The thalamic vascular supply is categorized into the anterior, paramedian, inferolateral, and posterior territories. The artery of Percheron (AOP), a solitary trunk that is an uncommon anatomic variant, provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions. The case described herein is of a patient with AOP who presented with the sudden onset of lethargy.
Arteries ; Humans ; Infarction ; Lethargy ; Mesencephalon ; Thalamus

The thalamic vascular supply is categorized into the anterior, paramedian, inferolateral, and posterior territories. The artery of Percheron (AOP), a solitary trunk that is an uncommon anatomic variant, provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions. The case described herein is of a patient with AOP who presented with the sudden onset of lethargy.
Arteries ; Humans ; Infarction ; Lethargy ; Mesencephalon ; Thalamus

A case of isolated hypoaldosteronism 5 month old male infant was presented. He was admitted to the pediatric ward with the chief complants of frequent vomiting, dehydration, lethargy and failure to thrive. The diagnosis was established by salt-losing manifestation, laboratory fiding and good response after salt-retaining steroid therapy. A brief review of related literatures were also presented.
Dehydration ; Diagnosis ; Failure to Thrive ; Humans ; Hypoaldosteronism ; Infant ; Lethargy ; Male ; Vomiting

Desmoplastic cerebral astrocytoma of infancy is a massive cystic tumor, typically occurring in the cerebral hemisphere and a rare intracranial tumor that arises in subjects usually below the age of 18 months and shows a favorable prognosis. A 5.5-month-old boy was presented with a rapidly increasing head circumference and lethargy. A computerized tomography scan revealed a large, multicystic, partially enhancing right parieto-occipital mass with hydrocephalus. This patient was treated with a surgery and a firm plaque-like tumor along withmulticystic component was gross totally removed. The tumor mass was firmly attached to the dura and extended in fingerlike projections onto the cortical surface. The infant underwent no further therapy and has developed normally during 6 months after surgery. Desmoplastic cerebral astrocytoma of infancy is a rare intracranial tumor but recognition of this tumor should be appreciated because, despite its massive size and rapidly growing characterstics, this tumor often has a relatively benign clinical course.
Astrocytoma* ; Cerebrum ; Head ; Humans ; Hydrocephalus ; Infant ; Lethargy ; Male ; Prognosis

Two Whooper swan (Cygnus cygnus) died after suffering from pododermatitis, lethargy, and ataxia; necropsy was performed. Grossly, the liver was swollen and firm. The kidney and spleen were also enlarged and a pale tan color. On histopathologic examination with Congo red staining, amyloidosis was noted in liver, spleen, and kidney. In addition, marked osseous metaplasia was present in the liver. Based on these results, systemic amyloidosis involving liver, spleen, and kidney with osseous metaplasia in the liver was diagnosed. Study results indicate that an inflammatory reaction associated with pododermatitis had a role in the amyloidosis in this particular case.
Amyloidosis* ; Ataxia ; Congo Red ; Kidney ; Lethargy ; Liver ; Metaplasia ; Spleen ; Triacetoneamine-N-Oxyl

Isovaleric acidemia is an inborn error in metabolism due to a defect in isovaleryl-CoA dehydrogenase. Accumulation of serum isovaleric acid causes poor feeding, vomiting, lethargy, hypothermia, convulsion, mental retardation, etc. It is inherited as an autosomal recessive trait. Since the first reports of isovaleric acidemia by Tanaka et al in 1966, more than 60 cases have been reported. There are two clinically different presentations of isovaleric acidemia, with about half the patients presenting with an acute severe neonatal form and about half with a chronic intermittent forrn. The difference in clinical presentation may not be a consequence of differing severities of the causative mutation, but a result of the timing of application of catabolic stress or the ability to form isovalerylglycine. We described here clinical and organic acid analytical findings of brothers with chronic intermittent form of isovaleric acidemia. (J Korean Pediatr Soc 2000;43:828-831)
Humans ; Hypothermia ; Intellectual Disability ; Isovaleryl-CoA Dehydrogenase ; Lethargy ; Metabolism ; Seizures ; Siblings* ; Vomiting

PURPOSE: Intestinal malrotation can have variable clinical presentations, and is a disease that may cause bilious vomiting. This study was performed to analyze the clinical characteristics of patients with symptomatic intestinal malrotation. METHODS: From Jan 2001 to Dec 2005, 11 cases of malrotation, receiving surgical procedure, and were retrospectively reviewed for their clinical characteristics. RESULTS: There were 8 male (72.7%) and 3 female (27.3%) patients. At the time of the operation, 10 patients (90.9%) were in the neonatal period. According to the clinical manifestations, bilious vomiting was seen in all cases (100%), with other symptoms (fever, lethargy and abdominal distention) observed in certain cases. Of the several diagnostic tools available, abdominal sonography and UGI series showed sensitivities of 100%. According to the operative findings, 6 cases (54.5%) had malrotation only, with the other 5 (45.5%) having additional midgut volvulus. The Ladd procedure was routinely performed in all cases, with additional detorsion or bowel resection performed in the cases of malrotation with midgut volvulus. After a definite procedure, an adhesive intestinal obstruction developed in 3 cases (27.3%), with surgical correction for the obstruction performed in one case. There were no cases of mortality. CONCLUSION: Intestinal malrotation could be of preferential concern for those neonates presenting with bilious vomiting. The proper diagnosis, via abdominal sonography, and early surgical management for intestinal malrotation will show a good result.
Adhesives ; Diagnosis ; Female ; Humans ; Infant, Newborn ; Intestinal Obstruction ; Intestinal Volvulus ; Lethargy ; Male ; Mortality ; Retrospective Studies ; Vomiting

Posttransplant erythrocytosis (PTE) is a common complication of renal transplantation, which can occur in approximately 10% to 15% of renal transplant patients and usually affects males with relatively good renal function. It is also associated with an increased incidence of thromboembolic events. Clinical manifestations of PTE include malaise, headache, plethora, lethargy, and dizziness. It is correlated with use of cyclosporin, gender, posttransplant renal function, and type of antihypertensive medication. The angiotensin receptor blocker (ARB) or angiotensin-converting enzyme inhibitor is preferred as an initial treatment for PTE because these agents are effective and reasonably safe in the majority of patients with PTE, and can also provide a necessary antihypertensive effect for kidney transplant patients. We report here on a 35-year-old male who had erythrocytosis after renal transplantation. After renal transplantation, his level of hemoglobin was 21 g/dL. We treated this patient with ARB and his symptoms and signs have been completely relieved.
Adult ; Angiotensin Receptor Antagonists ; Angiotensins ; Cyclosporine ; Dizziness ; Headache ; Humans ; Incidence ; Kidney Transplantation ; Kidney* ; Lethargy ; Male ; Polycythemia

Metastatic involvement of the central nervous system during the course of leukemia is an increasingly frequent occurrence because of the longer survival time brought about by the efficacious cytotoxic therapy available today. The onset of acute leukemia may be abrupt with a great variety of clinical manifestations. Most commonly, such as vomiting, headache, papilledema, lethargy and vertigo, are referable to increased intracranial pressure caused by infiltration of the cortex and meninges. The acute paraplegia as the initial symptom of acute leukemia is very rare. A case in which acute paraplegia occurred as the initial symptom of acute leukemia in a 15-year-old boy is reported.
Adolescent ; Central Nervous System ; Headache ; Humans ; Intracranial Pressure ; Lethargy ; Leukemia* ; Male ; Meninges ; Papilledema ; Paraplegia* ; Vertigo ; Vomiting

Metastatic involvement of the central nervous system during the course of leukemia is an increasingly frequent occurrence because of the longer survival time brought about by the efficacious cytotoxic therapy available today. The onset of acute leukemia may be abrupt with a great variety of clinical manifestations. Most commonly, such as vomiting, headache, papilledema, lethargy and vertigo, are referable to increased intracranial pressure caused by infiltration of the cortex and meninges. The acute paraplegia as the initial symptom of acute leukemia is very rare. A case in which acute paraplegia occurred as the initial symptom of acute leukemia in a 15-year-old boy is reported.
Adolescent ; Central Nervous System ; Headache ; Humans ; Intracranial Pressure ; Lethargy ; Leukemia* ; Male ; Meninges ; Papilledema ; Paraplegia* ; Vertigo ; Vomiting