脑疟疾导致的光盘升高完全在曼尼托尔的使用后得到解决,并且与临床改善相对应
Matthew Douglas-Vail1,2, James Fah3, Alexander Cotran-Lenrow4
1Department of Emergency Medicine, The University of British Columbia, Vancouver, CAN.
Cureus
|July 21, 2023
概括
护理点超声波 (POCUS) 有效地评估了脑疟疾儿童的脑内压力增加. 在资源有限的环境中,POCUS引导治疗,导致症状完全消失.
科学领域:
- 热带医学 热带医学
- 儿科神经学 儿科神经学
- 医疗成像医学成像
背景情况:
- 大脑疟疾是Plasmodium falciparum感染的严重并发症,特别是在资源有限的地区.
- 增加的内压力 (ICP) 是大脑疟疾严重程度的关键指标.
- 在资源有限的环境中,先进的神经成像通常是不可用的,这阻碍了ICP评估.
研究的目的:
- 描述治疗点超声波 (POCUS) 在儿童脑疟疾病例中评估光盘升高的实用性.
- 评估POCUS指导的治疗脑疟疾中内压升高的有效性.
- 突出POCUS作为一个可行的诊断工具在资源有限的环境.
主要方法:
- 一个14岁男孩患有症状性脑疟疾的病例报告.
- 由于缺乏先进的神经成像技术,使用护理点超声波 (POCUS) 评估光盘升高.
- 进行的治疗包括基于体重的曼尼托尔剂量.
主要成果:
- POCUS成功地发现了光盘的升高,这表明内压力增加.
- 在服用曼尼托尔后,视盘升高完全消失.
- 患者在治疗后经历了显著的临床改善.
结论:
- 护理点超声波 (POCUS) 是一种有价值的,可访问的工具,用于评估脑疟疾中内压力的增加.
- 在资源有限的环境中,POCUS可以指导及时有效的管理决策.
- 这一案例支持将POCUS纳入重症儿科疟疾的诊断和管理方案.
相关概念视频
Cryptococcal Meningitis
Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Cerebral Edema l: Introduction
Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...


