Welcome to the WSC 2022 Interactive Program
The congress will officially run on Singapore Standard Time (SGT/UTC+8)
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*Please note that all sessions in halls Summit 1, Summit 2 & Hall 406 will be live streamed in addition to the onsite presentation
ASK THE SPEAKER
Sessions in Halls 406, Summit 1 and Summit 2 have a Q&A component, through the congress App called “Ask the Speaker”
PEDIATRIC STROKE IN A NEW-ONSET TYPE 1 DIABETES MELLITUS WITH AND WITHOUT DKA: CASE SERIES.
Abstract
Background and Aims
Background: Neurological deterioration in children with a new-onset diabetes mellitus is caused by cerebral edema. It is associated with diabetic ketoacidosis (DKA) or cerebrovascular accident secondary to a hypercoagulable state and thrombosis produced by prolonged exposure to uncontrolled hyperglycemia. A focal neurological deficit in a newly diagnosed type 1 diabetes mellitus (T1DM) should raise the suspicion of sino-venous or ischemic stroke secondary to thrombosis.
Aim : To determine the causes, clinical and radiological profiles of strokes in children presenting with T1DM
Methods
Methods: A retrospective chart review for all newly diagnosed children with T1DM who presented acutely with clinical and radiological picture suggestive of strokes , and admitted to King Khalid University Hospital,Riyadh, Saudi Arabia over a period of 5 years ( 2015-2020 ).
Results
Results: We identified three cases of pediatric stroke associated with new-onset T1DM. A 24-month-old girl presented with Sino-venous thrombosis related to infection, while the second one was a 7-year-old girl who presented with cortical vein thrombosis. The last one, a 9-year-old girl, was shown in DKA and had a late diagnosis of ischemic stroke and epilepsy following neurological deterioration.
Conclusions
Pediatric stroke in a new-onset T1DM is rare. The physicians should keep a high index of suspicion for patients presenting with DKA, especially the infantile type and those with poor glycaemic control. The presence of intracranial infection and dehydration, even in a negative pro-thrombotic screen, can increase the risk of stroke. Promote diagnosis and medical or mechanical interventions for stroke are associated with reduction of morbidity and mortality.
POSTERIOR CEREBRAL ARTERY DISSECTION IN CHILDREN - A RARE CASE REPORT AND REVIEW OF LITERATURE
Abstract
Background and Aims
Most Intracranial arterial dissections involve the vertebrobasilar system and to a lesser extent the middle and anterior cerebral arteries. Isolated dissection involving the posterior cerebral artery (PCA) is extremely uncommon.
Methods
A twelve-year-old boy, with a normal developmental history and no significant history, presented to the emergency room of our hospital with the complaint of sudden onset diminution of vision for 4 days. He had difficulty seeing objects on the left. It was associated with the headache that was located in occipital region. He also reported an episode of sudden onset numbness in left side of the body.
Results
Visual field testing revealed an incongruous incomplete homonymous hemianopia with macular sparing. MRI brain showed ill-defined area of altered signal intensity in the right occipito-temporal lobe and adjoining part of thalamus with restricted diffusion, consistent with a right sided PCA territory infarct. In MR angiography, there was luminal narrowing and effacement of right sided PCA in the proximal part and the distal branches showed diffuse effacement. DSA revealed acute disruption of right P1-P2 junction, near total occlusion with loss of distal run off due to dissection. The patient was managed with a more conservative approach with low dose anti-platelet therapy and was discharged in a stable condition with improvement reported in the visual deficits.
Conclusions
Isolated PCA dissections are rare and it occur most commonly near the P1-P2 junction. The diagnosis of intracranial dissection and dissecting aneurysms is predominantly made by DSA, which remains the gold standard technique.