Rejected

Posterior reversible encephalopathy syndrome is potentially reversible clinicoradiological syndrome. In this study we explored potential, clinical and radiological presentation, risk factor and outcome of patient.

Post-traumatic headache is the most common sequela of brain injury and can last months or years after the damaging event. Many headache types are associated with visual concerns also known to stem from concussion.

A major barrier to adequate headache care is the relative lack of formal education and training of healthcare professionals. Concerted efforts should be made to pinpoint major gaps in knowledge in healthcare professionals to facilitate better educational policies in headache training. The aim of this study was to identify deficiencies and barriers in headache training among residents in neurology in Denmark.

Infectious myositis, whether viral or bacterial, is frequent in pediatric age. It causes muscle pain and weakness, associated with fever and general malaise. One cause is Bartonella henselae, responsible for cat scratch disease, which sometimes causes systemic symptoms. We report the case of an adolescent who came to the emergency room with intense myalgia, malaise, weight loss and splenomegaly. Blood tests showed high inflammatory markers. She had been in touch with a cat. Studies were carried out including: lower limbs MRI suggestive of bilateral inflammatory myositis, abdominal MRI with three previously undetected splenic lesions and dilated fundus examination that showed possible retinal arterial occlusion or vasculitis. After 21 days of intravenous antibiotic therapy (cefotaxime + cloxaciline), she became asymptomatic, but inflammatory markers remained high. Suspecting Bartonella henselae infection (myositis + chorioretinitis + splenic abscess), oral azithromycin and rifampicin were prescribed for 14 days. Blood tests and control MRI became normal, and IgG was positive.

The pandemic that resulted from the spread of SARS-CoV-2 viral infections has affected the population worldwide but has characteristically shown a preponderance for affecting adults. However, cases of SARS-CoV-2 infection have been reported in children, showing a systemic echo and severe damage. Multisystem inflammatory syndrome in children (MIS-C) can occur, on average, 4 weeks after the infection of a child with SARS-CoV-2. The aim of the present study was to examine 30 cases of children affected by MIS-C in terms of symptoms, laboratory tests, and evolution. Patients included in the study presented with neurological symptomatology including headache, meningism, and drowsiness. Treatment was administered in concordance with the protocol for MIS-C. The evolution of the patients in the present study was favorable and the symptomatology remitted in days to weeks. The importance of identifying the features of this disease, its treatment, and that the most probable evolution is favorable is significant in the medical world, especially as the pandemic is ongoing.

Ineffective management of postoperative pain following pediatric cardiac surgeries adversely affects a patient's postoperative course. The erector spinae plane (ESP) block has been described in the literature regarding perioperative pain management. We hypothesized that bilateral ESP blocks in pediatric patients would decrease intraoperative fentanyl consumption, reduce the need for postoperative morphine consumption, and improve pain scores.

 To evaluate postoperative pain, using the visual analog scale (VAS), in patients undergoing anterior cruciate ligament reconstruction (ACLR) and receiving intra-articular anesthetic solutions.  The present is a randomized clinical trial with a sample of 48 patients divided into 4 groups: Group I (n = 12) – 20 mL of saline solution (control); Group II (n = 12) – 20 mL of 0.5% bupivacaine; Group III (n = 12) – 20 mL of 0.5% bupivacaine + 0.1 mg of epinephrine; and Group IV (n = 12) – 20 mL of saline solution + 0.1 mg of epinephrine. These solutions were injected into the knee at the end of the surgery. Pain was assessed using the VAS immediately and 6, 12, 24 and 48 hours after the procedure.  The VAS scores were highly variable among the groups. A Kruskal-Wallis analysis of variance (ANOVA), considering a level of significance of 5%, revealed that all intra-articular anesthetic solutions influenced the assessment of pain (  = 0.003), and that Group-III subjects presented less postoperative pain. There was no evidence of a higher or lower use of supplemental analgesic agents, or of adverse effects resulting from these anesthetic solutions.  Bupivacaine combined with epinephrine was the most effective solution for pain control in patients undergoing ACLR, but with no statistically significant differences when compared to Group II (  = 0.547). There was no decrease or increase in the use of supplemental analgesics or in the occurrence of adverse systemic effects (  > 0.05).