Aim: To describe the clinical and radiological diagnostic for a sickle cell patient who got a bithalamic vasculature accident. Observation: This was a 4-year-old female child admitted to the pediatric ward for convuls...Aim: To describe the clinical and radiological diagnostic for a sickle cell patient who got a bithalamic vasculature accident. Observation: This was a 4-year-old female child admitted to the pediatric ward for convulsive seizures in a feverish context. The physical examination did not find signs of meningeal irritation. The effective workup including thick gout, lumbar puncture, complete blood count, and C reactive protein was normal. An electrocencephalogram was not performed due to lack of availability of the device. Based on clinical data and the fact that Burundi is an area of high malaria prevalence, antimalarial and anticonvulsant treatment has been started. An alteration of consciousness (the Glasgow score of 7) had motivated a CT scan. Bithalamic hypodensities in favor of a vascular accident have been demonstrated. Etiological investigation revealed homozygous sickle cell disease ss during hemoglobin electrophoresis. The final evolution has been characterized by a return to normal consciousness. Conclusion: The complexity of the clinical picture following occlusion of Percherons artery makes it difficult to diagnose. Sickle cell disease may favour the occurrence of ischaemic lesions. Cerebral imaging enables the diagnosis to be made with certainty and avoids delays in treatment.展开更多
文摘Aim: To describe the clinical and radiological diagnostic for a sickle cell patient who got a bithalamic vasculature accident. Observation: This was a 4-year-old female child admitted to the pediatric ward for convulsive seizures in a feverish context. The physical examination did not find signs of meningeal irritation. The effective workup including thick gout, lumbar puncture, complete blood count, and C reactive protein was normal. An electrocencephalogram was not performed due to lack of availability of the device. Based on clinical data and the fact that Burundi is an area of high malaria prevalence, antimalarial and anticonvulsant treatment has been started. An alteration of consciousness (the Glasgow score of 7) had motivated a CT scan. Bithalamic hypodensities in favor of a vascular accident have been demonstrated. Etiological investigation revealed homozygous sickle cell disease ss during hemoglobin electrophoresis. The final evolution has been characterized by a return to normal consciousness. Conclusion: The complexity of the clinical picture following occlusion of Percherons artery makes it difficult to diagnose. Sickle cell disease may favour the occurrence of ischaemic lesions. Cerebral imaging enables the diagnosis to be made with certainty and avoids delays in treatment.
