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4 results

  • 11 - What Are Essential Pediatric Epilepsy Clinical Diagnoses and Treatment Plans?

  • Patrick Landazuri, University of Kansas Medical Centre, Nuria Lacuey Lecumberri, University of Texas Health Science Center, Houston, Laura Vilella Bertran, University of Texas Health Science Center, Houston, Mark Farrenburg, University of Kansas Medical Centre, Samden Lhatoo, University of Texas Health Science Center, Houston
  • Book:
    Seizure and Epilepsy Care
    Published online:
    28 January 2023
    Print publication:
    09 February 2023, pp 186-220

  • Summary

    Pediatric epilepsy is a broad topic with specific syndromes highlighted in this chapter. A thorough discussion for the evaluation and management of febrile seizures is first. The chapter then transitions to a discussion of high-yield epileptic and developmental encephalopathies. Examples include diagnoses like infantile spasms, Dravet syndrome, and FIRES (febrile infection-related epilepsy syndrome). The chapter than progresses toward the self-limiting epilepsy of childhoods and a discussion of clinical features, management, and long-term prognosis.The generalized epilepsies are then discussed since they commonly commence in the pediatric time period. High-yield EEG examples are provided as they so frequently confirm the diagnosis. Specific neurocutaneous syndromes are next reviewed in a concise table that defines key differences and diagnostic criteria.Lastly, the two diagnoses of Rasmussen’s encephalitis and hemimegaloencephaly that can benefit from early consideration of hemispherectomy are reviewed.

  • Chapter 14 - Emergency Prescribing in Neurosurgery

  • from Part 3 - Emergency Prescribing
  • Edited by Hugh Montgomery, Robert Shulman, Mayur Murali
  • Book:
    Surviving Prescribing
    Published online:
    08 June 2020
    Print publication:
    25 June 2020, pp 57-60

  • Summary

    While the neurosurgical patient is not normally one junior prescribers should be caring for in a nonspecialist area, they may encounter them in the acute setting while a referral is being made. Readers are provided with key information on the management of subarachnoid haemorrhage, including how to manage blood pressure, prevent vasospasm and rebleeding. Adjuncts to reduce the chances of secondary brain injury, including steroids, mannitol and anticonvulsants, are also discussed, while the importance of good quality analgesia is also emphasised.

  • Factors affecting vascular access complications in children undergoing congenital cardiac catheterization

  • Alaa M. Roushdy, Noha Abdelmonem, Azza A. El Fiky
  • Journal:
    Cardiology in the Young / Volume 22 / Issue 2 / 02 March 2012
    Published online by Cambridge University Press:
    25 July 2011, pp. 136-144
  • Background

    Complications at the vascular access sites are among the most common adverse events in congenital cardiac catheterization. The use of small-gauge catheters may reduce these events; however, other factors can contribute to the development of vascular complications.

    Objectives

    To determine factors associated with the development of vascular access complications in children undergoing congenital cardiac catheterization.

    Methods

    We performed a prospective study of 403 patients who underwent diagnostic (62.5%) or interventional (37.5%) cardiac catheterization over a period of 6 months, and analysed the vascular complications during and immediately after the procedure.

    Results

    The most common access-related adverse event was transient loss of pulsation (17.6%). Other less common access-related adverse events included subcutaneous haematoma (2%), bleeding (3%), vessel tear (0.2%), and vein thrombosis (0.2%). Patients who had no access-related adverse events had significantly higher age and body weight compared with those who had one or more access problems. Among 81 patients who had vascular access established in unplanned access sites, 30 patients (37%) had lost pulsations. Among the 322 patients who had vascular access established in planned access sites, however, only 41 patients had lost pulsation (13%). In addition, patients who had lost pulsations had significantly longer puncture time compared to those who had normal pulsations (p value 0.01).

    Conclusion

    Factors other than sheath size can contribute to access-related adverse events in children undergoing cardiac catheterization. Obtaining vascular access in unplanned access sites and longer puncture times increases the incidence of lost pulsations after catheterization. Younger age and smaller body weight are also associated with significant increase in access-related adverse events.