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

Although oxcarbazepine (OXC)-induced hyponatremia is usually asymptomatic, it can lead to serious complications. We reports two cases of symptomatic hyponatremia induced by OXC. First case was 39-year-old female with partial epilepsy who developed the exceeding tiredness, headache, and seizures under OXC with a serum sodium level of 121 mEq/L. After the discontinuation of OXC, serum sodium was normalized and the clinical symptoms disappeared. Second case was 48-year-old female with partial epilepsy who complained of the fluctuating tiredness and fatigability, and then eventually developed seizures after OXC was increased in dosage. At that time, serum sodium was 121 mEq/L. She remained asymptomatic with normal level of serum sodium even if OXC was maintained with topiramate. Our cases may suggest that symptomatic hyponatremia is not rare unlike the results from previous studies. Therefore, clinician should be alert to mild symptoms such as headache, lethargy, and tiredness in patients treated with OXC.
Adult ; Epilepsies, Partial ; Female ; Headache ; Humans ; Hyponatremia* ; Lethargy ; Middle Aged ; Seizures ; Sodium

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

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