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Micro-light-emitting diodes (µLEDs) have gained significant interest as an activation source for gas sensors owing to their advantages, including room temperature operation and low power consumption. However, despite these benefits, challenges still exist such as a limited range of detectable gases and slow response. In this study, we present a blue µLED-integrated light-activated gas sensor array based on SnO2 nanoparticles (NPs) that exhibit excellent sensitivity, tunable selectivity, and rapid detection with micro-watt level power consumption. The optimal power for µLED is observed at the highest gas response, supported by finite-difference time-domain simulation. Additionally, we first report the visible light-activated selective detection of reducing gases using noble metal-decorated SnO2 NPs. The noble metals induce catalytic interaction with reducing gases, clearly distinguishing NH3, H2, and C2H5OH. Real-time gas monitoring based on a fully hardware-implemented light-activated sensing array was demonstrated, opening up new avenues for advancements in light-activated electronic nose technologies.
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The development of hydrogen (H2) gas sensors is essential for the safe and efficient adoption of H2 gas as a clean, renewable energy source in the challenges against climate change, given its flammability and associated safety risks. Among various H2 sensors, gasochromic sensors have attracted great interest due to their highly intuitive and low power operation, but slow kinetics, especially slow recovery rate limited its further practical application. This study introduces Pd-decorated amorphous WO3 nanorods (Pd-WO3 NRs) as an innovative gasochromic H2 sensor, demonstrating rapid and highly reversible color changes for H2 detection. In specific, the amorphous nanostructure exhibits notable porosity, enabling rapid detection and recovery by facilitating effective H2 gas interaction and efficient diffusion of hydrogen ions (H+) dissociated from the Pd nanoparticles (Pd NPs). The optimized Pd-WO3 NRs sensor achieves an impressive response time of 14 s and a recovery time of 1 s to 5% H2. The impressively fast recovery time of 1 s is observed under a wide range of H2 concentrations (0.2-5%), making this study a fundamental solution to the challenged slow recovery of gasochromic H2 sensors.
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Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders found in children and adolescents. The American Academy of Pediatrics (AAP) first published a clinical practice guideline on ADHD in 2000, which was revised in 2011 and republished together with an accompanying process-of-care algorithm. More recently, the 2019 clinical practice guideline revision was published. Since the 2011 guideline, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), was released. In addition, the Society of Developmental and Behavioral Pediatrics (SDBP) recently released another clinical practice guideline for complex ADHD. Although there are nonessential changes reflected in these updates, a number of changes have still been made; for example, the DSM-5 criteria lowered the diagnostic threshold for ADHD in older teens and adults. Additionally, the criteria were revised to facilitate application to older teens and adults, and a comorbid diagnosis with autism spectrum disorder is now allowed. Meanwhile, the 2019 AAP guideline added the recommendation related to comorbid conditions with ADHD. Lastly, SDBP developed a complex ADHD guideline, covering areas such as comorbid conditions, moderate-to-severe impairment, treatment failure, and diagnostic uncertainty. In addition, other national ADHD guidelines have been published, as have European guidelines for managing ADHD during the coronavirus disease 2019 pandemic. To facilitate ADHD management in a primary care, it is important to provide and review clinical guidelines and recent updates. In this article, we will review and summarize the recent clinical guidelines and their updates.
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Noble metal nanoparticle decoration is a representative strategy to enhance selectivity for fabricating chemical sensor arrays based on the 2-dimensional (2D) semiconductor material, represented by molybdenum disulfide (MoS2). However, the mechanism of selectivity tuning by noble metal decoration on 2D materials has not been fully elucidated. Here, we successfully decorated noble metal nanoparticles on MoS2 flakes by the solution process without using reducing agents. The MoS2 flakes showed drastic selectivity changes after surface decoration and distinguished ammonia, hydrogen, and ethanol gases clearly, which were not observed in general 3D metal oxide nanostructures. The role of noble metal nanoparticle decoration on the selectivity change is investigated by first-principles density functional theory (DFT) calculations. While the H2 sensitivity shows a similar tendency with the calculated binding energy, that of NH3 is strongly related to the binding site deactivation due to preferred noble metal particle decoration at the MoS2 edge. This finding is a specific phenomenon which originates from the distinguished structure of the 2D material, with highly active edge sites. We believe that our study will provide the fundamental comprehension for the strategy to devise the highly efficient sensor array based on 2D materials.
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Electroencephalography (EEG) has been and is still widely used in brain function research. EEG has advantages over other neuroimaging modalities. First, it not only directly images the electrical activity of neurons; it has a higher temporal resolution. Furthermore, current advanced technologies enable accurate mathematical calculations and sophisticated localization from EEG data. Several important factors should be considered for EEG analysis using these advanced technologies. First, raw EEG data contain physiological or nonphysiological artifacts. Therefore, preprocessing methods and algorithms to detect and remove these artifacts have been proposed and developed. In the analysis of preprocessed EEG, forward and inverse problems require solving and several proposed models have been applied. To solve the forward problem, the source information and matrix parameters from which the EEG originates are essential. Therefore, an accurate head model is required. In contrast, the possible combinations of the current sources computed inversely from EEG measured at a limited number of electrodes are infinite, referring to the inverse problem. The inverse problem can be solved by setting limits based on assumptions made of the anatomy and physiology on the generation and propagation of the current sources. Thus, methods such as dipole source models and distributed source models have been proposed. Source localization requires the consideration of many factors such as the preprocessing of raw EEG data, artifact removal, accurate head models and forward problems, and inverse computation problems. This review summarizes the methods and considerations applied to the above EEG source localization process. It also introduces the applications of EEG source localization for epilepsy and other diseases as well as brain function studies and discusses future directions.
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BACKGROUND: The purpose of this study is to estimate the overall prevalence and incidence of constipation in Korean children and adolescent based on health insurance claims data. METHODS: This study is a retrospective cohort study using the Korean National Health Insurance Service - National Sample Cohort from 2002 to 2013. Patients age less than 19 years old were selected, and the prevalence and incidence of constipation were estimated. RESULTS: The standardized incidence rate was 10.8 per 1,000 persons in 2004 to 14.3 per 1,000 persons in 2012. The standardized prevalence increased from 12.2 per persons in 2002 to 26.4 per persons in 2013. Females had a higher incidence rate and prevalence rate than males during the study period. The overall recurrence rates were 13.2%. The recurrence rates were 12.9% in males and 13.5% in females. The overall average constipation duration was 229 days. The duration was 222 days in males and 236 days in females. CONCLUSIONS: This is the first study to conduct a population-based study of all children in Korea with constipation. These data reveal the increasing burden and impact of constipation on children and could enable effective public and clinical health strategies to be planned.
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Constipação Intestinal , Adolescente , Adulto , Criança , Constipação Intestinal/epidemiologia , Feminino , Humanos , Incidência , Masculino , Prevalência , República da Coreia/epidemiologia , Estudos Retrospectivos , Adulto JovemRESUMO
Juvenile myoclonic epilepsy (JME) is a common generalized epilepsy syndrome considered the prototype of idiopathic generalized epilepsy. To date, generalized and focal seizures have been the fundamental concepts for classifying seizure types. In several studies, focal features of JME have been reported predominantly in the frontal lobe. However, results in previous studies are inconsistent. Therefore, we investigated the origin of epileptiform discharges in JME. We performed electroencephalography source localization using a distributed model with standardized low-resolution brain electromagnetic tomography. In 20 patients with JME, standardized low-resolution brain electromagnetic tomography images corresponding to the midpoint of the ascending phase and the negative peak of epileptiform discharges were obtained from a total of 362 electroencephalography epochs (181 epochs at each timepoint). At the ascending phase, the maximal current source density was located in the frontal lobe (58.6%), followed by the parietal (26.5%) and occipital lobes (8.8%). At the negative peak, the maximal current source density was located in the frontal lobe (69.1%), followed by the parietal (11.6%) and occipital lobes (9.4%). In the ascending phase, 41.4% of discharges were located outside the frontal lobe, and 30.9% were in the negative peak. Frontal predominance of epileptiform discharges was observed; however, source localization extending to various cortical regions also was identified. This widespread pattern was more prominent in the ascending phase (P = .038). The study results showed that JME includes widespread cortical regions over the frontal lobe. The current concept of generalized epilepsy and pathophysiology in JME needs further validation.
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Epilepsia Generalizada , Epilepsia Mioclônica Juvenil , Fenômenos Eletromagnéticos , Epilepsia Generalizada/diagnóstico por imagem , Lobo Frontal/diagnóstico por imagem , Humanos , Epilepsia Mioclônica Juvenil/diagnóstico por imagem , Convulsões , TomografiaRESUMO
BACKGROUND: It is important to assess the degree of brain injury and predict long-term outcomes in neonates diagnosed with hypoxic-ischemic encephalopathy (HIE). However, routine studies, including magnetic resonance imaging (MRI) and conventional encephalography (EEG) or amplitude-integrated EEG (aEEG), have their own limitations in terms of availability and accuracy of evaluation. Recently, quantitative EEG (qEEG) has been shown to improve the predictive reliability of neonatal HIE and has been further refined with brain mapping techniques. METHODS: We investigated background EEG activities in 29 neonates with HIE who experienced therapeutic hypothermia, via qEEG using a distributed source model. MRI images were evaluated and classified into two groups (normal-to-mild injury vs moderate-to-severe injury), based on a scoring system. Non-parametric statistical analysis using standardized low-resolution brain electromagnetic tomography was performed to compare the current density distribution of four frequency bands (delta, theta, alpha, and beta) between the two groups. RESULTS: Electrical neuronal activities were significantly lower in the moderate-to-severe injury group compared with the normal-to-mild injury group. Background EEG activities in moderate-to-severe HIE were most significantly reduced in the temporal and parietal lobes. Quantitative EEG also revealed a decrease in background activity at all frequency bands, with a maximum in decrease in the delta component. The maximum difference in current density was found in the inferior parietal lobule of the right parietal lobe for the delta frequency band. CONCLUSIONS: Our study demonstrated quantitative and topographical changes in EEG in moderate-to-severe neonatal HIE. They also suggest possible implementation and evaluation of conventional EEG and aEEG in neonatal HIE. The findings have implications as biomarkers in the assessment of neonatal HIE.
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Hipotermia Induzida , Hipóxia-Isquemia Encefálica , Encéfalo/diagnóstico por imagem , Eletroencefalografia/métodos , Fenômenos Eletromagnéticos , Humanos , Hipóxia-Isquemia Encefálica/diagnóstico por imagem , Recém-Nascido , Imageamento por Ressonância Magnética , Reprodutibilidade dos TestesRESUMO
Background: With the outbreak of the COVID-19 pandemic, non-pharmaceutical interventions such as social distancing have been implemented worldwide, and a decrease in other infectious diseases has been reported as an unexpected benefit. However, to date, studies are lacking regarding the effects of the COVID-19 pandemic on neuroinfectious diseases; therefore, we aimed to determine the effects of the COVID-19 pandemic on the incidence of meningitis, which is the most common infectious disease in children. Methods: This retrospective study used electronic medical record data from five university hospitals located in the metropolitan cities in Korea. This study included patients aged <18 years who were diagnosed with meningitis between January 2017 and December 2020. We analyzed the clinical characteristics of patients with meningitis and changes in the incidence and causative pathogens of meningitis before and after the COVID-19 outbreak. Results: The study included 677 patients with meningitis. Following the outbreak of COVID-19 in Korea in January 2020, the incidence of childhood meningitis significantly decreased and seasonal changes noted yearly disappeared. There was a difference in the age distribution of patients with meningitis. The incidence of meningitis decreased significantly in children aged >5 years, and the incidence in children <5 years of age relatively increased (p < 0.001). In addition, there was a notable decrease in the cases of suspected meningitis (p < 0.001). The incidence of enteroviral meningitis, the most common cause of meningitis, significantly decreased. Conclusion: After the COVID-19 outbreak, the incidence of childhood meningitis significantly decreased with the implementation of non-pharmaceutical interventions. Absence of enteroviral meningitis and decrease in the proportion of patients aged ≥5 years with meningitis having mild symptoms were noted. Consequently, it can be concluded that the non-pharmaceutical interventions (NPIs) instituted to prevent the spread of COVID-19 had some effect on reducing the incidence of meningitis.
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BACKGROUND: By definition, the background EEG is normal in juvenile myoclonic epilepsy (JME) patients and not accompanied by other developmental and cognitive problems. However, some recent studies using quantitative EEG (qEEG) reported abnormal changes in the background activity. QEEG investigation in patients undergoing anticonvulsant treatment might be a useful approach to explore the electrophysiology and anticonvulsant effects in JME. METHODS: We investigated background EEG activity changes in patients undergoing valproic acid (VPA) treatment using qEEG analysis in a distributed source model. In 17 children with JME, non-parametric statistical analysis using standardized low-resolution brain electromagnetic tomography was performed to compare the current density distribution of four frequency bands (delta, theta, alpha, and beta) between untreated and treated conditions. RESULTS: VPA reduced background EEG activity in the low-frequency (delta-theta) bands across the frontal, parieto-occipital, and limbic lobes (threshold log-F-ratio = ±1.414, p < 0.05; threshold log-F-ratio= ±1.465, p < 0.01). In the delta band, comparative analysis revealed significant current density differences in the occipital, parietal, and limbic lobes. In the theta band, the analysis revealed significant differences in the frontal, occipital, and limbic lobes. The maximal difference was found in the delta band in the cuneus of the left occipital lobe (log-F-ratio = -1.840) and the theta band in the medial frontal gyrus of the left frontal lobe (log-F-ratio = -1.610). CONCLUSIONS: This study demonstrated the anticonvulsant effects on the neural networks involved in JME. In addition, these findings suggested the focal features and the possibility of functional deficits in patients with JME.
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Epilepsia Mioclônica Juvenil , Ácido Valproico , Encéfalo/diagnóstico por imagem , Criança , Eletroencefalografia , Fenômenos Eletromagnéticos , Lobo Frontal , Humanos , Epilepsia Mioclônica Juvenil/tratamento farmacológico , Tomografia , Ácido Valproico/uso terapêuticoRESUMO
In the pandemic era, the development of high-performance indoor air quality monitoring sensors has become more critical than ever. NO2 is one of the most toxic gases in daily life, which induces severe respiratory diseases. Thus, the real-time monitoring of low concentrations of NO2 is highly required. Herein, a visible light-driven ultrasensitive and selective chemoresistive NO2 sensor is presented based on sulfur-doped SnO2 nanoparticles. Sulfur-doped SnO2 nanoparticles are synthesized by incorporating l-cysteine as a sulfur doping agent, which also increases the surface area. The cationic and anionic doping of sulfur induces the formation of intermediate states in the band gap, highly contributing to the substantial enhancement of gas sensing performance under visible light illumination. Extraordinary gas sensing performances such as the gas response of 418 to 5 ppm of NO2 and a detection limit of 0.9 ppt are achieved under blue light illumination. Even under red light illumination, sulfur-doped SnO2 nanoparticles exhibit stable gas sensing. The endurance to humidity and long-term stability of the sensor are outstanding, which amplify the capability as an indoor air quality monitoring sensor. Overall, this study suggests an innovative strategy for developing the next generation of electronic noses.
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Cisteína , Nanopartículas , Luz , Dióxido de Nitrogênio , Enxofre , Compostos de EstanhoRESUMO
For the last several years, indoor air quality monitoring has been a significant issue due to the increasing time portion of indoor human activities. Especially, the early detection of volatile organic compounds potentially harmful to the human body by the prolonged exposure is the primary concern for public human health, and such technology is imperatively desired. In this study, highly porous and periodic 3D TiO2 nanostructures are designed and studied for this concern. Specifically, extremely high gas molecule accessibility throughout the whole nanostructures and precisely controlled internecks of 3D TiO2 nanostructures can achieve an unprecedented gas response of 299 to 50 ppm CH3 COCH3 with an extremely fast response time of less than 1s. The systematic approach to utilize the whole inner and outer surfaces of the gas sensing materials and periodically formed internecks to localize the current paths in this study can provide highly promising perspectives to advance the development of chemoresistive gas sensors using metal oxide nanostructures for the Internet of Everything application.
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Acetona/análise , Técnicas Biossensoriais/métodos , Titânio/química , Técnicas Biossensoriais/instrumentação , Humanos , Nanoestruturas , Porosidade , Propriedades de SuperfícieRESUMO
Localizing the source of epileptiform discharges in generalized epilepsy has been controversial for the past few decades. Recent neuroimaging studies have shown that epileptiform discharges in generalized epilepsy can be localized to a particular region. Childhood absence epilepsy (CAE) is the most common generalized epilepsy in childhood and is considered the prototype of idiopathic generalized epilepsy (IGE). To better understand electrophysiological changes and their development in CAE, we investigated the origin of epileptiform discharges. We performed distributed source localization with standardized, low-resolution, brain electromagnetic tomography (sLORETA). In 16 children with CAE, sLORETA images corresponding to the midpoint of the ascending phase and the negative peak of the spike were obtained from a total of 242 EEG epochs (121 epochs at each timepoint). Maximal current source density (CSD) was mostly located in the frontal lobe (69.4%). At the gyral level, maximal CSD was most commonly in the superior frontal gyrus (39.3%) followed by the middle frontal gyrus (14.0%) and medial frontal gyrus (8.7%). At the hemisphere level, maximal CSD was dominant in the right cerebral hemisphere (63.6%). These results were consistent at the midpoint of the ascending phase and the negative peak of the spike. Our results demonstrated that the major source of epileptiform discharges in CAE was the frontal lobe. These results suggest that the frontal lobe is involved in generating CAE. This finding is consistent with recent studies that have suggested selective cortical involvement, especially in the frontal regions, in IGE.
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Mapeamento Encefálico/métodos , Encéfalo/fisiopatologia , Eletroencefalografia/métodos , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/fisiopatologia , Criança , Feminino , Humanos , Masculino , Modelos Teóricos , Processamento de Sinais Assistido por ComputadorRESUMO
BACKGROUND: Several neuroimaging studies have reported neurophysiological alterations in patients with benign childhood epilepsy with centrotemporal spikes (BCECTS). However, reported outcomes have been inconsistent, and the progression of these changes in the brain remains unresolved. Moreover, background electroencephalography (EEG) in cases of BCECTS has not been performed often. METHODS: We investigated background EEG activity changes after six months of oxcarbazepine treatment to better understand the neurophysiological alterations and progression that occur in BCECTS. In 18 children with BCECTS, non-parametric statistical analyses using standardized low resolution brain electromagnetic tomography (sLORETA) were performed to compare the current density distribution of four frequency bands (delta, theta, alpha, and beta) between untreated and treated conditions. RESULTS: Background EEG activity for the delta frequency band was significantly decreased in the fronto-temporal and limbic regions of the left hemisphere after oxcarbazepine treatment (threshold log-F-ratio = ±2.729, P < 0.01). The maximum current density difference was found in the parahippocampal gyrus of the left limbic lobe (Montreal Neurological Institute coordinate [x, y, z = 25, - 20, - 10], Brodmann area 28) (log-F-ratio = 3.081, P < 0.01). CONCLUSIONS: Our results indicate the involvement of the fronto-temporal and limbic cortices in BCECTS, and limbic lobe involvement, including the parahippocampal gyrus, was noted. In addition to evidence of the involvement of the fronto-temporal and limbic cortices in BCECTS, this study also found that an antiepileptic drug could reduce the delta frequency activity of the background EEG in these regions.
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Anticonvulsivantes/uso terapêutico , Epilepsia Rolândica , Neuroimagem/métodos , Oxcarbazepina/uso terapêutico , Tomografia/métodos , Encéfalo/diagnóstico por imagem , Criança , Estudos de Coortes , Eletroencefalografia , Epilepsia Rolândica/diagnóstico por imagem , Epilepsia Rolândica/tratamento farmacológico , Epilepsia Rolândica/fisiopatologia , HumanosRESUMO
CASE PRESENTATION: A 6-year-old girl complained of diplopia and headache over a 2-week period after sustaining a minor head injury. Her neurological examinations were normal, but visual examination identified bilateral papilledema. Magnetic resonance imaging of the brain revealed a protruding nodular lesion causing compression within the anterior superior sagittal sinus in the midline, showing high signal intensity on T2-weighted imaging (T2WI) and low signal intensity on T1WI, similar to that of cerebrospinal fluid. Enhanced T1WI showed irregular narrowing of the anterior superior sagittal sinus adjacent to this lesion. The cortical vein drained to the frontal pole of the arachnoid granulation lesion and into the superior sagittal sinus. No other parenchymal abnormality was noted. A lumbar puncture showed increased opening pressure (30 mmHg), and the laboratory findings were normal. Based on the imaging and clinical findings, benign intracranial venous hypertension with giant arachnoid granulation was diagnosed. The patient's symptoms were reduced satisfactorily following daily treatment with 750 mg acetazolamide. CONCLUSION: We report a case of giant arachnoid granulation involving the anterior superior sagittal sinus in a 6-year-old girl who presented with benign intracranial hypertension. Clinicians should be aware of this rare anatomic variant to avoid unnecessary invasive procedures or examinations in children with benign intracranial hypertension.
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Aracnoide-Máter/patologia , Pseudotumor Cerebral/etiologia , Acetazolamida/uso terapêutico , Criança , Diuréticos/uso terapêutico , Feminino , Humanos , Pseudotumor Cerebral/tratamento farmacológico , Pseudotumor Cerebral/patologiaRESUMO
Valproate (VPA) is an antiepileptic drug (AED) used for initial monotherapy in treating childhood absence epilepsy (CAE). EEG might be an alternative approach to explore the effects of AEDs on the central nervous system. We performed a comparative analysis of background EEG activity during VPA treatment by using standardized, low-resolution, brain electromagnetic tomography (sLORETA) to explore the effect of VPA in patients with CAE. In 17 children with CAE, non-parametric statistical analyses using sLORETA were performed to compare the current density distribution of four frequency bands (delta, theta, alpha, and beta) between the untreated and treated condition. Maximum differences in current density were found in the left inferior frontal gyrus for the delta frequency band (log-F-ratio = -1.390, P > 0.05), the left medial frontal gyrus for the theta frequency band (log-F-ratio = -0.940, P > 0.05), the left inferior frontal gyrus for the alpha frequency band (log-F-ratio = -0.590, P > 0.05), and the left anterior cingulate for the beta frequency band (log-F-ratio = -1.318, P > 0.05). However, none of these differences were significant (threshold log-F-ratio = ±1.888, P < 0.01; threshold log-F-ratio = ±1.722, P < 0.05). Because EEG background is accepted as normal in CAE, VPA would not be expected to significantly change abnormal thalamocortical oscillations on a normal EEG background. Therefore, our results agree with currently accepted concepts but are not consistent with findings in some previous studies.
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Anticonvulsivantes/uso terapêutico , Eletroencefalografia , Epilepsia Tipo Ausência/tratamento farmacológico , Ácido Valproico/uso terapêutico , Adolescente , Encéfalo/efeitos dos fármacos , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Criança , Ritmo Delta/efeitos dos fármacos , Eletroencefalografia/métodos , Fenômenos Eletromagnéticos , Epilepsia Tipo Ausência/fisiopatologia , Feminino , Humanos , Masculino , Neuroimagem/métodosRESUMO
Benign childhood epilepsy with centrotemporal spikes (BCECTS), also known as Rolandic epilepsy, is the most common benign childhood epilepsy. Centrotemporal spikes are characteristic findings on electroencephalography (EEG). Though the condition is considered benign, many studies have reported some degree of neuropsychological impairment in individuals with BCECTS. There is also growing evidence from neuroimaging studies that BCECTS may affect a larger portion of the brain than originally thought. We performed distributed source localization analysis of interictal spikes in BCECTS. Current-source density (CSD) of the maximal negative peak of the interictal spikes averaged from each of 20 EEG epochs in 11 patients with BCECTS was measured using standardized low-resolution brain electromagnetic tomography (sLORETA). Rolandic area was included in the distribution of the CSD in all of the patients. The significant CSD and its maximal point were distributed in multiple cortical regions over the Rolandic area. It is suggested that the widespread cortical distribution of interictal spikes seen in this study may be associated with atypical presentation and a variety of comorbidities of BCECTS. Our results imply that BCECTS represents a deviation from normal development during a critical period of brain maturation and that children with BECTS might be more likely to need special medical attention.
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Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiopatologia , Eletroencefalografia/métodos , Epilepsia Rolândica/diagnóstico por imagem , Epilepsia Rolândica/fisiopatologia , Magnetoencefalografia/métodos , Tomografia/métodos , Criança , Pré-Escolar , Feminino , Humanos , MasculinoRESUMO
Several radiographic mimics of subarachnoid hemorrhage (SAH) have been reported. The pseudosubarachnoid sign may be seen in patients with marked hypoxic-ischemic injury. Our case was a 12-year-old boy with a known history of autism spectrum disorder. He was submersed in water for 20 minutes, after diving into a river, and brought to our emergency department where resuscitation was performed. He achieved a return of spontaneous circulation 45 minutes after the accident but was in a coma. Brain computed tomography showed severe brain edema and loss of sulci with increased attenuation of the basal cisterns that was compatible with SAH, but was later revealed as the pseudosubarachnoid sign. In this case, the misdiagnosis of SAH had several clinical implications for the management of the patient. This could have clinical implications if a patient with the Glasgow Coma Score greater than 3 were inappropriately treated for SAH. Furthermore, there are possible medical-legal implications regarding child abuse with SAH misdiagnosis.