Browsing by Author "Tavares, S."
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- Acute Ischemic Stroke in a Child Successfully Treated with Thrombolytic Therapy and Mechanical ThrombectomyPublication . Souto Silva, R.; Rodrigues, R.; Reis Monteiro, D.; Tavares, S.; Pereira, J.; Xavier, J.; Melo, C.; Ruano, L.Acute ischemic stroke in the pediatric population is rare but carries lasting and often lifelong morbidity. Thrombolysis and mechanical thrombectomy are mainstays of care in adults, yet there is very little evidence for these treatments in children. We present the case of a 4-year-old boy with complex congenital heart disease, admitted 30 min after sudden onset of an aphasia and right hemiplegia, scoring 14 on the Pediatric National Institutes of Health Stroke Scale (PedNIHSS). Non-contrast brain computed tomography (CT) showed no evidence of acute ischemia. CT angiogram demonstrated a thrombus in the M1 segment of the left middle cerebral artery. Intravenous recombinant tissue plasminogen activator (rTPA) was infused 3.5 h after onset of symptoms. An improvement was observed in the hour after rTPA, with a PedNIHSS score of 7. Digital subtraction angiography was performed approximately 9 h from the onset of symptoms, showing a complete left M1 occlusion. The patient underwent successful mechanical thrombectomy and was discharged with a PedNIHSS score of 2. This case emphasizes the importance of early recognition to direct children towards rapid diagnosis and hyperacute treatment.
- Quisto dermóide do pavimento da boca: a propósito de dois casos clínicosPublication . Teixeira, S.; Rodrigues, S.; Tavares, S.; Pilar, C.; Rodrigues, C.RESUMO Os quistos dermóides são raros no pavimento da boca. Actualmente são aceites duas teorias quanto à sua etiologia: a congénita e a adquirida. Podem classificar-se de acordo com a sua origem embriológica, localização e histologia. Habitualmente apresentam-se como tumefacção mole não dolorosa, de crescimento lento, estando os sintomas dependentes da localização e suas relações de vizinhança anatómica. O tipo de abordagem cirúrgica está dependente da sua localização, sendo o prognóstico bom. Os autores apresentam os casos clínicos de duas crianças com quisto dermóide do pavimento da boca, submetidos a exérese cirúrgica. Num dos casos é colocada a hipótese de se tratarem de dois quistos síncronos. ABSTRACT Dermoid cysts of the mouth floor are rare. Two theories are accepted for their origin: congenital or acquired. Classification is based on location, embryologic origin and histologic findings. They are painless and slow growing, and symptons depend on the location and relationships with other structures. The type of surgical approach is dependent on the location, and the prognosis is good. The authors present the case report of two children with dermoid cysts of the mouth floor, who underwent surgical resection. In one of the cases it is discussed the hypothesis of being two cysts concomitantly.
- Tics en niños y adolescentes:análisis retrospectivo de 78 casosPublication . Prior, C.; Tavares, S.; Figueiroa, S.; Temudo, T.Introducción Los tics son el trastorno del movimiento más frecuente en la edad pediátrica. Es común la existencia de historia familiar de tics y de antecedentes familiares y personales de trastornos neurocomportamentales. Los tics pueden comprometer de modo importante las actividades de la vida diaria del individuo. Objetivo Estudio de las características de los tics de niños y adolescentes de la Consulta de Neuropediatría del Hospital Geral de Santo António. Materiales y métodos Análisis retrospectivo de los casos de tics usando la información recogida de las respectivas historias clínicas. Se utilizaron los criterios del Manual diagnóstico y estadístico de los trastornos mentales en su cuarta revisión de textos (DSM-IV-TR) de 2000, de la Asociación Americana de Psiquiatría. Resultados Fueron analizadas las historias clínicas de 78 individuos, 84,6 % de los cuales eran del sexo masculino. Más de un tercio de los casos pertenecía al grupo etario de los 4 a los 8 años de edad. En el 5,1% los tics se iniciaron antes de los 2 años. Historia familiar de tics, depresión y trazos de enfermedad obsesivo-compulsiva ocurrieron en aproximadamente un 30 % de los casos. La comorbilidad más frecuente fue el trastorno por déficit de atención e hiperactividad (TDAH) (67,9%). Se verificó la posible ocurrencia de trastorno neuropsiquiátrico autoinmune pediátrico (PANDAS) en 5 casos. Los tics motores precedieron a los vocales en todos los casos. En más de dos tercios los tics eran simples. En el 59,0 % de los casos los tics eran crónicos, y el 45,7 % de éstos cumplían criterios de trastorno de Gilles de la Tourette. El 43,1 % de los individuos con tics crónicos habían sido medicados, la mayoría con risperidona. Conclusiones De un modo general los resultados de este estudio son concordantes con los descritos en la literatura especializada, subrayándose la necesidad de considerar el diagnóstico en edades precoces, y señalándose la importancia de identificación y terapéutica adecuada de las comorbilidades.Introduction Tics are the most frequent abnormal movement in children. A familial history of tics and a personal and familial history of neurobehavioral disturbances are common in children with this abnormality. Tics may seriously compromise daily activities in affected individuals. Objective To identify the characteristics of tics in children and adolescents followed-up in the Neuropediatric Unit of the Hospital Geral de Santo António. Materials and methods We performed a retrospective analysis of patients with tics based on information collected from medical records. The diagnostic criteria of the DSM IV-TR 2000 of the American Psychiatric Association were used. Results The medical records of 78 children were analyzed, 84.6% of whom were boys. More than one third of the patients were aged 4 to 8 years old. In 5.1% of the patients tics developed before the age of 2 years. A familial history of tics, depression and obsessive disorder traits was found in approximately 30 % of patients. The most frequent comorbidity was attention deficit hyperactivity disorder (67.9 %). The occurrence of pediatric autoimmune neuropsychiatric disorders associated with streptococcus infection (PANDAS) was suggested in five patients. In all patients, motor tics occurred before vocal tics. In more than two thirds of the patients, tics were simple. In 59.0% of the patients, tics were chronic, and in 45.7% of these met the criteria for Tourette’s syndrome. A total of 43.1% of the patients with chronic tics received pharmacotherapy, risperidone being the most frequently used drug. Conclusions In general the results of the present study are in agreement with those of previous studies, underlining the need to consider a diagnosis of tics in young children and highlighting the importance of identification and appropriate treatment of comorbidities.
- Tiques em crianças e adolescentes Revisão teórica e abordagem terapêuticaPublication . Prior, A.; Tavares, S.; Figueiroa, S.; Temudo, T.RESUMO Os tiques são o distúrbio do movimento mais comum em crianças e adolescentes. São mais frequentes no sexo masculino que no feminino, e podem começar a manifestar-se já no primeiro ano de vida. O espectro de gravidade dos tiques é muito amplo, podendo passar praticamente despercebidos ou, pelo contrário, apresentar evidentes repercussões negativas nos vários aspectos da vida dos doentes. A sua associação a distúrbios neurocomportamentais como a perturbação de hiperactividade e défice de atenção, comportamentos obsessivocompulsivos e dificuldades de aprendizagem é frequente, aspecto que deverá ser tido em conta aquando do estabelecimento do plano terapêutico. Os autores apresentam uma revisão teórica versando os Transtornos de Tiques, na qual incluem a sua abordagem terapêutica, considerando a existência de co-morbilidade(s).