Vascular Malformation Involving the Brachial Plexus: A Case Report and Review of Literature.

Introduction: Vascular anomalies, comprising up to 4.5% of the general population, are aberrations occurring during vascular development. Vascular abnormalities are frequently identified in children and frequently exhibit characteristics similar to nerve sheath tumors. We report a case of 16 years old boy with a arterio-venous (AV) malformation (AVM) affecting the brachial plexus. We discuss the clinical features, diagnosis, treatment, and histopathological findings in this patient and review the relevant literature. Case Report: A 16- year-s old boy presented with pain, paresthesia, swelling, and reduced grip strength of the hand. Radiological investigations revealed a vascular lesion encasing C5, C6 nerve roots and displacing the C7 root. Near total surgical excision of the lesion was done with preservation of nerve. Histopathology confirmed arteriovenous AVMmalformation with distinct features. Conclusion: High-resolution ultrasound is crucial for diagnosing soft- tissue vascular anomalies. Surgeons well versed in micro surgical skill play a vital key role in minimizing neural deficits. In the case of vascular malformations of brachial plexus, near total excision is the most favorable option.

Neurological Manifestations of Coronavirus Disease 2019 and Mpox in Pediatric Patients and Their Management: A State-of-the-Art Systematic Review.

BACKGROUND: There is an increasing number of cases being reported of neurological manifestations of Coronavirus disease 2019 (COVID-19) infection and Monkeypox (Mpox), both during the course of the infection and as a presenting symptom. We aim to review the neurological manifestations of COVID-19 and monkeypox in pediatric patients and their management. METHODS: We conducted a systematic review that included cohort studies and case series or reports involving a pediatric population of patients with a confirmed COVID-19 or Mpox infection and their neurological manifestations. We searched the following electronic databases: PubMed, EMBASE, and Scopus. RESULTS: From 1136 articles identified, 127 studies were included. Headache, stroke, Guillain-Barré syndrome, seizure, nerve palsies, and multisystem inflammatory syndrome in children were the most common neurological symptoms caused by COVID-19, whereas encephalitis was commonly seen in patients with Mpox. Rare neurological manifestations of COVID-19 included cerebral venous sinus thrombosis, plexopathies, demyelinating disorders, encephalitis, etc., and rare neurological manifestations of Mpox included headache. CONCLUSIONS: Our review highlights the importance of investigating possible neurological manifestations and closely monitoring these patients to develop a better understanding of the treatment strategies that can be adopted.