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Although the diagnosis is rarely confirmed, enteroviruses are a common cause of meningitis. Coxsackie B is responsible for more than half of the cases of aseptic meningitis in infants less than 3 months old, but is less common as a cause of neurological disease in older persons. In addition to aseptic meningitis, Coxsackie B has been reported to cause a wide range of other neurological disorders, albeit rarely. The authors report a young adult with persistent Coxsackie B encephalitis that was heralded by focal seizures and evolved to intractable coma with multifocal myoclonus. The diagnosis was established by immunohistochemistry and reverse transcriptase–polymerase chain reaction (RT-PCR) on tissue obtained at brain biopsy. Cerebrospinal fluid (CSF) viral cultures and PCR were negative for enteroviruses. This case highlights unusual features of a persistent infection that could easily have been mistaken for a neurodegenerative or other noninfectious process. It also emphasizes the importance of performing brain biopsy on individuals with neurological disease of obscure nature. [ABSTRACT FROM AUTHOR]

Describes a mathematical model used to examine the forces required to cause a subdural hematoma in a child with external hydrocephalus. Diagnosis of infantile acute subdural hematoma; Distinction between subdural hematomas caused by minor trauma and those caused by abuse; Difficulty in defining the forces that are generated by trauma.

Discusses a case representing an atypical presentation of a distal shunt malfunction with cerebral edema. Status of the patient with a ventriculoperitoneal shunt; Details of operation procedures; Suggestions on treating patients with shunt malfunction and edema.

We present the case of a 15-year-old with a cerebellar infarct that involved multiple arterial territories. It was temporally related to, and probably caused by, heavy marijuana use. While the mechanism of marijuana-associated stroke is unclear, the drug is known to cause hypotension and to impair peripheral vasomotor reflexes. We suspect that the child had diminished cerebral autoregulatory capacity and developed the stroke during a period of hypotension.Copyright © 2000 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]