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Biomedical subjects

I Casteels

Publications and source records attributed to I Casteels.

52 records · Page 3Linked to original sources

Sudden blindness in a child: presenting symptom of a sphenoid sinus mucocele.

A 10-year-old girl with no nasal or respiratory symptoms developed a headache lasting a few hours. The next day she became totally blind in the right eye and over 5 days vision in the left eye deteriorated to bare light perception. The diagnosis of a sphenoid sinus mucocele was made radiologically and drainage via an endonasal sphenoidectomy produced 12 ml of brownish fluid. Endoscopic biopsy of the wall confirmed the diagnosis of a mucocele. Steroid treatment was given postoperatively, but vision recovered to 6/12 in the left eye only. The importance of urgent clinical diagnosis and treatment is stressed.

Acute Disease↗

Mucolipidosis type IV. Presentation of a mild variant.

The authors report a 16-year-old girl with mucolipidosis type IV. She was referred because of deteriorating vision over the past three years. Corneal clouding with the appearance of cornea verticillata and retinal dystrophy were the main ophthalmological findings. Except for clumsiness no psychomotor retardation was present. Ultrastructural analysis of a conjunctival biopsy and cultured fibroblasts suggested a diagnosis of mucolipidosis type IV which was confirmed by biochemical studies. This patient represents the mildest described presentation of mucolipidosis type IV.

Adolescent↗

Unilateral congenital nasolacrimal mucocele.

A case of a congenital nasolacrimal mucocele is reported. This very uncommon finding presents usually with a diagnostic triad on CT: an intranasal cystic mass, a dilated nasolacrimal duct and lacrimal sac.

Female↗

Retrolental white mass.

From 1985 till 1990 twenty-three children aged seven weeks to six years presented with a retrolental white mass. Six children had retinoblastoma, six Coats' disease, five retinopathy of prematurity, four persistent hyperplastic primary vitreous, one cysticercosis and one retinal detachment. Retinoblastoma and Coats' disease was only seen in children over eight months, whereas persistent hyperplastic primary vitreous and retinopathy of prematurity all presented before the age of six months. Differentiation between Coats' disease and retinoblastoma is not always easy. Most helpful for the diagnosis is to perform funduscopy under general anaesthesia with special attention to the vasculature. Ultrasounds are helpful, but can give confusing results. Cytological analysis of subretinal fluid is useful in Coats' disease.

Child↗

Orbital myositis following an upper respiratory tract infection: contribution of high resolution CT and MRI.

A case of isolated unilateral extraocular muscle myositis following an acute upper respiratory tract infection is reported. Painful eye movements, restricted eye motility and exophthalmus but a normal visual acuity are the most important clinical findings. High resolution contrast enhanced CT and MRI are the imaging modalities of choice to differentiate from other orbital pathologies. The solitary enlarged muscle was clearly seen on both the contrast enhanced CT and the MR examination. Preseptal cellulitis was better seen on MRI, whereas high resolution CT was superior in the demonstration of periscleritis. Graves' ophthalmopathy and orbital cellulitis first have to be excluded. Corticosteroids are the therapy of choice in orbital myositis. A control, contrast enhanced CT after 4 weeks showed an almost normal muscle.

Adrenal Cortex Hormones↗

Retinopathy of prematurity: any difference in risk factors between a high and low risk population?

PURPOSE: To document incidence of and risk factors for development of retinopathy of prematurity (ROP) in a population of low birthweight infants (< 1500 g). METHODS: The authors registered clinical characteristics (birthweight, gestational age (GA), Clinical Risk Index for Babies (CRIB), Apgar score, respiratory characteristics (intubation, ventilation, respiratory support, supplemental oxygen, oxygenation index), prescription of dopamine, and maximal creatinemia) by retrospective chart review in two consecutive CRIB score-based (< 851 g, 851-1350 g) categories. Chi square and Mann-Whitney U tests were used to compare clinical characteristics in both categories and a stepwise logistic regression was done to document independent risk factors for either stage 3 (< 851 g) or any grade of ROP (851-1350 g). RESULTS: Incidence of ROP was 65/157 (41%; 76% in < 851 g and 22% in 851-1350 g). Incidence of stage 3 ROP was 25/46 (54%) in the < 851 g and 4/84 (5%) in the 851-1350 g group. Among other risk factors, maximal creatinemia was a risk factor in the 851-1350 g cohort (p < 0.03). In a logistic regression model, only GA (OR 0.42) remained significant in the lowest birthweight category; in the 851-1350 g cohort, GA (OR 0.53) and CRIB score (OR 1.7) were independent risk factors for ROP. CONCLUSIONS: In relatively more mature infants (851-1350 g), the risk to develop ROP is based on GA and on neonatal severity of disease (CRIB score); in the tiniest infants, GA is the most important risk factor. Microangiopathy might explain the association of maximal creatinemia and the risk of developing ROP.

Gestational Age↗

Cortical visual impairment following perinatal hypoxia: clinicoradiologic correlation using magnetic resonance imaging.

PURPOSE: To evaluate the value of magnetic resonance imaging (MRI) in the visual prognosis of cortical visual impairment following perinatal hypoxia. METHODS: MRI findings of 19 babies with the diagnosis of a perinatal hypoxic-ischemic insult and cortical visual impairment (CVI) were reviewed. Two groups of patients based on gestational age were compared. Babies with a gestational age > or = 34 weeks were included in group 1(n = 8). Infants < 34 weeks' gestation were included in group 2(n = 11). All 19 children underwent MRI. RESULTS: Normal MRI always correlated with better visual outcome, regardless of the gestational age at which the insult occurred. Among infants born at or later than 34 weeks' gestation, a favorable visual recovery occurred in two with normal MRI findings. The presence of infarcts or periventricular leukomalacia indicated that full visual recovery would not occur. Among infants born before 34 weeks' gestation, the MRI findings were normal in two who had a favorable visual outcome. A normal visual cortex and the absence of periventricular leukomalacia were helpful in prognosticating the visual outcome. A general delay in the myelination-particularly in the myelination of the optic radiation-was a common finding and until now has not been described in children with CVI routinely. CONCLUSION: MRI's ability to follow the process of myelination may be of predictive value. MRI, therefore, should be obtained in a child with CVI following perinatal hypoxia.

Asphyxia Neonatorum↗

Treatment of glaucoma in children with Sturge-Weber syndrome.

BACKGROUND: Sturge-Weber syndrome is a rare congenital neuro-oculocutaneous disorder. Ocular involvement can include glaucoma and vascular malformations of the conjunctiva, episclera, choroid, and retina. METHODS: The records of 19 Sturge-Weber syndrome patients (mean age 8.2 years) treated at our institution were reviewed to determine the incidence of ophthalmologic manifestations in Sturge-Weber syndrome. RESULTS: Glaucoma occurred in 42% of all patients and was more frequent in patients with a port-wine stain involving both upper and lower eyelids. Other ocular manifestations included conjunctival/episcleral hemangioma, choroidal hemangioma, iris heterochromia, retinal detachment, strabismus, and homonymous hemianopia. In 7 of 8 patients with glaucoma, topical pharmacotherapy (beta-blockers and carbonic anhydrase inhibitors) alone failed to normalize intraocular pressures. In those patients, cryocoagulation of the ciliary body was performed. Mean postoperative intraocular pressure after a mean follow-up of 4-5 years was <22 mm Hg in 6 patients. CONCLUSIONS: Cryocoagulation of the ciliary body combined with topical medication is an effective and safe treatment option in the management of glaucoma in children with Sturge-Weber syndrome.

Adolescent↗

Unilateral Peters' anomaly in a patient with DiGeorge syndrome.

We report a case of unilateral Peters' anomaly in a 3-month-old infant with a microdeletion in chromosome 22q11.2, a finding not previously described. This anterior segment anomaly can be explained by a problem in neural crest development, as neural crest cells are known to play a role in the developmental defects of this disorder.

Chromosome Deletion↗