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Changes in EEG following surfactant therapy
Posters, Varia (V)
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cause of focal epilepsy and headache in the pediatric age group. 149V Early clinical symptoms of perinatal stroke R. Laugesaar1 , A. Kolk2 , I. Talvik2 , T. Talvik1 . 1 Children’s Clinic of Tartu University, Tartu, Estonia, 2 Unit of Neurology, Children’s Clinic of Tartu University Hospital, Tartu, Estonia Introduction: The incidence of perinatal stroke (PS) in Estonia is 63 per 100,000 live births and about 2/3 are diagnosed later when hemiparesis or seizures are noted and neuroimaging reveals evidence of a remote vascular event. Aim: To investigate signs and symptoms of the immediate postnatal period of children with early and delayed diagnosis of PS and to find out how it is feasible to promote earlier diagnosis of PS. Methods: A retro- and prospective study (1994 2006) was performed in the Children’s Clinic of Tartu University Hospital. From a total of 55 children with PS (gw > 32 weeks) 30 patients (15 boys, 15 girls) born in Women’s Clinic of Tartu University Hospital were selected into the study. In all cases, the diagnosis of PS was confirmed by neuroradiology (CT, MRI). History of early postnatal period was obtained from the obstetrical reports. Results: See the table. Sign/symptom
Muscular tone changes Respiratory problems Disturbed level of alertness Seizures Feeding difficulties Neurologically asymptomatic
Diagnosis of PS Early No = 12
Delayed No = 18
11 (92%) 9 (75%) 6 (50%) 6 (50%) 2 (17%) 0
6 (33%) 2 (11%) 1 (6%) 0 0 12 (67%)
Discussion: As described earlier main clinical findings of children with PS in the neonatal period were seizures and disturbed level of alertness. This study revealed that muscular tone changes were the additional important symptoms after birth in children with early and delayed diagnosis of PS. We can conclude that one third of cases of delayed diagnosis may be diagnosed in time if the changes of muscle tone can serve as the indication for the neuroimaging and may lead to early diagnosis of PS. 150V Cerebral venous thrombosis in child early intervention
the role of the
M. Budisteanu, C. Burloiu, A.M. Dumea, S. Magureanu. Clinical Hospital of Psychiatry, Bucharest, Romania Objective: The aim of this paper is to present the significance of the early diagnosis and treatment in cerebral venous thrombosis in child, starting from a clinical case. Material and Method: We present the case of a boy, 1 years 8 months old, admitted in our department for coma, tetraparesis involving especially the right limbs; these features occurred after a respiratory infection. The paraclinical exams included cerebral CT scan, cerebral MRI, EEG, coagulation tests. Results: Cerebral MRI showed cerebral venous thrombosis with left thalamic ischemic stroke. Anticoagulation therapy (first with heparine, then oral anticoagulation), antibiotherapy, cerebral depletion, was started immediately after establishment of the diagnosis (3 days); also, kinetotherapy was started early. The outcome was good, with significant improvement of the motor deficits and cognitive status. Conclusions: Cerebral venous thrombosis can present with severe manifestations, often threathening the child’s life. An early diagnosis and a proper therapy allow a good recovery.
151V Changes in EEG following surfactant therapy W. Podraza1 , H. Podraza1 , J. Rudnicki2 . 1 Department of Medical Physics, Pomeranian Medical University, Szczecin, Poland, 2 Department of Neonatology, Pomeranian Medical University, Szczecin, Poland Purpose: To evaluate possible changes in EEG during surfactant therapy and to discuss literature data. Materials and Methods: We have performed nine channels video-EEG in preterm neonate born in 25th week of gestational age, weighted 680 grams, 2 hours after birth, before, during and after administration of natural surfactant. Results: Electrographic discontinuity was seen during entire recording. Interburst intervals (inactive EEG periods) lasted up to 34 seconds before, and up to 24 seconds after surfactant administration. That pattern looks like depression in EEG, but it is normal EEG activity of an immature brain. Interburst intervals, in period of 30 minutes of the record with no artifacts, before and after surfactant administration lasted 11 minutes 58 seconds, and 7 minutes 11 seconds, respectively. Discussion: We have not observed EEG depression after surfactant therapy. There are inconsistent data in the literature. The authors who observed EEG depression have aEEG (amplitude-integrated used the different method EEG) with semilogarithmic amplitude compression, peak rectification and smoothing. The processing might cause misinterpretation of the data. Video-EEG can provide continuous acquisition of more information in the same time than aEEG and is good diagnostic tool to verify presented problem. More patients in the study are required for further conclusions. 152V Spinal cord subdural hematoma 1
case report
1
V. Sabolic Avramovska , M. Kuturec , F. Duma1 , O. Lekovska1 , N. Angelkova, J. Ugrinovski2 , B. Ilievski3 , G. Damjanovski4 . 1 University Children hospital, Skopje, R. Macedonia, 2 Neurosurgery Clinic, Skopje, R. Macedonia, 3 Institute of Pathology, Skopje, R. Macedonia, 4 Radiology Institute, Skopje, R. Macedonia Background: Spinal cord subdural haematoma in childhood is rare condition. It is commonly caused by trauma, vascular malformation or bleeding diathesis. Vascular malformation is rare and difficult to document. When the malformation has significant intramedullar component or haemorrhage causing compressive symptoms it can be identified and localized with MRI or MRA. Methods: Standard neuropediatric examination, lumbar puncture, MRI. Case report: A six month female infant was admitted because of hypotony of neck, arms, lack of movements and poor feeding. These symptoms developed suddenly seven days before admission with crying and irritability, usually when parents put her to lay in a prone position. In few days she developed flaccid paralysis of upper extremities. Parents denied trauma or infection. Blood analyses were normal. On lumbar puncture the cerebrospinal fluid was bloody. CT and MRI scanning confirmed presence of subdural haematoma in cervico thoracic region C7-Th2. Spinal surgery was performed, evacuation of haematoma was done and bleeding like a spike formation of pia mater was removed. After operation she completely recovered. 153V Natural history of multiloculated hydrocephalus L. Sagan1 , G. Hnatyszyn2 . 1 Department of Neurosurgery, Pomeranian Medical University, Szczecin, Poland, 2 Department of Neonatology, Pomeranian Medical University, Szczecin, Poland Purpose: In purpose to better understand the mechanisms of multiloculated hydrocephalus (MLH) development we analyzed sequence of events leading to intraventricular septa
S67
cause of focal epilepsy and headache in the pediatric age group. 149V Early clinical symptoms of perinatal stroke R. Laugesaar1 , A. Kolk2 , I. Talvik2 , T. Talvik1 . 1 Children’s Clinic of Tartu University, Tartu, Estonia, 2 Unit of Neurology, Children’s Clinic of Tartu University Hospital, Tartu, Estonia Introduction: The incidence of perinatal stroke (PS) in Estonia is 63 per 100,000 live births and about 2/3 are diagnosed later when hemiparesis or seizures are noted and neuroimaging reveals evidence of a remote vascular event. Aim: To investigate signs and symptoms of the immediate postnatal period of children with early and delayed diagnosis of PS and to find out how it is feasible to promote earlier diagnosis of PS. Methods: A retro- and prospective study (1994 2006) was performed in the Children’s Clinic of Tartu University Hospital. From a total of 55 children with PS (gw > 32 weeks) 30 patients (15 boys, 15 girls) born in Women’s Clinic of Tartu University Hospital were selected into the study. In all cases, the diagnosis of PS was confirmed by neuroradiology (CT, MRI). History of early postnatal period was obtained from the obstetrical reports. Results: See the table. Sign/symptom
Muscular tone changes Respiratory problems Disturbed level of alertness Seizures Feeding difficulties Neurologically asymptomatic
Diagnosis of PS Early No = 12
Delayed No = 18
11 (92%) 9 (75%) 6 (50%) 6 (50%) 2 (17%) 0
6 (33%) 2 (11%) 1 (6%) 0 0 12 (67%)
Discussion: As described earlier main clinical findings of children with PS in the neonatal period were seizures and disturbed level of alertness. This study revealed that muscular tone changes were the additional important symptoms after birth in children with early and delayed diagnosis of PS. We can conclude that one third of cases of delayed diagnosis may be diagnosed in time if the changes of muscle tone can serve as the indication for the neuroimaging and may lead to early diagnosis of PS. 150V Cerebral venous thrombosis in child early intervention
the role of the
M. Budisteanu, C. Burloiu, A.M. Dumea, S. Magureanu. Clinical Hospital of Psychiatry, Bucharest, Romania Objective: The aim of this paper is to present the significance of the early diagnosis and treatment in cerebral venous thrombosis in child, starting from a clinical case. Material and Method: We present the case of a boy, 1 years 8 months old, admitted in our department for coma, tetraparesis involving especially the right limbs; these features occurred after a respiratory infection. The paraclinical exams included cerebral CT scan, cerebral MRI, EEG, coagulation tests. Results: Cerebral MRI showed cerebral venous thrombosis with left thalamic ischemic stroke. Anticoagulation therapy (first with heparine, then oral anticoagulation), antibiotherapy, cerebral depletion, was started immediately after establishment of the diagnosis (3 days); also, kinetotherapy was started early. The outcome was good, with significant improvement of the motor deficits and cognitive status. Conclusions: Cerebral venous thrombosis can present with severe manifestations, often threathening the child’s life. An early diagnosis and a proper therapy allow a good recovery.
151V Changes in EEG following surfactant therapy W. Podraza1 , H. Podraza1 , J. Rudnicki2 . 1 Department of Medical Physics, Pomeranian Medical University, Szczecin, Poland, 2 Department of Neonatology, Pomeranian Medical University, Szczecin, Poland Purpose: To evaluate possible changes in EEG during surfactant therapy and to discuss literature data. Materials and Methods: We have performed nine channels video-EEG in preterm neonate born in 25th week of gestational age, weighted 680 grams, 2 hours after birth, before, during and after administration of natural surfactant. Results: Electrographic discontinuity was seen during entire recording. Interburst intervals (inactive EEG periods) lasted up to 34 seconds before, and up to 24 seconds after surfactant administration. That pattern looks like depression in EEG, but it is normal EEG activity of an immature brain. Interburst intervals, in period of 30 minutes of the record with no artifacts, before and after surfactant administration lasted 11 minutes 58 seconds, and 7 minutes 11 seconds, respectively. Discussion: We have not observed EEG depression after surfactant therapy. There are inconsistent data in the literature. The authors who observed EEG depression have aEEG (amplitude-integrated used the different method EEG) with semilogarithmic amplitude compression, peak rectification and smoothing. The processing might cause misinterpretation of the data. Video-EEG can provide continuous acquisition of more information in the same time than aEEG and is good diagnostic tool to verify presented problem. More patients in the study are required for further conclusions. 152V Spinal cord subdural hematoma 1
case report
1
V. Sabolic Avramovska , M. Kuturec , F. Duma1 , O. Lekovska1 , N. Angelkova, J. Ugrinovski2 , B. Ilievski3 , G. Damjanovski4 . 1 University Children hospital, Skopje, R. Macedonia, 2 Neurosurgery Clinic, Skopje, R. Macedonia, 3 Institute of Pathology, Skopje, R. Macedonia, 4 Radiology Institute, Skopje, R. Macedonia Background: Spinal cord subdural haematoma in childhood is rare condition. It is commonly caused by trauma, vascular malformation or bleeding diathesis. Vascular malformation is rare and difficult to document. When the malformation has significant intramedullar component or haemorrhage causing compressive symptoms it can be identified and localized with MRI or MRA. Methods: Standard neuropediatric examination, lumbar puncture, MRI. Case report: A six month female infant was admitted because of hypotony of neck, arms, lack of movements and poor feeding. These symptoms developed suddenly seven days before admission with crying and irritability, usually when parents put her to lay in a prone position. In few days she developed flaccid paralysis of upper extremities. Parents denied trauma or infection. Blood analyses were normal. On lumbar puncture the cerebrospinal fluid was bloody. CT and MRI scanning confirmed presence of subdural haematoma in cervico thoracic region C7-Th2. Spinal surgery was performed, evacuation of haematoma was done and bleeding like a spike formation of pia mater was removed. After operation she completely recovered. 153V Natural history of multiloculated hydrocephalus L. Sagan1 , G. Hnatyszyn2 . 1 Department of Neurosurgery, Pomeranian Medical University, Szczecin, Poland, 2 Department of Neonatology, Pomeranian Medical University, Szczecin, Poland Purpose: In purpose to better understand the mechanisms of multiloculated hydrocephalus (MLH) development we analyzed sequence of events leading to intraventricular septa