’s Hospital for a hemorrhage in her brain from an intracranial aneurysm, a type of vascular malformation. Despite long odds, Amanda survived two life-saving brain surgeries and a massive stroke that left ...
Source: Thrive, Children's Hospital Boston - May 22, 2017 Category: Pediatrics Authors: Ellen Greenlaw Tags: Our Patients’ Stories brain aneurysm Dr. Caroline Robson Dr. Craig McClain Dr. Edward Smith Dr. Peter Manley Hydrocephalus low-grade glioma pediatric stroke Source Type: news

A new life for Lynkin after encephalocele surgery
When you meet Lynkin Bell, the first things you notice are her big personality and chubby cheeks. You might also see how she adores her brother Lukis and hamming it up for the camera. But you’d never guess that this playful 14-month-old from Texas wasn’t expected to survive, never mind talk, stand or play peekaboo like a pro. And yet, thanks to her parents’ faith and persistence — and surgery at Boston Children’s Hospital — Lynkin can do all those things, and lots more, with the gusto befitting any toddler her age. “It’s a miracle,” says Kaylen Gaston, Lynkin’s mom. “We were told so many times she wou...
Source: Thrive, Children's Hospital Boston - April 24, 2017 Category: Pediatrics Authors: Ellen Greenlaw Tags: Diseases & Conditions Our Patients’ Stories Craniofacial Program Dr. John Meara Dr. Mark Proctor encephalocele Source Type: news

A father ’s hope for his son’s life
Juan and Fredy in 2017. Juan was looking forward to having his son, Fredy, 14, finally come home to live with him. The teenager had been living under the care of his grandmother since he was a toddler. But on that long-awaited homecoming day, Juan was quickly jarred from feeling great joy to grave concern. “When I saw his face, one side looked very different from the other and his lip was swollen,” says Juan. “He admitted right away that his face had been hurting.” Juan remembered that the last time he’d seen his son — more than one year ago — Fredy’s face had looked slightly different then too. But whateve...
Source: Thrive, Children's Hospital Boston - April 12, 2017 Category: Pediatrics Authors: Kat J. McAlpine Tags: Diseases & Conditions Our Patients’ Stories Dr. Cameron Trenor Dr. Carolyn Rogers Dr. Darren Orbach Dr. Reza Rahbar Dr. Salim Afshar interventional radiology juvenile nasopharyngeal angiofibroma tumor Source Type: news

Superhero Joey: Five-year-old fights moyamoya disease
It’s been said that not all heroes wear capes — but Joey Gallagher owns several. The five-year-old has already amassed a collection of superhero gear, from a Superman Halloween costume to a t-shirt emblazoned with the Batman logo. Yet even the most diehard comic book fan would likely admit that feats like flying, leaping tall buildings and fighting bad guys don’t hold a candle to the challenges this little boy has already surmounted. Just last June, Joey was out of town with his family when he had what his parents, Leila and Scott, feared was a seizure. Clinicians in the emergency department dismissed the event as he...
Source: Thrive, Children's Hospital Boston - April 4, 2017 Category: Pediatrics Authors: Jessica Cerretani Tags: Diseases & Conditions Our Patients’ Stories childhood stroke Dr. Edward Smith Dr. Michael Scott moyamoya Moyamoya Disease Program Source Type: news

Fighting for Kennedy: Coping with moyamoya disease
If you happen to be waiting in line at the supermarket with Kennedy Grace Cheshire, you’ll likely leave the store with a whole new group of friends. This outgoing five-year-old can’t resist introducing herself to her fellow shoppers — and then introducing them to each other. “She’s never met a stranger,” says her mother, Amber. Kennedy, who lives in Texas, brought that playful attitude to the East Coast last year when she and her family arrived at Boston Children’s Hospital for evaluation and treatment. At age two, she had been diagnosed with neurofibromatosis 1 (NF1), a genetic condition that causes symptoms...
Source: Thrive, Children's Hospital Boston - March 21, 2017 Category: Pediatrics Authors: Jessica Cerretani Tags: Diseases & Conditions Our Patients’ Stories Dr. Edward Smith moyamoya Moyamoya Disease Program Source Type: news

What Causes Hyperammonemia?
Discussion Reye’s syndrome (RS)is named for Dr. Douglas Reye who along with Drs. G. Morgan and J. Baral described encephalopathy and fatty accumulation and degeneration in children in a 1963 Lancet article. RS usually affects children but can occur at all ages. All organs can be affected but the liver and brain are primarily affected causing liver failure and encephalopathy as toxic metabolites (especially ammonia) accumulate, and intracranial hypertension and cerebral edema occurs. As the ammonia levels begin to rise (> 100 mg/dL) patients lose their appetite, have nausea and emesis and mental status changes whic...
Source: PediatricEducation.org - February 20, 2017 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Annelizabeth ’s story: Care that feels like home, close to home
When you’re 5, it’s nice to have a place that feels like a second home. Where there are lots of hugs. And songs. And games. And you can curl up and watch “Frozen,” your favorite movie. For Annelizabeth Jean-Baptiste, a spunky Waltham kindergartener, that place is Boston Children’s Hospital at Waltham. Annelizabeth, or Annie (but never Anna, she says), first came to Boston Children’s at Waltham two weeks after she was born. Her mother Elcie wasn’t expecting that her fourth child would need special care. “It was a difficult pregnancy. I was very excited and relieved when she was born.” But that sense of rel...
Source: Thrive, Children's Hospital Boston - August 29, 2016 Category: Pediatrics Authors: Lisa Fratt Tags: Our Patients’ Stories Boston Children's at Waltham Dr. Rachael Grace sickle cell disease Source Type: news

After Moyamoya surgery, a back-to-normal birthday for Carolyn
Before Moyamoya surgery Carolyn Milks turns 8 on August 21. It’s a big celebration. Carolyn and her family aren’t just celebrating her birthday — they’re celebrating Carolyn’s return to normal. For most of the summer, things like swimming, riding her bicycle and horsing around with her sisters and cousins had been out of the question for Carolyn. But on August 11, Dr. Ed Smith, co-director of the Boston Children’s Hospital Cerebrovascular Surgery and Interventions Center, gave Carolyn the green light. She could go back to being a kid. “This is what kids really want. They just want to ...
Source: Thrive, Children's Hospital Boston - August 18, 2016 Category: Pediatrics Authors: Joyce Choi Tags: Our Patients’ Stories Boston Children's at Waltham Cerebrovascular Surgery and Interventions Center Dr. Ed Smith moyamoya Source Type: news

Paraplegics Regain Some Feeling, Movement After Using Brain-Machine Interfaces
This study was funded by grants from the Brazilian Financing Agency for Studies and Projects (FINEP 01 ·12·0514·00), Brazilian Ministry of Science, Technology and Innovation, and the Itaú Bank. The authors list additional acknowledgements in the manuscript. They declared no competing financial interests related to this work.###
Source: DukeHealth.org: Duke Health Features - August 11, 2016 Category: Pediatrics Tags: Duke Medicine Source Type: news

Different stroke(s)
A 13-year-old boy with mild learning difficulties presented to his district general hospital after an unwitnessed episode of collapse with vomiting but no loss of consciousness. He had 3 days of lethargy and intermittent occipital headaches waking him from sleep. Two days later, after another ‘funny turn’, he represented with right-side paraesthesia, weakness and word-finding difficulty. He had three previous ‘collapses’ over the last 6 months, including symptoms of transient dizziness, slurred speech, dribbling, difficulty swallowing and left-facial paraesthesia from which he had recovere...
Source: Archives of Disease in Childhood - Education and Practice - May 17, 2016 Category: Pediatrics Authors: Mundada, V., Krishnakumar, D., Chitre, M., Das, T. Tags: Oncology, Eye Diseases, Drugs: cardiovascular system, Echocardiography, Headache (including migraine), Infection (neurology), Neurooncology, Pain (neurology), Stroke, Hypertension, Ophthalmology, Valvar diseases, Radiology, Rheumatology, Dermatology, Clin Source Type: research

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