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Brain Injury Mar 2024This study aims to create a pediatric head injury database based on cranial CT examinations and explore their epidemiologic characteristics.
PRIMARY OBJECTIVE
This study aims to create a pediatric head injury database based on cranial CT examinations and explore their epidemiologic characteristics.
METHODS
Data related to cranial CT examinations of pediatric head injuries from March 2014 to March 2021 were collected at outpatient and emergency department of a pediatric medical center. The causes of injury, observable post-injury symptoms, and cranial injury findings were extracted with the assistance of natural language processing techniques.
RESULTS
Reviewing the data from records on 52,821 children with head injuries over a period of 7 years, the most common causes of pediatric head injury were falls (58.3%), traffic accidents (26.0%), smash/crush/strike (13.9%), violence (1.5%) and sports-related incidents (0.3%). Overall, most of those injured were boys which accounting for 62.2% of all cases. Skull fractures most commonly occur in the parietal bone (9.0%), followed by the occipital (5.2%), frontal (3.3%) and temporal bones (3.0%). Most intracranial hemorrhages occurred in epidural (5.8%), followed by subdural (5.1%), subarachnoid (0.9%), intraparenchymal (0.5%) and intraventricular (0.2%) hemorrhages. Spring and autumn showed more events than any other season.
CONCLUSIONS
To the best of our knowledge, this is the largest sample of epidemiological study of head injury in the Chinese pediatric population to date.
Topics: Male; Child; Humans; Female; Retrospective Studies; Skull Fractures; Craniocerebral Trauma; Skull; Tomography, X-Ray Computed
PubMed: 38282240
DOI: 10.1080/02699052.2024.2309545 -
Surgical and Radiologic Anatomy : SRA Mar 2024The parietal foramen (PF) of the skull is a variable anatomic feature with important implications for venous drainage, infection, and injury. Its topography is...
BACKGROUND
The parietal foramen (PF) of the skull is a variable anatomic feature with important implications for venous drainage, infection, and injury. Its topography is clinically relevant for neurosurgeons for intracranial navigation and preoperative planning.
METHODS
PF topography was investigated in a series of 440 head computed-tomography scans of Omani subjects at Sultan Qaboos University Hospital. The mean age of the patients was 52 ± 17 years and there were 160 males and 280 females. The topography features of the PF, including frequency, diameter, patency, and relative position in relation to the superior sagittal sinus (SSS), were recorded. Additionally, sex and laterality differences in PF parameters were analyzed using a Chi-square test.
RESULTS
The overall prevalence of PF was 72.3% (318/440). The bilateral presence of PF was identified in 34% of skulls. Unilateral right-side prevalence was 18.2%, while left prevalence was 13.2% (p = 0.62). The prevalence of unilateral accessory PF on the right side was 1.8%, while it was 1.1% on the left (p = 0.69). PF within the sagittal suture/or intra-sutural PF was observed in 6.8% of skulls, with a frequency of 9.4% in men and 5.4% in women (p = 0.29). The diameter of the PF was 1.45 ± 0.74 mm on the right side, and 1.54 ± 0.99 mm on the left side (p = 0.96). There were 2% of incomplete PF. The PF was located over the SSS in 70.3% on the right side and 53.8% on the left side. No significant differences were observed between the PF topography parameters and sex or laterality.
CONCLUSION
The present study for the first time reports the baseline data of PF topography in a large sample of CT scans in the Arab population. The geography and race influence the PF topography differences. PF may be used as a reliable landmark of SSS. The morphological characteristics and distribution of PF reported in this study have clinical implications for imaging diagnosis, intracranial navigation of vascular disorders, and treatment.
Topics: Male; Adult; Humans; Female; Middle Aged; Aged; Retrospective Studies; Sphenoid Bone; Tomography, X-Ray Computed; Superior Sagittal Sinus; Head
PubMed: 38280004
DOI: 10.1007/s00276-023-03284-8 -
BMJ Case Reports Jan 2024A man in his 60s, known with multiple sclerosis, presented with seizures and paresis of the left arm and leg. Brain imaging showed a white matter lesion, right parietal,...
A man in his 60s, known with multiple sclerosis, presented with seizures and paresis of the left arm and leg. Brain imaging showed a white matter lesion, right parietal, which was progressive over the last 6 years and not typical for multiple sclerosis. Brain biopsy showed a B-cell infiltrate with IgA lambda monotypic plasma cell differentiation and amyloid deposits, typed as lambda immunoglobulin light chain (AL). Bone marrow biopsy and PET/CT ruled out a systemic lymphoma. Extended history taking, blood and urine testing (including cardiac biomarkers) identified no evidence of systemic amyloidosis-induced organ dysfunction.Primary cerebral AL amyloidoma is a very rare entity where optimal treatment is difficult to assess. The patient was treated with locally applied volumetric modulated arc radiotherapy, 24 Gy, divided in 12 fractions. Afterwards, the paresis of the left arm partially resolved, and the function of the left leg improved. Seizures did not occur anymore.
Topics: Male; Humans; Immunoglobulin Light Chains; Positron Emission Tomography Computed Tomography; Multiple Sclerosis; Amyloidosis; Immunoglobulin lambda-Chains; Soft Tissue Neoplasms; Seizures; Paresis
PubMed: 38272520
DOI: 10.1136/bcr-2023-256537 -
Cureus Dec 2023The most prevalent kind of skin cancer is basal cell carcinoma (BCC). BCC invasion of the brain occurs quite rarely. Reconstruction approaches along with surgical...
The most prevalent kind of skin cancer is basal cell carcinoma (BCC). BCC invasion of the brain occurs quite rarely. Reconstruction approaches along with surgical excision are the gold standard for treating BCC. In this case, we describe a 75-year-old female patient with highly invasive BCC of the head with subdural invasion. The patient underwent surgery in 2022 in another neurosurgery clinic due to BCC of the head, frequent infection of the skin, and involvement of bone structures by the tumor. The patient presented in 2023 to the neurosurgery clinic at Saint Marina University Hospital with cephalgia, right-side hemiparesis, and a 10 x 10 cm skin defect. On a CT scan, we discovered an invasion of the parietal bones of the skull with an extension to the left subdural space. A craniectomy was performed under general anesthesia, along with hard resection to clear the margins of the BCC that had penetrated the cranial bone. Following the resection of the BCC, reconstruction of the skin defect was performed by a plastic surgeon. Consequently, a satisfactory cosmetic outcome was achieved. Postoperative complications were not observed. The patient was followed up for six months.
PubMed: 38249215
DOI: 10.7759/cureus.50938 -
Brain Injury Jan 2024Surgical treatment remains the mainstream therapeutic regimen for chronic subdural hematoma (CSDH), and burr-hole craniostomy with subdural drainage is the preferable...
BACKGROUND
Surgical treatment remains the mainstream therapeutic regimen for chronic subdural hematoma (CSDH), and burr-hole craniostomy with subdural drainage is the preferable approach. Herein, we reported a case of intracranial granuloma formation as a late complication of burr-hole surgery for CSDH.
CASE PRESENTATION
A 31-year-old man presented with a 1-month history of headache. Head computed tomography (CT) showed a subdural hematoma in the left frontal-temporal-parietal region with significant midline shifting. A burr-hole evacuation of the hematoma with closed-system drainage was performed. CT obtained immediately after the surgery demonstrated that the hematoma was mostly evacuated. Nine months later, he presented to us again due to intermittent headache in the left temporoparietal region. Brain magnetic resonance imaging revealed a space-occupying mass at the site of the original hematoma. A bone-flap craniotomy was performed for resecting the mass. Histopathological examination revealed a granuloma. The microbial cultivation of the resected specimen was negative. The postoperative course was uneventful, and the headache was relieved.
CONCLUSION
Granuloma formation is an extremely rare late complication of burr-hole surgery for CSDH. Physicians involved in the perioperative management of CSDH should be aware of this condition, and bone-flap craniotomy may be warranted.
Topics: Male; Humans; Adult; Hematoma, Subdural, Chronic; Craniotomy; Subdural Space; Magnetic Resonance Imaging; Drainage; Headache; Treatment Outcome
PubMed: 38225760
DOI: 10.1080/02699052.2024.2304860 -
Journal of the Mechanical Behavior of... Mar 2024The course of the middle meningeal vessels can be traced through imprints on the inner table of the human neurocranium. It is as yet unexplored whether these notches...
The course of the middle meningeal vessels can be traced through imprints on the inner table of the human neurocranium. It is as yet unexplored whether these notches lower the load-bearing capacity of the bone when compared to areas that are free of vascular imprints. Here, 310 temporo-parietal samples with and without vascular imprints, from 52 human Crosado-embalmed cadavers, were tested in a three-point bending setup with a half-cylindrical impactor (1 mm radius of curvature) contacting the sample at 11 m/s. The maximum forces before breaking, and the thicknesses of the samples, were statistically compared, including comparing the avascular group to several groups with vascular imprints of different orientations. Furthermore, the influence of sample length and impact location were investigated. To investigate structure and mechanical function of vascular imprints concomitantly, scanning electron microscopy was performed on selected samples in two different planes. The results showed that avascular samples were on average thicker (p < 0.001) and stronger (p ≤ 0.050) compared to samples with vascular imprints. When only thickness-matched samples were analysed, the observed maximum forces of vascular and avascular samples were statistically similar (p ≥ 0.531). Regarding the load-bearing capacity of samples with vascular imprints, it was irrelevant whether the imprint was placed parallel to and directly underneath the impactor, parallel to and offset from the impactor, or perpendicular to the impactor (p > 0.999). The overall results of this study were statistically unrelated to both sample length (p ≥ 0.720) and impact location (p > 0.999). Scanning electron microscopy revealed that vascular imprints are formed through a curve of the inner table. Perforating holes of the inner table are present in avascular areas, however, they are considerably larger in size and higher in number within vascular imprints. In conclusion, vascular imprints are formed through curving of the inner table. In numerical models of human head mechanics, vascular imprints can be accounted for through a simple thinning of the bone assuming the same load-bearing capacity as for the surrounding imprint-free areas.
Topics: Humans; Skull; Cadaver; Head
PubMed: 38219431
DOI: 10.1016/j.jmbbm.2024.106386