Author Of 2 Presentations
THE USE OF CONTINUOUS ELECTROENCEPHALOGRAM MONITORING TO DETECT LATE ONSET OF SUBCLINICAL SEIZURES AND ABNORMAL HEAD MRI IMAGE IN INFANTILE ABUSIVE HEAD TRAUMA- CASE REPORT
Abstract
Background
Some infants with traumatic brain injury have been reported having biphasic clinical courses with abnormal head magnetic response imaging (MRI) images resembling acute encephalopathy with biphasic seizures and late reduced diffusion (AESD), which is the most common encephalopathy in Japanese children.
Objectives
We report a Japanese case of infantile traumatic brain injury with a biphasic clinical course and abnormal late head MRI image resembling AESD. It was diagnosed as abusive head trauma (AHT).
Methods
Case report.
Results
Case: A previously healthy 8-mouth-old boy fell backwards and presented with seizures for sixty minutes. Right after arrival, he was intubated because of consciousness disturbance. Brain computed tomography (CT) showed right acute subdural hematoma. He underwent barbiturate coma therapy (BCT) for the next 48 hours aiming at suppression-burst pattern on continuous electroencephalogram (cEEG) due to prolonged seizures. On day four, he had second phase of seizures detected by cEEG monitoring. Therefore, he underwent BCT for the next 48 hours again. On day five, he underwent brain MRI showing subcortical white matter lesions on diffusion-weighed image, mimicking AESD. On day thirty-six, he was discharged with developmental regression and tubal enteral feeding.
Conclusion
Late onset of subclinical seizures in infantile head trauma can be successfully detected by using cEEG for further neurological treatment.
MEDICAL MANAGEMENT OF CHILDREN, NEONATES, AND PREGNANT WOMEN OF OSAKA EARTHQUAKE 2018, JAPAN.
Abstract
Background
Children, neonates and pregnant women are most vulnerable population in disasters. However there were few pediatricians, neonatologists and obstetricians in Japan DMAT (Disaster Medical Assistance Team), so disaster medical headquarters had limited intelligence to treat these problems. We trained pediatric and perinatal disaster medical liaison (PPDML) to improve disaster medical managements for children and pregnant women since 2016.
Objectives
We analyze and report medical management of Osaka earthquake 2018.
Methods
We reviewed the records of PPDML in disaster drills and Osaka earthquake 2018.
Results
Japan DMAT had annual disaster drills, and PPDML participated the drill for the first time in July 2017. In the drill, PPDML coordinated the pediatric and perinatal issues with Japan DMAT and JGSDF (Japan Ground Self-Defense Force) in disaster headquarters. And of this disaster, PPDML coordinated the transport of 22 children and babies with congenital heart disease from damaged National Cerebral and Cardiovascular Center Hospital. The operation was finished within 5 hours after request transportation.
Conclusion
To protect children and pregnant women, cooperation between disaster medical network and pediatric and perinatal network is absolutely important of any phase in disaster. Because PPDML had attended in the disaster drills before the earthquake occurred, the experience could make PPDML to achieve good performance in real disaster. So we conclude cooperation between disaster medical network and PPDML is very useful to manage the disaster issues for children and pregnant women, and the most important thing is to cooperate not only in disaster, but also in ordinary days.
Presenter of 1 Presentation
THE USE OF CONTINUOUS ELECTROENCEPHALOGRAM MONITORING TO DETECT LATE ONSET OF SUBCLINICAL SEIZURES AND ABNORMAL HEAD MRI IMAGE IN INFANTILE ABUSIVE HEAD TRAUMA- CASE REPORT
Abstract
Background
Some infants with traumatic brain injury have been reported having biphasic clinical courses with abnormal head magnetic response imaging (MRI) images resembling acute encephalopathy with biphasic seizures and late reduced diffusion (AESD), which is the most common encephalopathy in Japanese children.
Objectives
We report a Japanese case of infantile traumatic brain injury with a biphasic clinical course and abnormal late head MRI image resembling AESD. It was diagnosed as abusive head trauma (AHT).
Methods
Case report.
Results
Case: A previously healthy 8-mouth-old boy fell backwards and presented with seizures for sixty minutes. Right after arrival, he was intubated because of consciousness disturbance. Brain computed tomography (CT) showed right acute subdural hematoma. He underwent barbiturate coma therapy (BCT) for the next 48 hours aiming at suppression-burst pattern on continuous electroencephalogram (cEEG) due to prolonged seizures. On day four, he had second phase of seizures detected by cEEG monitoring. Therefore, he underwent BCT for the next 48 hours again. On day five, he underwent brain MRI showing subcortical white matter lesions on diffusion-weighed image, mimicking AESD. On day thirty-six, he was discharged with developmental regression and tubal enteral feeding.
Conclusion
Late onset of subclinical seizures in infantile head trauma can be successfully detected by using cEEG for further neurological treatment.