Hyperechoic lesions in the basal ganglia: An incidental sonographic finding in neonates and infants

Cerebral ultrasound (US) imaging was performed as a screening procedure in approximately 3,600 neonates and infants over a period of 18 months. Hyperechoic lesions in the basal ganglia and thalamic region were detected incidentally in 15 of these patients. Clinical diagnoses included cytomegalovirus infection, asphyxia, rotavirus infection, prematurity, amniotic infection, dysmorphic stigmata, hyperbilirubinemia, congenital heart disease, and diabetic fetopathia. Lesions showed a single punctate (n=5), multiple punctate (n=8), or stripe-like pattern (n=2), with no disease-specific distribution. Computed tomography performed in two of the 15 patients was normal. Lesions resolved within four to seven months in four of eleven cases who had follow-up studies, whereas echogenicities persisted in the remaining seven patients over a period of observation ranging between one to 15 months. Our results indicate that hyperechoic lesions in the basal ganglia and thalamic region may be associated with congenital infections and asphyxia, but could indicate some other unknown pathology. No correlation was found between the morphology of foci and both clinical diagnosis and results of follow-up studies.     

Primary intracranial abscess localized in the basal ganglia: a case report

Brain abscesses are serious infections that cause neurological problems and generally require antibiotic treatment and surgical drainage. Hematogenous brain abscesses are generally located in the region fed by the middle cerebral artery, but are occasionally found in deep tissues, such as the basal ganglia and thalamus.     

特发性基底节钙化症一家三例报告

先证者女,13岁,因头晕4 d,抽搐1次入当地县医院.既往体健.体检:身高119.5 cm,体重25 kg,体形匀称,第二性征未出现,神清语利,心肺无异常,肝右肋下4 cm,质中,脾左肋下恰及.神经系统体征均阴性.腹部及甲状腺B超未见异常;头颅CT:颅内广泛钙化(图1),血电解质正常.当时未能确诊,经当地治疗无好转于5 d后死亡,具体死因不详.因患儿存在体格发育明显落后及颅内广泛钙化,疑为遗传代谢性疾病,故其直系家属均进行了头颅CT检查,发现先证者两个妹妹均存在颅内广泛钙化.为求进一步诊治而转我院,我院综合其临床表现、血液生化检查结果、头颅CT和家族发病等特点,排除其他继发因素后,诊断为特发性基底节钙化症.     

Beckwith-Wiedemann syndrome and splenic hemangioma: report of a case

Surveillance sonography is performed in Beckwith-Wiedemann syndrome because of the risk of malignant tumors. Benign neoplasms, although reportedly less common, also occur. A splenic hemangioma was found in a patient by routine sonography. Received: 30 January 1996 Accepted: 28 June 1996     

儿童 IgA 肾病合并膀胱血管瘤 1 例报告并文献复习

目的探讨儿科临床血尿性疾病的诊断思路。方法总结分析1例IgA肾病合并多发性膀胱血管瘤患儿的临床资料。结果女性患儿,9岁,临床表现为多次呼吸道感染后诱发间断肉眼血尿、持续性镜下血尿,伴尿中血凝块6年余,尿常规蛋白+++,RBC满视野/HP;24 h尿蛋白定量0.54~1.02 g,肾早期损伤指标以微量白蛋白为主;腹部、泌尿系超声未见异常;泌尿系增强CT扫描未见异常;肾动脉造影未见动静脉畸形或瘘;肾活检病理诊断为局灶增生性IgA肾病;膀胱镜检查提示多发性血管瘤。结论儿童膀胱血管瘤临床较为罕见,对于表现为肉眼血尿伴血凝块,影像学检查无明确异常或其他疾病者,如IgA肾病诊断后治疗不满意,应行膀胱镜检查,以除外膀胱血管瘤的可能。     

Moebius syndrome with central hypoventilation and brainstem calcification: a case report

Moebius syndrome (MS) is described in an infant with central hypoventilation and brainstem calcification. The patient had limb defects and bilateral paralysis of the 6th, 7th, 9th, 10th, and 12th cranial nerves. Mechanical ventilation was continued from birth because of shallow spontaneous respiration. Computed tomography revealed brainstem atrophy and four small calcifications restricted to the dorsal portion of the pons and medulla. Prenatal brainstem injury such as ischaemia may have caused MS and central hypoventilation.     

轻微外伤和基底节钙化可能是儿童卒中的危险因素

儿童脑卒中的危险因素远较成人复杂,包括心脏病、血液系统紊乱、感染、血管性疾病、外伤以及遗传代谢性疾病等[1-2].外伤在儿童期非常常见,但90%以上为轻微或较轻微的外伤[3],多无明显临床表现,但近年来,常有轻微头外伤后发生脑卒中的报道[4-6],发病机制不详.我院医治29例发病前仅有轻微外伤的脑卒中患儿,现对其临床表现及影像学检查分析如下,以探讨脑卒中可能的发病机制.     

Diffuse intracerebral calcification in a beta-thalassaemia major patient with hypoparathyroidism: a case report

Beta-thalassemia major is a complex medical problem found worldwide. Endocrinopathies are some of the most frequent dysfunctions found in these patients. Iron overload in different organs is responsible for multiple endocrine complications particularly in the absence of adequate chelation therapy. One of the most prevalent endocrine complications of thalassemia major is hypoparathyroidism. It can cause cerebral calcifications in the basal ganglia but seldom outside of the extrapyramidal system. There are few studies about intracerebral calcification due to hypoparathyroidism in patients with thalassemia major. We report the case of a 14 year-old girl who came to our Center with the chief complaint of a generalized tonic-clonic seizure. The patient was known to have beta-thalassemia major since she was 9 months old. Computerized tomographic scan of the brain was done which showed diffuse intracranial calcifications in deep white matter, posterior fossa, basal ganglia and both thalami. Laboratory and neuroimaging assessments revealed the diagnosis of hypoparathyroidism. We strongly recommend periodic assessment and tight control of serum calcium level in all patients with betathalassemia major. Prompt treatment with oral calcium supplements and an active form of vitamin D can prevent hypoparathyroidism and its neurologic complications. Comprehensive evaluation and treatment of other endocrinopathies in accordance with hypoparathyroidism is suggested.     

Incidental finding of idiopathic unilateral adrenal calcification in an 18-month-old child: case report and review of the literature

The presence of calcified lesions in the adrenal gland requires a careful endocrine, microbiological and radiological evaluation combined with detailed clinical history to confirm its non-evolving nature and avoid unnecessary surgery. We report an 18-month-old male child hospitalized with an incidentally discovered calcification in his right adrenal gland. All biochemical data as well as liver, renal and adrenal function tests were normal. Abdominal computed tomography scan showed that the right adrenal gland was completely occupied by a large calcification, which was put in relationship with an undetected adrenal distress during the neonatal period, as macrosomy and clavicle fracture of the newborn could let us suggest. Our report describes the diagnostic approach to disclose the nature of a suprarenal mass, which is particularly problematic when this is found incidentally. In addition, an extensive review of the medical literature dealing with non-traumatic adrenal calcifications and haemorrhages in children has been carried out.     

Congenital bilateral agenesis of diaphragm: report of a case

Bilateral agenesis of the diaphragm is a rare, life-threatening malformation. Infants with this defect rarely survive to have surgical intervention. We report a 32-week premature female infant who was born to a 36-year-old mother via vaginal delivery. The pregnancy course was complicated by hypertension and polyhydramnios. Cytogenetic study showed a normal 46 XX female karyotype. She had cyanosis, respiratory distress and scaphoid abdomen at birth. A roentgenograph confirmed the diagnosis of diaphragmatic hernia. Surgery was performed at 21 h of age. Bilateral agenesis of diaphragm, herniation of abdominal organs and oesophagus and pulmonary hypoplasia were noted. Furthermore, stomach and spleen were adherent to the mediastinum and vertebrae. The patient developed hypotension and persistent hypoxaemia and expired at age of 26 h. Autopsy revealed bilateral agenesis of diaphragm, hypoplasia of lungs, and pancreas fibrosis with mild hypoplasia of islets of Langerhans. Conclusion Bilateral agenesis of diaphragm associated with pancreas fibrosis is a rare entity, and its clinical significance needs further investigation. Received: 26 September 1996 / Accepted: 17 December 1996     

Idiopathic infantile arterial calcification: a case report and review of the literature

Idiopathic infantile arterial calcification (IIAC) was diagnosed radiologically in an infant with sudden onset of heart failure. The clinical picture, radiological, laboratory and postmorten findings, are described in detail. There was no family history and a metabolic abnormality could not be detected.Calcifications of major arteries and particularly ligaments are pathognomonic radiologic signs of this condition but diagnosis of IIAC during life has been established only rarely. The value of early diagnosis is emphasised.     

Vaginal hemangioma revealed by bleeding in a girl: a case report]

We report on the case of a 9-year-old girl who presented vaginal bleeding which led to the diagnosis of vaginal hemangioma. Such localisation is rare, and requires a clinical follow-up by vaginoscopy. A spontaneous regression can be expected but, at this time, the progress of puberty and future fertility are unknown.     

Amniotic band sequence and bilateral choanal atresia: a case report

Amniotic band sequence (ABS) is a group malformation that mainly affects limbs; clinically, constriction rings and lymphedema of the fingers, arms and legs, acrosyndactyly and pseudosyndactyly are observed; also there is congenital amputation of limbs due to distal swelling. Less frequently, craniofacial and trunk involvement are reported in some patients. Etiology is still unknown and most cases are isolated. In this report we present the case of a 45-day-old male with diagnosis of SBA and bilateral choanal atresia as attached finding, and review possible causes of SBA and associated alterations.