Clinical Evaluation of Stroke in Infants and Children

PURPOSE: The causes of stroke in children are varied and morbidity by stroke is significant, it needs further investigations to identify the underlying causes. Despite significant morbidity in childhood, only a few studies have been reported. So we reviewed retrospectively clinical records, diagnosed stroke in neuroradiologic study and analyzed sex, age, cause, clinical features, mortality, lesion of brain injury and residual deficits. METHODS: From January 1994 to July 1997, 67 patients diagnosed with stroke in neuroradiologic study were studied retrospectively. We described age, sex distribution, underlying causes, clinical features, mortality, lesion of brain injury and residual deficits. RESULTS: There were 50 cases(74.6%) of ischemic stroke and 14 cases(20.9%) of hemorrhagic stroke. The most common cause was moyamoya disease in ischemic stroke and hemato- oncologic disease in hemorrhagic stroke. The presenting features were seizure, 30 cases(44.8%) ; motor deficit, 27 cases(40.3%) ; mental change, 15 cases(22.4%) ; and headache, 11 cases(16.4%). Forty-five cases(67.1%) involved carotid system and 13 cases(19.5%) involved vertebrobasilar system. The mortality rate was 19.4% and the rate of residual deficit was 63.0%. CONCLUSION: Cerebrovascular disease in childhood is not an uncommon occurrence in Korea considering these results. As a consequence of medical progress, early mortality rate has decreased, but the rate of residual deficits tended to increase. So further studies on childhood stroke are required for early diagnosis and treatment which are important in decreasing mortality and morbidity.

A Case of Mollaret Meningitis

Mollaret meningitis is a recurrent aseptic meningitis with characteristic clinical features and Mollaret cells in cerebrospinal fluid. Since Mollaret first reported Mollaret meningitis in 1944, further reports had been made mainly in Europe. The syndrome consists of brief attacks of meningitis that recur at regular intervals and alternate with a symptom-free period lasting for weeks or months. The symptoms subside as quickly as they develop, and the patient is completely asymptomatic until the next episode, without any residual neurologic abnormalities. Specific changes in the cytologic pattern of the cerebrospinal fluid occur over the course of an attack. In the early stages, polymorphonuclear leukocytes and endothelial cells appear in the cerebrospinal fluid, called Mollaret cell. We experienced a case of Mollaret meningitis in a 15-year-old female child who had 5 episodes of recurrent aseptic meningitis, always accompanied by vesicles on the face and anterior neck. We observed Mollaret cells which had faint, finely vacuolated cytoplasm, eccentrically located nuclei show on Papanicolau stain. We present a case of Mollaret meningitis with a brief review of related literatures.

A Case of Mollaret Meningitis

Mollaret meningitis is a recurrent aseptic meningitis with characteristic clinical features and Mollaret cells in cerebrospinal fluid. Since Mollaret first reported Mollaret meningitis in 1944, further reports had been made mainly in Europe. The syndrome consists of brief attacks of meningitis that recur at regular intervals and alternate with a symptom-free period lasting for weeks or months. The symptoms subside as quickly as they develop, and the patient is completely asymptomatic until the next episode, without any residual neurologic abnormalities. Specific changes in the cytologic pattern of the cerebrospinal fluid occur over the course of an attack. In the early stages, polymorphonuclear leukocytes and endothelial cells appear in the cerebrospinal fluid, called Mollaret cell. We experienced a case of Mollaret meningitis in a 15-year-old female child who had 5 episodes of recurrent aseptic meningitis, always accompanied by vesicles on the face and anterior neck. We observed Mollaret cells which had faint, finely vacuolated cytoplasm, eccentrically located nuclei show on Papanicolau stain. We present a case of Mollaret meningitis with a brief review of related literatures.

A Case of Gastric Submucosal Tumors in Children Diagnosed by Endoscopic Ultrasonography / 대한소화기내시경학회지

Benign neoplasms of the stomach are uncommon in children. They include adenomatous and hyperplastic polpys, leiomyomas, lipomas, and other lesions. Gastric leiomyoma in childhood represent only 1% of all gastrointestinal neoplasms reported, and slightly more than half of these are gastric. The tumor arises in the muscle layer of the stomach and is usually intragastric and submucosal. Barium contrast studies are useful in localizing leiomyoma with significant intramural or submucosal growth. An endoscopy can permit histologic confirmation if the tumor has eroded through the mucosa. Differentiation however, of malignant lesions from benign submucosal leiomyomas may be difficult. Using endoscopic ultrasonund imaging, highly accurate gastrointestinal tumor characterization, especially submucosal masses, and differentiation of malignant from benign lesion are now relatively possible without surgery. We experienced a case of a gastric submucosal tumor regarded as a leiomyoma, which was diagnosed using endoscopic ultrasonography, and report the findings with a review of related literatures.