RESUMEN
Brachial artery aneurysms in children are rare. Surgical treatment is generally recommended.We present the case of a female toddler with a pulsatile swelling on the medial aspect of the right upper arm without history of recent trauma. Medical history revealed a traumatic birth with labour arrest. Postnatally diffuse trunk and arm haematomas as well as a temporary right arm discolouration were detected. Preoperative ultrasound revealed a true brachial artery aneurysm. A full-body MRI ruled out any accompanying lesions. Primary resection and end-to-end anastomosis were performed. Recovery was uneventful. 6-month and 12-month follow-up showed normal motor function and arterial patency; ultrasound also demonstrated harmonious growth of the anastomosed vessel segments.No other publication has associated birth trauma with brachial artery aneurysm yet. Correct diagnosis and prompt curative surgery are key to prevent severe complications. Further reports and data on long-term outcome are needed to optimise clinical management.
Asunto(s)
Aneurisma , Arteria Braquial , Humanos , Femenino , Arteria Braquial/diagnóstico por imagen , Arteria Braquial/cirugía , Arteria Braquial/patología , Aneurisma/complicaciones , Aneurisma/diagnóstico por imagen , Anastomosis Quirúrgica/efectos adversos , Resultado del TratamientoAsunto(s)
Equinococosis Pulmonar/tratamiento farmacológico , Equinococosis Pulmonar/parasitología , Equinococosis Pulmonar/cirugía , Echinococcus granulosus/aislamiento & purificación , Exudados y Transudados/parasitología , Sistema Respiratorio/microbiología , Sistema Respiratorio/fisiopatología , Albendazol/uso terapéutico , Animales , Antiprotozoarios/uso terapéutico , Niño , Equinococosis Pulmonar/fisiopatología , Humanos , Masculino , Sistema Respiratorio/diagnóstico por imagen , Suiza , Resultado del TratamientoAsunto(s)
Hernia Umbilical/tratamiento farmacológico , Hernia Umbilical/cirugía , Enfermedades del Prematuro/tratamiento farmacológico , Enfermedades del Prematuro/cirugía , Antiinfecciosos Locales/administración & dosificación , Vendajes , Hernia Umbilical/patología , Humanos , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro/patología , Compuestos de Plata/administración & dosificación , Factores de TiempoRESUMEN
BACKGROUND: Even though the etiologies, therapies and prognoses of acute peripheral facial palsy (PFP) differ among children and adults, not many studies focus on children. METHODS: We performed a retrospective study of 84 children, aged 10 months to 16 3/12 years, who were seen at the Children's Hospital of Eastern Switzerland between 1998 and 2007 due to PFP. Data about etiology, diagnostics and therapy were gathered from medical files, the outcome by questionnaires. Among 9 patients with residual symptoms, 6 returned for a follow-up visit and the results were documented with photographs. Recovery was graded by the House-Brackmann scale. RESULTS: There were 83 unilateral and 1 bilateral case(s) of FP; neuroborreliosis (NB) causing 26 cases (31.0%), other infections 6 cases (7.1%) and toxicity of methotrexat 1 case (1.2%); 51 cases (60.7%) were classified as idiopathic (IPFP). Between the months June and November, the number of cases with NB rose to 53.3%, while there was no case between the months of January and April. Only 4 patients with IPFP received steroids. 75 patients (89.3%) recovered completely (HB-Grade I). 9 patients (10.7%) showed slight residual symptoms (HB-Grade II). Of these, 6 had IPFP, 1 had NB and 2 had otitis media (OM). DISCUSSION: Almost a third of all palsies were caused by NB; during summer and fall, NB accounted for over half the cases. Patients with borreliosis showed a higher recovery rate than those with OM or IPFP. Almost 90% of the patients investigated recovered completely, even without steroid treatment. Residual symptoms were slight.
