RESUMO
We report on a case of a 13-month-old female infant who was admitted to our department with the chief complaints of drowsiness and vomiting. A history of an unspecified viral infection was reported. Clinical examination was negative for focal neurological signs or signs of central nervous system infection. Initial CT scan revealed obstructive hydrocephalus, and shunting was scheduled. Dexamethasone treatment was started. Eight hours after admission the child almost restored his baseline mental status and the operation was postponed. The dexamethasone treatment was discontinued 3 days later. Follow up CT and MRI scans were normal. We discuss the case and the possible causes of transient hydrocephalus in children.
Assuntos
Hidrocefalia/patologia , Anti-Inflamatórios/uso terapêutico , Infecções do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções do Sistema Nervoso Central/complicações , Ventrículos Cerebrais/patologia , Ventriculografia Cerebral , Dexametasona/uso terapêutico , Feminino , Humanos , Hidrocefalia/tratamento farmacológico , Hidrocefalia/etiologia , Lactente , Imageamento por Ressonância Magnética , Exame Neurológico , Tomografia Computadorizada por Raios X , Viroses/líquido cefalorraquidiano , Viroses/complicaçõesRESUMO
BACKGROUND AND PURPOSE: Limited information exists on the possibility of pregnant women undergoing radiotherapy for Hodgkin's disease in early pregnancy. The purpose of this study was to measure embryo dose resulting from treatment of supra-diaphragmatic Hodgkin's disease at the first trimester of gestation. MATERIALS AND METHODS: A humanoid phantom was used to simulate pregnancy at the first trimester of gestation. Embryo dose, was measured using three different field sizes that may be applied for local field irradiation in each of the regions of neck, axilla, neck-mediastinum and for mantle treatment. A shielding device consisting of 5 cm of lead was used to reduce the embryo dose. Dose measurements were carried out using thermoluminescent dosimeters. Phantom exposures were made with a 6 MV photon beam. RESULTS: Local field irradiation in the regions of neck or axilla always resulted in embryo doses below 10 cGy. For local field irradiation in the region of neck-mediastinum and for mantle treatment, the radiation dose to a shielded embryo was 2.8-18.6 and 4.2-24.5 cGy depending upon the distance from the field isocenter and the field size used, respectively. The corresponding dose for an unshielded embryo exceeded 10 cGy. All the above embryo doses were obtained for a tumor dose of 40 Gy. CONCLUSIONS: Local field irradiation in the regions of neck or axilla may be safely performed even without uterus shielding. For local field irradiation in the region of neck-mediastinum and for mantle radiotherapy, the extent of the irradiated area, the distance separating the embryo from the field isocenter and the tumor dose are the factors, determining whether the radiation dose to a shielded embryo may possibly be reduced below 10 cGy.