RESUMEN
â¢Mesial temporal sclerosis (MTS) is a potential late complication of hematological malignancies.â¢Seizures are usually drug resistant with MTS yet seizure freedom may be achieved by surgery.â¢Early evaluation for epilepsy surgery is warranted for drug resistant seizures due to AML.
RESUMEN
We report the neurologic and radiologic manifestations of three adolescent girls with acute carbon monoxide poisoning. The girls were found collapsed and unconscious in a bathroom where liquid petroleum gas was being used as heating fuel. As hyperbaric oxygen therapy was not available locally, they only received oxygen supplementation via nasal cannula (4 L/minute) as treatment in the first 2 days. On transfer to a tertiary center in Hong Kong, evolving neurologic manifestations of visual acuity and field deficits, confusion, and focal motor weaknesses were observed. Focal infarctions were evident in cerebral computed tomography in one patient and cortical lesions on magnetic resonance imaging in all three patients. [18F]Fluorodeoxyglucose (FDG) positron emission tomography (PET) revealed additional decreased metabolism in the basal ganglia in two patients, which was typical of carbon monoxide poisoning. The neurologic deficits resolved completely at 3 weeks after the exposure, but psychologic symptoms succeeded. This report serves to alert clinicians to the varied neuro-ophthalmologic manifestations and psychologic impairment even with the same duration of carbon monoxide poisoning. PET might be more sensitive in detecting cerebral injuries specific for carbon monoxide poisoning.
Asunto(s)
Ganglios Basales/metabolismo , Intoxicación por Monóxido de Carbono/complicaciones , Infarto Cerebral/etiología , Confusión/etiología , Trastornos de la Visión/etiología , Enfermedad Aguda , Adolescente , Ganglios Basales/patología , Intoxicación por Monóxido de Carbono/diagnóstico por imagen , Intoxicación por Monóxido de Carbono/terapia , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/metabolismo , Corteza Cerebral/patología , Infarto Cerebral/diagnóstico por imagen , Niño , Confusión/fisiopatología , Femenino , Humanos , Terapia por Inhalación de Oxígeno , Tomografía de Emisión de Positrones , Sobrevivientes , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Trastornos de la Visión/fisiopatologíaRESUMEN
Hemangioma is the most common vascular tumor of infancy; presentation is often as cutaneous infantile hemangioma (IH). Cutaneous hemangioma is a clinical diagnosis. Most IHs follow a benign course, with complete involution without treatment in the majority of cases. Visceral hemangioma often involves the liver and manifests as a life-threatening disorder. Hepatic hemangiomas may be associated with high output cardiac failure, coagulopathy, and hepatomegaly which generally develop between 1 and 16 weeks of age. Mortality has been reportedly high without treatment. We report a rare case of a male infant with neonatal hemangiomatosis with diffuse peritoneal involvement, which mimicked a malignant-looking tumor on imaging, and discuss therapeutic options and efficacy. Propranolol is efficacious for IH but generally not useful for other forms of vascular hemangiomas, tumors, and malformations. In our case of neonatal peritoneal hemangiomatosis, propranolol appears to have halted the growth and possibly expedite the involution of the hemangiomatosis without other treatments.