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Howley L, Eyerly-Webb S, Killen SAS, Paul E, Krishnan A, Gropler MRF, Drewes B, Dion E, Lund A, Buyon JP, Cuneo BF. Variation in prenatal surveillance and management of anti-SSA/Ro autoantibody positive pregnancies. J Matern Fetal Neonatal Med 2024; 37:2323623. [PMID: 38443062 PMCID: PMC11005667 DOI: 10.1080/14767058.2024.2323623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To describe international surveillance and treatment strategies for managing anti-SSA/Ro autoantibody positive pregnancies. STUDY DESIGN An electronic REDCap questionnaire was distributed to Fetal Heart Society and North American Fetal Therapy Network members which queried institution-based risk stratification, surveillance methods/frequency, conduction abnormality treatments, and postnatal anti-SSA/Ro pregnancy assessment. RESULTS 101 responses from 59 centers (59% US, 17% international) were collected. Most (79%) do not risk stratify pregnancies by anti-SSA/Ro titer; those that do use varied cutoff values. Many pregnant rheumatology patients are monitored for cardiac abnormalities regardless of maternal anti-SSA/Ro status. Surveillance strategies were based on maternal factors (anti-SSA/Ro status 85%, titer 25%, prior affected child 79%) and monitoring durations varied. Most respondents treat 2° and 3° fetal atrioventricular block, commonly with dexamethasone and/or IVIG. CONCLUSIONS Wide variation exists in current fetal cardiac surveillance and treatment for anti-SSA/Ro autoantibody positive pregnancies, highlighting the need for evidence-based protocols to optimize care.
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Affiliation(s)
- Lisa Howley
- Midwest Fetal Care Center, Children’s Minnesota, Minneapolis, MN, USA
- The Children’s Heart Clinic, Children’s Minnesota, Minneapolis, MN USA
| | | | - Stacy A. S. Killen
- Vanderbilt University Medical Center, Monroe Carell Jr. Children’s Hospital, Nashville, TN, USA
| | - Erin Paul
- Icahn School of Medicine, Mount Sinai Children’s Heart Center, New York, NY, USA
| | | | | | - Bailey Drewes
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Eric Dion
- Midwest Fetal Care Center, Children’s Minnesota, Minneapolis, MN, USA
| | - Amy Lund
- Midwest Fetal Care Center, Children’s Minnesota, Minneapolis, MN, USA
- The Children’s Heart Clinic, Children’s Minnesota, Minneapolis, MN USA
| | - Jill P. Buyon
- New York University Grossman School of Medicine, NYU Langone Medical Center, New York, NY, USA
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Howley LW, Strasburger J, Maleszewski JJ, Snowise S, Lund A, Schneider A, MacIver R, Edens E, Eyerly-Webb S, Silverman NH. Fetal Unguarded Mitral Valve Orifice, Aortic Atresia, and Severe Left Heart Enlargement. JACC Case Rep 2021; 3:206-211. [PMID: 34041497 PMCID: PMC8145915 DOI: 10.1016/j.jaccas.2020.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Unguarded mitral valve orifice is a rare disease with only 7 described cases in the literature. We describe the first known case of unguarded mitral valve orifice with normal segmental cardiac anatomy, severe left ventricular dilatation and dysfunction, aortic atresia, and atrial flutter. (Level of Difficulty: Advanced.)
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Affiliation(s)
- Lisa W Howley
- Division of Cardiology, Department of Pediatrics, The Children's Heart Clinic, Children's Minnesota, Minneapolis, Minnesota, USA.,Midwest Fetal Care Center, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Janette Strasburger
- Division of Cardiology, Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA
| | - Joseph J Maleszewski
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Saul Snowise
- Midwest Fetal Care Center, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Amy Lund
- Division of Cardiology, Department of Pediatrics, The Children's Heart Clinic, Children's Minnesota, Minneapolis, Minnesota, USA.,Midwest Fetal Care Center, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Andrew Schneider
- Division of Cardiology, Department of Pediatrics, The Children's Heart Clinic, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Robroy MacIver
- Division of Cardiac Surgery, The Children's Heart Clinic, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Erik Edens
- Division of Cardiology, Department of Pediatrics, The Children's Heart Clinic, Children's Minnesota, Minneapolis, Minnesota, USA
| | | | - Norman H Silverman
- Division of Cardiology, Department of Pediatrics, University of California, San Francisco, California, USA
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Groth S, Eyerly-Webb S, LaForest L, Dion E, Fisher J, Lillegard J. Bilateral chest wall mesenchymal hamartoma: Prenatal diagnosis and staged surgical resection. Journal of Pediatric Surgery Case Reports 2020. [DOI: 10.1016/j.epsc.2020.101474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Eyerly-Webb S, Nicolas CT, Watson D, Dion E, Amin R, Wagner AJ, Lampland A, Bendel-Stenzel E, Macardle CA, Kunisaki SM, Jorgenson A, Lillegard J, Feltis B. Dynamic discriminant model for predicting respiratory distress at birth based on mass volume ratio in fetuses with congenital lung malformation. Ultrasound Obstet Gynecol 2019; 54:759-766. [PMID: 30834623 DOI: 10.1002/uog.20255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/13/2019] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The congenital lung malformation volume ratio (CVR) is a prenatal ultrasound measurement that parameterizes congenital lung malformation (CLM) size. The aims of this study were to use serial measurements to create estimated growth curves of fetal CVR for asymptomatic and symptomatic neonates with CLM and to investigate whether a discriminant prognostic model based on these measurements could predict accurately which fetuses with CLM will require invasive respiratory support at delivery and should therefore be delivered at a tertiary-care facility. METHODS This was a retrospective study of fetuses diagnosed prenatally with CLM at three tertiary-care children's hospitals between 2009 and 2016. Those with two or more sonographic measurements of CVR were included. Serial fetal CVR measurements were used to create estimated growth curves for neonates with and those without respiratory symptoms at delivery, defined as requiring invasive respiratory support for the first 24 h after delivery. A discriminant model based on serial CVR measurements was used to calculate the dynamic probability of the need for invasive respiratory support. The performance of this model overall and in preterm and term neonates was compared with those using maximum CVR thresholds of 1.0 and 1.6. RESULTS Of the 147 neonates meeting the inclusion criteria, 16 (10.9%) required postnatal invasive respiratory support. The estimated CVR growth curve models showed different growth trajectories for asymptomatic and symptomatic neonates, with significantly higher CVR in symptomatic neonates, and values peaking late in the second trimester at around 25 weeks' gestation in asymptomatic neonates. All prognostic methods had high accuracy for the prediction of the need for invasive respiratory support in term neonates, but the discriminant model had the best performance overall (area under the receiver-operating characteristics curve (AUC) = 0.88) and in the preterm population (AUC = 0.85). CONCLUSIONS The estimated CVR growth curves showed different growth patterns in asymptomatic and symptomatic neonates with CLM. The dynamic discriminant model performed well overall and particularly in neonates that were carried to term. Development of an externally validated clinical tool based on this analysis could be useful in determining the site of delivery for fetuses with CLM. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- S Eyerly-Webb
- Children's Hospitals and Clinics of Minnesota, Midwest Fetal Care Center, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - C T Nicolas
- Children's Hospitals and Clinics of Minnesota, Midwest Fetal Care Center, Minneapolis, MN, USA
- Mayo Clinic, Division of General Surgery Research, Rochester, MN, USA
| | - D Watson
- Children's Hospitals and Clinics of Minnesota, Research Design and Analytics, Minneapolis, MN, USA
| | - E Dion
- Children's Hospitals and Clinics of Minnesota, Midwest Fetal Care Center, Minneapolis, MN, USA
| | - R Amin
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - A J Wagner
- Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | - A Lampland
- Children's Hospitals and Clinics of Minnesota, Midwest Fetal Care Center, Minneapolis, MN, USA
| | - E Bendel-Stenzel
- Children's Hospitals and Clinics of Minnesota, Midwest Fetal Care Center, Minneapolis, MN, USA
| | - C A Macardle
- St Joseph Mercy Health System, Ypsilanti, MI, USA
| | - S M Kunisaki
- Johns Hopkins Children's Center, Baltimore, MD, USA
| | - A Jorgenson
- Children's Hospitals and Clinics of Minnesota, Midwest Fetal Care Center, Minneapolis, MN, USA
| | - J Lillegard
- Children's Hospitals and Clinics of Minnesota, Midwest Fetal Care Center, Minneapolis, MN, USA
- Mayo Clinic, Division of General Surgery Research, Rochester, MN, USA
- Pediatric Surgical Associates, Minneapolis, MN, USA
| | - B Feltis
- Children's Hospitals and Clinics of Minnesota, Midwest Fetal Care Center, Minneapolis, MN, USA
- Pediatric Surgical Associates, Minneapolis, MN, USA
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Nicolas CT, Lynch-Salamon D, Bendel-Stenzel E, Tibesar R, Luks F, Eyerly-Webb S, Lillegard JB. Fetoscopy-Assisted Percutaneous Decompression of the Distal Trachea and Lungs Reverses Hydrops Fetalis and Fetal Distress in a Fetus with Laryngeal Atresia. Fetal Diagn Ther 2019; 46:75-80. [PMID: 31238308 DOI: 10.1159/000500455] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/16/2019] [Indexed: 11/19/2022]
Abstract
We present a case of prenatal hydrops secondary to congenital high airway obstruction syndrome (CHAOS) that was treated with fetoscopy-assisted needle decompression. A 22-year-old G3P2 woman presented after a 21-week ultrasound demonstrated CHAOS. The fetus developed hydrops at 25 weeks, characterized by abdominal ascites, pericardial effusion, and scalp edema. Fetal MRI showed complete obstruction of the glottis and subglottic airway, suggestive of laryngeal atresia. At 27 weeks, due to the progression of the hydrops, operative fetoscopy was proposed and performed. Fetal laryngoscopy confirmed fusion of the vocal cords and laryngeal atresia. The atretic segment was a solid cartilaginous block, preventing intubation. Using the fetoscope to stabilize the fetal head and neck, we performed ultrasound-guided percutaneous needle drainage of the cervical trachea through the anterior fetal neck. We removed 17 mL of viscous fluid from the lower trachea, resulting in immediate lung decompression. Two weeks later, ultrasound confirmed hydrops resolution. The patient was delivered and tracheostomy performed at 30 weeks via an ex utero intrapartum treatment (EXIT) procedure after progression of preterm labor. At 27 days of life, the infant was stable on minimal ventilator support. To our knowledge, this is the first successful report of an ultrasound-guided percutaneous tracheal decompression through the anterior neck of a fetus with CHAOS secondary to laryngeal atresia.
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Affiliation(s)
- Clara T Nicolas
- Children's Hospital of Minnesota, Midwest Fetal Care Center, Minneapolis, Minnesota, USA.,Mayo Clinic, Division of Surgery Research, Rochester, Minnesota, USA
| | - David Lynch-Salamon
- Children's Hospital of Minnesota, Midwest Fetal Care Center, Minneapolis, Minnesota, USA
| | - Ellen Bendel-Stenzel
- Children's Hospital of Minnesota, Midwest Fetal Care Center, Minneapolis, Minnesota, USA.,Minnesota Neonatal Physicians, Minneapolis, Minnesota, USA
| | - Robert Tibesar
- Children's Hospital of Minnesota, Midwest Fetal Care Center, Minneapolis, Minnesota, USA
| | - Francois Luks
- Hasbro Children's Hospital and The Fetal Treatment Program of New England, Providence, Rhode Island, USA
| | - Stephanie Eyerly-Webb
- Children's Hospital of Minnesota, Midwest Fetal Care Center, Minneapolis, Minnesota, USA
| | - Joseph B Lillegard
- Children's Hospital of Minnesota, Midwest Fetal Care Center, Minneapolis, Minnesota, USA, .,Mayo Clinic, Division of Surgery Research, Rochester, Minnesota, USA, .,Pediatric Surgical Associates, Minneapolis, Minnesota, USA,
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Stein AA, Eyerly-Webb S, Solomon R, Tani C, Shachar E, Kimball R, Hertzler D, Spader H. Peripheral blood neutrophil-to-lymphocyte ratio in preterm infants with intraventricular hemorrhage. Clin Neurol Neurosurg 2019; 180:52-56. [PMID: 30928808 DOI: 10.1016/j.clineuro.2019.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/21/2019] [Accepted: 03/14/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Intraventricular hemorrhage (IVH) remains a major complication of prematurity, affecting 20-25% of premature infants of very low birth weight. Preterm infants with IVH are at risk for developing significant complications, including posthemorrhagic hydrocephalus and seizures. Multiple studies have reported an association between the neutrophil-to-lymphocyte ratio (NLR) in peripheral blood and outcomes after acute intracranial hemorrhage in adults. However, the prognostic value of the NLR in preterm infants, particularly those with IVH, has not been investigated previously. PATIENTS AND METHODS This retrospective, observational cohort study included premature infants with IVH and a neonatal reservoir placed between January 2013 and January 2018. For each patient, peripheral blood and available cerebrospinal fluid laboratory results within 50 days of IVH diagnosis were averaged. NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. Differences in NLR levels for patients with seizures or shunt placement were analyzed. RESULTS Data for 13 surviving preterm infants (mean gestational age, 26.5 ± 3.0 weeks) were analyzed. The mean peripheral NLR (n = 13) was 1.6 ± 1.3 for all patients. Patients who experienced seizures had significantly higher peripheral blood NLR (p = 1.2 × 10-6, t-test) than those who did not, and an NLR > 3 correlated with seizure outcomes (p = 0.0035, Fisher's exact). Patients with sepsis or meningitis also had NLR values >3 (p = 0.01 and 0.005, respectively) but there was no correlation between the sepsis/meningitis and seizures patients. No significant correlation was found between NLR and the development of hydrocephalus. CONCLUSION The development of seizures in preterm infants with IVH is known to significantly increase morbidity. In this study, higher peripheral blood NLR (>3) correlated with the development of seizures, independent of sepsis or meningitis. Further prospective validation of the role of NLR as a predictive marker for seizures in preterm infants is warranted.
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Affiliation(s)
- Alan A Stein
- Florida Atlantic University, College of Medicine, 777 Glades Road, Boca Raton, FL, 33431, USA
| | - Stephanie Eyerly-Webb
- Office of Human Research, Memorial Healthcare System, 4411 Sheridan Street, Hollywood, FL, 33021, USA
| | - Rachele Solomon
- Office of Human Research, Memorial Healthcare System, 4411 Sheridan Street, Hollywood, FL, 33021, USA
| | - Christine Tani
- Division of Pediatric Neurosurgery, Joe DiMaggio Children's Hospital, 1150 N 35th Ave., Hollywood, FL, 33021, USA
| | - Elad Shachar
- Florida Atlantic University, 777 Glades Road, Boca Raton, FL, 33431, USA
| | - Rebekah Kimball
- Florida Atlantic University, College of Medicine, 777 Glades Road, Boca Raton, FL, 33431, USA
| | - Dean Hertzler
- Division of Pediatric Neurosurgery, Joe DiMaggio Children's Hospital, 1150 N 35th Ave., Hollywood, FL, 33021, USA
| | - Heather Spader
- Division of Pediatric Neurosurgery, Joe DiMaggio Children's Hospital, 1150 N 35th Ave., Hollywood, FL, 33021, USA.
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Eyerly-Webb S, Solomon R, Young L, Bard K, Laituri C, Rosenthal A, Long J. Impact of Holidays on Pediatric Trauma Admissions to a Community Hospital in South Florida. South Med J 2019; 112:164-169. [PMID: 30830230 DOI: 10.14423/smj.0000000000000947] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The data from temperate regions indicate increases in pediatric traumatic injuries during the spring and summer months with anticipated admission spikes on warm weather holidays; hospitals in southern subtropical regions should not anticipate the same trends. The objectives of this study were to identify holiday-specific spikes in pediatric traumatic injury admissions at a community hospital in South Florida and report injury patterns in age, mechanism of injury, and surgical consults. METHODS A 5-year retrospective review of pediatric traumatic injuries during holiday periods was conducted; patterns in age, mechanism of injury, and surgical consults were described. A ratio of the mean number of patients seen per day for holiday periods versus nonholiday days of the same month was calculated for each holiday. RESULTS The most notable spikes in injury volume were for autumn and winter holidays; average volume doubled during the holiday periods for New Year's Day, Super Bowl weekend, Valentine's Day, St Patrick's Day, and Halloween. Holiday periods had increases in the proportion of injuries related to motorcycle crashes. CONCLUSIONS Hospitals located in southern subtropical climates should consider increasing staffing as necessary during select autumn and winter holidays.
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Affiliation(s)
- Stephanie Eyerly-Webb
- From the Departments of Pediatric Trauma Services, Division of Acute Care Surgery and Trauma, and the Office of Human Research, Memorial Regional and Joe DiMaggio Children's Hospitals, Hollywood, Florida
| | - Rachele Solomon
- From the Departments of Pediatric Trauma Services, Division of Acute Care Surgery and Trauma, and the Office of Human Research, Memorial Regional and Joe DiMaggio Children's Hospitals, Hollywood, Florida
| | - LeAnne Young
- From the Departments of Pediatric Trauma Services, Division of Acute Care Surgery and Trauma, and the Office of Human Research, Memorial Regional and Joe DiMaggio Children's Hospitals, Hollywood, Florida
| | - Keren Bard
- From the Departments of Pediatric Trauma Services, Division of Acute Care Surgery and Trauma, and the Office of Human Research, Memorial Regional and Joe DiMaggio Children's Hospitals, Hollywood, Florida
| | - Carrie Laituri
- From the Departments of Pediatric Trauma Services, Division of Acute Care Surgery and Trauma, and the Office of Human Research, Memorial Regional and Joe DiMaggio Children's Hospitals, Hollywood, Florida
| | - Andrew Rosenthal
- From the Departments of Pediatric Trauma Services, Division of Acute Care Surgery and Trauma, and the Office of Human Research, Memorial Regional and Joe DiMaggio Children's Hospitals, Hollywood, Florida
| | - Julie Long
- From the Departments of Pediatric Trauma Services, Division of Acute Care Surgery and Trauma, and the Office of Human Research, Memorial Regional and Joe DiMaggio Children's Hospitals, Hollywood, Florida
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Moldovan K, Boxerman JL, O'Muircheartaigh J, Dean D, Eyerly-Webb S, Cosgrove GR, Pucci FG, Deoni SCL, Spader HS. Myelin water fraction changes in febrile seizures. Clin Neurol Neurosurg 2018; 175:61-67. [PMID: 30384118 DOI: 10.1016/j.clineuro.2018.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 09/27/2018] [Accepted: 10/07/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The objective of this feasibility study was to investigate whether myelin water fraction (MWF) patterns can differentiate children presenting with febrile seizures who will go on to develop nonfebrile epilepsy from those who will not. PATIENTS AND METHODS As part of a prospective study of myelination patterns in pediatric epilepsy, seven subjects with febrile seizures underwent magnetic resonance imaging (MRI) including the following standard sequences-T1-weighted, T2-weighted, fluid-attenuated inversion recovery (FLAIR)-and an additional experimental sequence, multicomponent-derived equilibrium single-pulse observation of T1 and T2 (mcDESPOT) to quantify MWF. For each of these subjects, MWF maps were derived and compared with an age-matched population-averaged MWF atlas. RESULTS All seven subjects (<5 years old) initially presented with febrile seizures. Of the seven, four had complex seizures and three had simple seizures. All of the children with simple febrile seizures had higher MWF compared with model-derived controls and did not develop epilepsy. All of the children with complex febrile seizures had lower MWF than their model-derived control, and two of these subjects later developed epilepsy. CONCLUSION This is the first study in which MWF maps were used to study children with febrile *seizures. This data suggests that relatively higher or stable MWF compared with normative data indicates a lower risk of nonfebrile epilepsy while relatively lower MWF may indicate a pathological condition that could lead to nonfebrile epilepsy.
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Affiliation(s)
- Krisztina Moldovan
- Department of Neurosurgery, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA.
| | - Jerrold L Boxerman
- Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA.
| | | | - Doug Dean
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI, 53705, USA.
| | - Stephanie Eyerly-Webb
- Office of Human Research, Memorial Healthcare System, 3501 Johnson Street, Hollywood, FL, 33021, USA.
| | - G Rees Cosgrove
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Neurosciences Center, 60 Fenwood Road, 1st Floor, Boston, MA, 02115, USA.
| | - Francesco G Pucci
- Department of Neurosurgery, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA
| | - Sean C L Deoni
- Brown University Advanced Baby Imaging Lab, Memorial Hospital of Rhode Island, Department of Pediatrics, 111 Brewster Street, Pawtucket, RI, 02860, USA.
| | - Heather S Spader
- Division of Pediatric Neurosurgery, Joe DiMaggio Children's Hospital, 1150N 35th Ave, Hollywood, FL, 33021, USA.
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Weiner EJ, Ditchek JJ, Solomon RJ, Eyerly-Webb S, Kiffin C, Carrillo EH, Davare DL. A unique case of popliteal artery transection after a motorcycle collision. J Surg Case Rep 2017; 2017:rjx222. [PMID: 29181147 PMCID: PMC5697403 DOI: 10.1093/jscr/rjx222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/24/2017] [Indexed: 11/12/2022] Open
Abstract
Popliteal artery injuries may have devastating consequences if not recognized in a timely fashion. The risk of delayed diagnosis of a vascular injury is particularly high in blunt trauma to the lower extremity. We present a case of popliteal artery injury that is unusual in two respects: severity (a complete transection in the setting of a blunt injury) and lack of clinical and radiographic signs of the commonly associated musculoskeletal injuries.
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Affiliation(s)
- Eric J Weiner
- Washington University School of Medicine, St. Louis, MO, USA
| | - Jordan J Ditchek
- Department of Radiology, Memorial Regional Hospital, Hollywood, FL, USA
| | - Rachele J Solomon
- Office of Human Research, Memorial Regional Hospital, Hollywood, FL, USA
| | | | - Chauniqua Kiffin
- Division of Acute Care Surgery and Trauma, Memorial Regional Hospital, Hollywood, FL, USA
| | - Eddy H Carrillo
- Division of Acute Care Surgery and Trauma, Memorial Regional Hospital, Hollywood, FL, USA
| | - Dafney L Davare
- Division of Acute Care Surgery and Trauma, Memorial Regional Hospital, Hollywood, FL, USA
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