Giant cerebral cavernous malformation in a newborn: a rare case report and review of literature.

BACKGROUND: Cavernous malformations (CMs), also known as cavernomas or cavernous angiomas, are vascular malformations characterized by sinusoidal spaces lined by endothelial cells. Giant CMs (GCMs) are extremely rare, with limited understanding of their presentation and management. We present a case of symptomatic GCM in a newborn and review the literature on this rare entity. CASE DESCRIPTION: A 1-month-old newborn presented with focal seizures and signs of increased intracranial pressure. Imaging revealed a massive right frontal-parietal GCM, prompting surgical resection. Histopathological examination confirmed the diagnosis of cerebral cavernous malformation. The patient recovered well postoperatively with no neurological deficits. CONCLUSIONS: GCMs are exceedingly rare in children and have not been reported in newborns until now. Symptoms typically include seizures and mass effects. Gross total resection is the standard treatment, offering favorable outcomes. Further research is needed to understand the natural history and optimal management of GCMs, particularly in newborns, emphasizing the importance of heightened clinical awareness for timely diagnosis and appropriate management.

Evaluación de la procalcitonina sérica en recién nacidos a término con sospecha de infección/sepsis / Evaluation of the serum-procalcitonin in full-term newborns with suspicion of infection/sepsis

Tipo de estudio: cohorte prospectivo. Antecedentes: la infección/sepsis bacteriana es una causa importante de morbi-mortalidad en unidades de cuidados intensivos neonatales; siendo la causante de 1.6 millones de muertes a nivel mundial en este grupo etario. Debido a su sintomatología inespecífica y baja sensibilidad de exámenes diagnósticos, los neonatólogos se han visto en la necesidad de usar métodos rápidos, tales como la procalcitonina, para el diagnóstico de infección/sepsis bacteriana al momento de su sospecha. Objetivo: comparar los valores de la procalcitonina con los resultados obtenidos del hemocultivo y los valores de glóbulos blancos en neonatos con diagnóstico de infección/sepsis tardía. Metodología: se realizó un estudio cohorte/prospectivo en la Unidad de Cuidados Intensivos Neonatal (UCIN) del hospital "Dr. Francisco de Ycaza Bustamante", durante el período de tres meses, donde se incluyeron 15 neonatos a término de 2 a 28 días de vida con criterios de sepsis, a quienes se les realizó biometría hemática completa, procalcitonina sérica y hemocultivo; se realizó el seguimiento del grupo de estudio hasta el alta médica o fallecimiento. Resultados: la procalcitonina sérica se efectuó en un total de 15 pacientes, teniendo como punto de corte ≥0.5ng/ml, donde se observ¨® un resultado positivo en 7 pacientes (6.6% ¡Ý0.5ng/ml; 33.3% ¡Ý2ng/ml y 6.6% ¡Ý10ng/ml), obteniéndose una sensibilidad del 75% (IC 95%= 19.41%-99.37%) y especificidad del 63.6% (IC 95%= 30.79%- 89.07%) [p= 0.179]. Conclusiones: se demostró que la elevación de la PCT en pacientes con antecedentes prenatales y cuadro clínico sugestivo de infección/sepsis se correlacionó con el hallazgo de hemocultivo positivo; sin embargo sería deseable a futuro ampliar el universo de pacientes y controlar la PCT sérica cuantitativamente en 48-72 horas de iniciado el tratamiento. (AU)

Type of study: prospective cohort. Background: the bacterial infection/sepsis is one of the main causes of morbid-mortality in Units of Neonatal Intensive Care. It is the cause of 1.6 million of deaths worldwide in this age rage. Due to its nonspecific symptomatology and a low sensibility of diagnostic exams, neonatologists have been obliged to use fast methods, such as procalcitonin for the diagnosis of bacterial infection/sepsis if there is suspicion. Objective: to compare the values of the procalcitonin with the results obtained out of the hemocultive, and the amount of white cells in neonates with a diagnosis of late infection/sepsis. Methodology: a prospective/cohort study was carried out for a period of three months in the Neonatal Intensive Care Unit (NICU) of the hospital ¡°Dr. Francisco de Ycaza Bustamante¡±. Full-term neonates of 2 to 28 days of life with suspicion of sepsis were included in this study. A Complete Hematic Biometrics, a serum procalcitonin and a hemocultive were applied in these neonates, motoring until the medical discharge from the NICU service or until the death of the neonate. Results: the serum procalcitonin was applied in a total of 15 patients, having as cut-off point of ¡Ý0.5 ng/ml, positive results were noticed in 7 patients (6.6% ¡Ý0.5 ng/ml; 33.3% ¡Ý2 ng/ml and 6.6% ¡Ý10 ng/ml), obtaining a sensibility of 75% (IC 95%= 19.41%-99.37%) and Specificity of 63.6% (IC 95%= 30.79%- 89.07%) [p= 0.179]. Conclusions: it was demonstrated that the rise of procalcitonin in patients with prenatal backgrounds and symptoms of infection/sepsis was related to the finding of positive hemocultive. However it would be desirable to increase the universe of patients in the future and control the serum procalcitonin quantitatively in 48-72 hours of having started the treatment