Disección arterial cérvico-cefálica post trauma en pediatría / Cervicocephalic arterial dissection post trauma in children

Introducción: la disección arterial cérvico-cefálica (DACC) es una causa importante de accidente cerebrovascular (ACV) en pediatría. Dentro de los factores de riesgo más relevantes están los traumas cervicales y cefálicos, presentes en el 50% de los casos. El pronóstico es variable y depende de la magnitud de oclusión de la arteria afectada. Es importante la detección precoz de esta patología, que muchas veces se presenta con pocos síntomas en pediatría, lo que genera retraso en el diagnóstico y tratamiento. Objetivo:presentar la evidencia disponible sobre DACC incluyendo DACC post trauma para familiarizar a los médicos generales y especialistas sobre la sospecha diagnóstica, diagnóstico enfocado en neuroimágenes y posibles manejos de esta patología. Métodos: se llevó a cabo una revisión bibliográfica de la literatura científica sobre esta condición. Dentro de los criterios de selección de los estudios se consideró la fecha de publicación, el diseño y la relevancia.Conclusiones: la DACC post trauma es una causa frecuente de ACV en pediatría. Se puede presentar con escasa sintomatología, por lo que es importante mantener una alta sospecha en contexto de trauma cervical o cefálico, implementando un diagnóstico y tratamiento precoces para mejorar el pronóstico de los pacientes.

Introduction:Craniocervical arterial dissection (CCAD) is a major cause of arterial ischemic stroke (AIS) in children. The most important risk factors are cervical and cephalic traumas, present in 50% of all cases.The prognosis changes depending on the magnitude of the artery affected. Early detection of this pathology is important. It many times presents itself with few symptoms, which generates a de-lay in its diagnosis and treatment. Objective: To present the evidence available on CCAD, including CCAD post-trauma,to familiarize general physicians and specialists with this diagnosis, neuroimages required, and possible treatments.Methods: Extensive revision of bibliographic scientific literature about this condition. The criteria selection to include studies in this review were the date of publication, the design of the study, and their relevance.Conclusions: the CCAD post-trauma is asignificant cause of AIS in children. It can present itself with mild symptomatology, which is why it is relevant to suspect it in the context of cervical or cephalic trauma, aiming for an early diagnosis and treatment to improve the outcome of patients.

Severe respiratory disease caused by human respiratory syncytial virus impairs language learning during early infancy.

Human respiratory syncytial virus infection is a leading cause of pediatric morbidity and mortality. A previous murine study showed that during severe acute respiratory infections the virus invades the central nervous system, and that infected animals evolve with long-lasting learning difficulties associated with long-term potentiation impairment in their hippocampus. We hypothesized here that human infants who presented a severe episode of respiratory syncytial virus infection before 6 months of age would develop long-term learning difficulties. We measured the acquisition of the native phoneme repertoire during the first year, a milestone in early human development, comprising a reduction in the sensitivity to the irrelevant nonnative phonetic information and an increase in the sensitivity to the information relevant for the native one. We found that infants with a history of severe respiratory infection by the human respiratory syncytial virus presented poor distinction of native and nonnative phonetic contrasts at 6 months of age, and remained atypically sensitive to nonnative contrasts at 12 months, which associated with weak communicative abilities. Our results uncover previously unknown long-term language learning difficulties associated with a single episode of severe respiratory infection by the human respiratory syncytial virus, which could relate to memory impairments.