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Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

We have released issues of some journals on February 2013.
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American Journal of Medical Sciences and Medicine
American Journal of Medical and Biological Research
American Journal of Pharmacological Sciences
American Journal of Clinical Medicine Research
American Journal of Nursing Research
American Journal of Cancer Prevention
American Journal of Medicine Studies
American Journal of Infectious Diseases and Microbiology
American Journal of Cardiovascular Disease Research
American Journal of Biomedical Research
American Journal of Mechanical Engineering
American Journal of Microbiological Research
Journal of Preventive Medicine
American Journal of Food and Nutrition
American Journal of Hypertension Research
American Journal of Sports Science and Medicine
Journal of Cancer Research and Treatment
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Kimmerle Anomaly and Drop Attacks in Adolescent

Enrico Finale, Mauro Martinetti, Fabrizio La Rocca, Fulvio Guccione, Andrea Guala*

Department of Pediatrics and Neonatology Castelli Hospital Verbania, Italy

Abstract: A. is 12 years old and comes to the first aid for a fainting spell during gym class. Pediatric and Neurological examination, ECG, EEG and RMN are all negatives. The medical history is negative regarding the main causes of Drop Attacks. Only one cervicodorsal radiography allows diagnosis of Kimmerly’s anomaly. The Kimmerly’s anomaly occurs in adults in 14% of the population, but is extremely rare in adolescents. The conduct adopted, after discussion with the neurologist and neurosurgeon, is waiting and symptoms monitoring.

Keywords: drop attacks, Kimmerle anomaly

Received July 09, 2015; Revised July 15, 2015; Accepted July 17, 2015

Citation: Enrico Finale, Mauro Martinetti, Fabrizio La Rocca, Fulvio Guccione, Andrea Guala, Kimmerle Anomaly and Drop Attacks in Adolescent. American Journal of Medical Case Reports, 3 (8). 255-256. January 2015. doi:10.12691/ajmcr-3-8-9

1. Introduction

A. is 12 years old and she’s always been good. She started a gymnastic course, organised by her school. She arrived to the first aid, because during an exercise she fells to the ground; her legs gave way; She did not lose knowledge, she feels tingling, headache and after few minutes her legs have recovered strength and she started walking.

The same episode happened some times in the last weeks but today the gymnastic teacher wos worried and she colled as parents.

2. Discussion

The examination and neurological examination are normal. According to the stories, we can imagine that a falls to the ground when she rotates the head and when she moves her arms back in hyperextension.

Then began a depth about the “drop attaks” or sudden fall to the ground and possible differential diagnoses (Table 1).

Table 1.

Pediatric and neurological visits, electroencephalogram, electrocardiogram and then 24 hours holter, tilt test, echocardiogram, doppler ultrasound of neck vessels and RMN are all negatives.

We think is a cervical accessory rib but the radiography of the cervicodorsal don’t shows are not even mega apophysis transverse; it is highlighted instead a Kimmerle’s anomaly (Figure 1).

Figure 1. Kimmerle anomaly

The vertebral artery passes near the posterior arch of the atlas, and impressing a groove in the bone. If the fibrous ligament of the condyle is ossifies, the groove can transform in a hole-channel, this determining an entrapment of the vertebral artery whit the venous plexus and the suboccipital nerve [1]. This anomaly is not uncommon in the adults (14% of the population) and usually is asymptomatic, but sometimes is associated a headache crisis, deafness, dizziness, paresthesia and drop attaks [2,3]. The ligament ossification is moreover very uncommon in the childhood.

3. Conclusion

After tolking whit the neurologist and neurosurgeon it was decided to wait. Although thay have been reported pediatric cases of stroke by stretching of the vertebral artery in the arcuate foramen and dissection by repetitive neck trauma [4,5].

References

[1]   | Prakash BS et al. “Left arteriae vertebralis canal in atlas-Kimmerle anomaly” Int J Anatom Variat 3:130, 2010.
[2]   | Koutsouraki E. et al. “Kimmerle’s anomaly as a causative factor of chronic tension headaches and neurosensory hearing loss”. Encephalos 47:150, 2010.
[3]   | Split W. et al. “Clinical symptoms and signs in Kimmerle anomaly” Wlad Lek 55:416, 2002.
[4]   | Eliott RE, Tanweer O. “The prevalence of the arcuate foramen and its importance” World Neurosurg 82:335, 2014.
[5]   | Cusching KE et al. “Tethering of the vertebral artery in the congenital arcuate foramen of the atlas vertebra: a possible cause of vertebral artery dissection in children” Dev Med Child Neurol 43:491, 2001.