Vertebral artery dissection (VAD) has been infrequently recognized in children. The authors have reviewed 68 reported cases of VAD in children in the existing literature. An association between routine types of neck movement in sports and the evolution of VAD was recognized in half of the reported cases. Boys outnumbered girls by a ratio of 6.6 to 1, in contrast to adults, for whom the male to female ratio is approximately equal (1.3 to 1). Neck pain, one of the hallmark symptoms of VAD in adults, was infrequently noted in this young population (12%). Most children presented with various combinations of symptoms and signs, including ataxia (53%), headache (38%) and vomiting (34%). Eye signs or symptoms were noted in 72% of patients, and paresis/paralysis of one or more extremity occurred in 54%. Angiography was the method most frequently used to diagnose VAD (63/68; 93%). Magnetic resonance angiography (MRA) revealed pathognomonic signs of VAD in only 3 out of 13 patients evaluated (23%). In this series of 68 patients, 48 reports failed to indicate whether or not a cervical X-ray was performed, but in the 20 patients for whom such information was recorded, half had skeletal abnormalities in the occipital/atlas/axis region. The most common treatments were antiplatelet therapy (n = 15) and anticoagulation with (n = 8) or without (n = 7) supplemental antiplatelet therapy. Asymptomatic recovery occurred in 12 of the 15 patients (80%) who received antiplatelet therapy compared with 4 of the 15 patients (27%) who received anticoagulation therapy with or without antiplatelet therapy. There is a very high incidence of associated cervical anomalies in children with VAD. Further studies are required to determine if noninvasive examinations such as magnetic resonance imaging, ultrasonography, computed tomography angiography and MRA could replace angiography as the modality of choice in establishing the diagnosis of VAD in children. The role of different therapies for children presenting with symptoms related to VAD is unclear.

No abstract

No abstract

Vertebral artery dissection may rarely be associated with Klippel-Feil abnormality in children.

Malnutrition is a problem at varying proportions in developing countries, and anthropometry is a simple tool to assess its magnitude in children. This study was aimed at identifying the prevalence of malnutrition among 500 children of govt schols of Azad Nagar, bangalore south Asia. The value of using various field based formulae and of various anthropometric indicators used for classification of malnutrition was also studied. The study was focused on children aged 8-14 years studying in class 1 st to 8 th in govt schools. Anthropometric data and eating practices of children were collected with the help of a pretested questionnaire and food intake diary. Selected anthropometric measurements were taken using standard techniques. Their Body Mass Index (B.M.I) for age was calculated and compared with WHO (2007) standards. Compared to WHO standards, mean BMI of school children in Azad Nagar and its surrounding area was inferior at all ages. The prevalence of malnutrition was 68%, males recorded a relatively high high rate of malnutrition 57.94% (197) than females 42.06% (143). The study reveals that the average of govt school children in Azad Nagar are underweighted. Poor nutrition of children do not only affects the cognitive development of children but also likely to reduce the work capacity in future.