Neonatal strokes are defined by the occurrence of any cerebrovascular event between the 20th week of gestation and 28th day after birth. It is an uncommon disease whose incidence varies according to the authors. The localized seizures are the main symptoms. But nonspecific symptoms like bradycardia, bradypnea and poor feeding may reveal the pathology. The diagnosis has been facilitated by the development of brain imaging techniques. It can be done during the acute phase or retrospectively by viewing sequelae's images. They are characterized by their etiology and therapeutic management that differ from those found in young adults. The prognosis is dominated by the occurrence of neurological sequelae such as epilepsy or motor deficits. We report a case of stroke in the neonatal period, observed on the sixteenth day of life.

No abstract

Introduction: Congenital diaphragmatic hernia is often detected during the prenatal or neonatal period by severe respiratory symptoms. Late-presenting congenital diaphragmatic hernia is uncommon entity resulting in frequent misdiagnosis and inappropriate treatment. Case Report: We report the case of a left congenital diaphragmatic hernia revealed by an inaugural diabetic ketoacidosis in a 9-year-old girl. She has presented progressive weight loss without loss of appetite associated with polyuro-polydipsia, then epigastric pain with vomiting. Blood glucose was 3.2 g/L, ketonuria and 2+ glycosuria. Despite a well-conducted treatment, there was persistence of dyspnea. Chest X-ray and chest CT-scan confirmed the presence of a left diaphragmatic hernia. Evolution was marked by the death of the child on day 2 post-operative from a multivisceral failure. Conclusion: Clinical and radiological signs of congenital diaphragmatic hernia after the neonatal period may be difficult to interpret and may result in delayed diagnosis, erroneous treatment and potentially fatal outcome.

Background: Severe hypoglycemia is a lifethreatening iatrogenic complication in the management of diabetic ketoacidosis, however, few studies have described how often this complication occurs. Objective: To identify the risk factors for severe hypoglycemia in children treated for diabetic ketoacidosis and to describe the sociodemographic, clinical characteristics and outcome of these children. Methods: From January 2013 to December 2017, 69 children admitted to pediatric intensive care unit with a diagnosis of diabetic ketoacidosis were enrolled in a retrospective and prospective study. Data of children with and without severe hypoglycemia were compared. Data were analyzed using Epi Info 7.1.5.0. Results: Out of 69 children enrolled, 10 (14.5%) had severe hypoglycemia (girls: 60%, median age 144 months (interquartile range, 108-168 months)). Episodes of severe hypoglycemia occurred during the first 48 hours of hospitalization in 8 (80%) children and during the late night shift in 6 (60%) children. Causes of severe hypoglycemia were: excessive insulin dose (60%), inappropriate infusion solution (70%), failure to properly monitor blood glucose levels (40%). Severe hypoglycemia risk factors were: age < 5 years (p = 0.00004; OR = 42.0 [95% CI: 6.3-279]) and severe malnutrition (p = 0.002; OR = 10.9 [95% CI: 2.4-48.6]). Of 8 (11.6%) children died, 4 had severe hypoglycemia (p = 0.01; OR = 8.8 [95% CI, 1.7-44.8]). Conclusion: The importance and severity of severe hypoglycemia require preventive measures to control risk factors.