Can Craniometry Play a Role in Cluster Headache Diagnosis? A Pilot Exploratory TC-3D Based Study

Pain Medicine ◽  
2021 ◽  
Author(s):  
Antonio Russo ◽  
Marcello Silvestro ◽  
Laura Vanore ◽  
Raffaella Capasso ◽  
Mattia Siciliano ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Logistic Regression ◽  
Cluster Headache ◽  
Frontal Bone ◽  
Diagnostic Process ◽  
Cutoff Score ◽  
3D Computed Tomography ◽  
Headache Diagnosis ◽  
Probable Presence ◽  
Bone Height

Abstract Background Since the pioneering reports of the so-called leonine face in cluster headache (CH) patients, cranial and facial features of these patients have been poorly investigated with conflicting results. We aimed to investigate whether abnormalities in craniometric measurements could characterize male CH patients and represent reliable and reproducible diagnostic biomarkers able to identify CH patients. Methods Brain CT images were recorded between 2018 and 2020 in 24 male patients with CH and in 24 matched healthy controls (HC). Then, craniometric measurements were obtained, and logistic regression and receiver operating characteristic curves analyses were used to identify the craniometric abnormalities able to distinguish CH patients from HC. Results Logistic regression analyses showed that frontal bone height and facial width were able to discriminate, one independently from the other, CH patients from HC with an overall accuracy of 77%. The optimal cutoff score in detecting the probable presence of CH was 11.50 cm for frontal bone height and 13.30 cm for facial width. Discussion In the present study we found, for the first time by means of brain 3D computed tomography approach, abnormal craniometric measurements in CH patients when compared with HC. The absence of differences in smoke and alcohol intake suggests that the observed craniometric abnormalities may represent a specific feature of CH patients. Conclusion The craniometric evaluation by means of brain 3D computed tomography could represent a widespread, noninvasive, and accurate tool to support CH diagnosis to avoid frequent misdiagnosis or delay in the diagnostic process.

scholarly journals Aneurysm Arising at the Origin of a Duplicated Middle Cerebral Artery

2021 ◽  
pp. 446-450
Author(s):  
Jean Roch Alliez ◽  
Luis Manera
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Haemorrhage ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
World Federation ◽  
Treatment Procedure ◽  
3D Computed Tomography ◽  
Ruptured Aneurysms ◽  
Tomography Reconstruction ◽  
Computed Tomography Reconstruction

A duplicated middle cerebral artery (DMCA) is a common anomaly. However, aneurysms arising from the origin of a DMCA are extremely rare. A 22-year-old female was admitted to our hospital with a World Federation of Neurosurgical Societies grade 2 subarachnoid haemorrhage. Four-vessel angiography revealed a DMCA and an aneurysm arising from the origin of this artery. The aneurysm was successfully treated by embolization, and the patient was discharged 2 weeks later. Ruptured aneurysms arising from the origin of a DMCA can be successfully treated by embolization. These aneurysms are small and 3D-computed tomography reconstruction is mandatory to detect them. It is important to preserve the DMCA during the treatment procedure.

scholarly journals Prediction of Patients with Acute Cholecystitis Requiring Emergent Cholecystectomy: A Simple Score

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Wael N. Yacoub ◽  
Mikael Petrosyan ◽  
Indu Sehgal ◽  
Yanling Ma ◽  
Parakrama Chandrasoma ◽  
...  
Keyword(s):  
Heart Rate ◽  
Logistic Regression ◽  
Acute Cholecystitis ◽  
High Probability ◽  
Acute Inflammation ◽  
Gallbladder Wall ◽  
Cutoff Score ◽  
Gangrenous Cholecystitis ◽  
Pathological Review ◽  
Low Probability

The objective was to develop a score, to stratify patients with acute cholecystitis into high, intermediate, or low probability of gangrenous cholecystitis. The probability of gangrenous cholecystitis (score) was derived from a logistic regression of a clinical and pathological review of 245 patients undergoing urgent cholecystectomy. Sixty-eight patients had gangrenous inflammation, 132 acute, and 45 no inflammation. The score comprised of: age > 45 years (1 point), heart rate > 90 beats/min (1 point), male (2 points), Leucocytosis > 13,000/mm3(1.5 points), and ultrasound gallbladder wall thickness>4.5 mm (1 point). The prevalence of gangrenous cholecystitis was 13% in the low-probability (0–2 points), 33% in the intermediate-probability (2–4.5 points), and 87% in the high probability category (>4.5 points). A cutoff score of 2 identified 31 (69%) patients with no acute inflammation (PPV 90%). This scoring system can prioritize patients for emergent cholecystectomy based on their expected pathology.

scholarly journals Factors associated with pericolic fat stranding of colon cancer on computed tomography colonography

2018 ◽  
Vol 7 (2) ◽  
pp. 205846011875757
Author(s):  
Tsuyoshi Morimoto ◽  
Takayuki Yamada ◽  
Kunihisa Miyakawa ◽  
Yasuo Nakajima
Keyword(s):  
Computed Tomography ◽  
Colon Cancer ◽  
Logistic Regression ◽  
Lymph Node ◽  
Univariate Analysis ◽  
Depth Of Invasion ◽  
Factors Associated ◽  
Longitudinal Length ◽  
Fat Stranding ◽  
Group Comparisons

Background Pericolic fat stranding on computed tomography (CT) scans has been an important feature for staging colon cancer. However, the factors associated with pericolic fat stranding have not been elucidated to date. Purpose To determine factors associated with pericolic fat stranding of colon cancer on CT colonography (CTC). Material and Methods Overall, 150 patients with 155 colon cancer lesions were retrospectively assessed by two radiologists for pericolic fat stranding on CTC. Circumferential proportion of the tumor (CPtumor; <50%, 50–75%, and ≥75%), longitudinal length, depth of invasion (≤T2, T3, T4), lymph node and distant metastasis, and lymphovascular invasion were recorded. Univariate and multivariate logistic regression analyses were performed between pericolic fat stranding and each factor. Multi-group comparisons were performed for the CPtumor and depth of invasion. Results Pericolic fat stranding was identified in 57 lesions (36.8%). Univariate analysis revealed significant associations of pericolic fat stranding with all factors ( P < 0.027), except for lymph node metastasis ( P = 0.087). Multi-group comparisons revealed that pericolic fat stranding was more frequent with increasing CPtumor ( P < 0.001); however, no significant differences were observed beyond subserosal infiltration ( P = 0.225). Logistic regression analysis revealed the CPtumor (<75% vs. ≥75%; P = 0.008, <50% vs. 50–75%; P = 0.047) and longitudinal length ( P = 0.001) as explainable variables. Conclusion Pericolic fat stranding identified on CT images of colon cancer is demonstrated more frequently with increasing circumferential proportion of the tumor and longitudinal length.

scholarly journals Retrobulbar Cryptococcoma Mimicking Tumor in a Labrador Retriever

2021 ◽  
Vol 49 ◽  
Author(s):  
Fábio Luiz da Cunha Brito ◽  
Eduardo Perlmann ◽  
Jéssica Naiara Voitena ◽  
Andrea Kuner ◽  
Rayssa Dias Faleiro
Keyword(s):  
Computed Tomography ◽  
Olfactory Bulb ◽  
Cryptococcus Neoformans ◽  
Frontal Bone ◽  
Labrador Retriever ◽  
Dorsal Region ◽  
Fungal Propagules ◽  
Ocular Ultrasound ◽  
Orbital Wall ◽  
History Of

Background: Cryptococcosis is a systemic mycotic disease caused by encapsulated yeasts C. neoformans and C. gattii. Cryptococcus neoformans is predominantly found in soils and feces of pigeons and psittacids. Infection occurs mainly through the respiratory tract, through the inspiration of fungal propagules (basidiospores and/or desiccated yeast cells). The main lesions observed are in the nasal cavity and lungs, but in dogs, the central nervous system and eyes are widely affected. Despite some previously mentioned reports, the retrobulbar form has not been described in the literature. Therefore, the purpose of this report is to describe a case of retrobulbar cryptococcoma mimetizing a tumor in a young bitch.  Case: A 2-year-old female Labrador Retriever,  was admitted to one Veterinary Hospital with exophthalmia on the left eye for 15 days and other signs included negative retropulsion, mydriasis, and abscence of menace and pupillary reflexes. Ocular ultrasound imaging revealed a hyperecotic and heterogeneous retrobulbar mass in the mid-dorsal region compressing the optic nerve. Computed tomography of the skull showed the presence of proliferation of neoplastic tissue in a locally invasive retrobulbar region promoting      moderate rostrolateral displacement of the left ocular bulb, discrete osthelysis in maxillary bone, palatine, medial wall of the orbital bone and frontal bone, with destruction of cribiform plate adjacent to the dorsal region of the orbital wall and presence of mild contrast uptake in the region of the left olfactory bulb lobe, characterizing a picture compatible with neoplasia with malignancy and locally invasive characteristics. Exenteration and excision of part of the frontal bone were performed and histopathological examination revealed granulation with the presence of fibroblasts and  numerous typical blastoconidia of Cryptococcus neoformans. The patient was treated with Itraconazole [10 mg/kg, v.o, SID, for 90 days] and one year after diagnosis, X-ray was performed to control the lesion and radiographic aspects were within normal limits.Discussion: Cryptococcus sp. is an environmental fungus that has the potential to be pathogenic to humans and animals. Fungus present as a basidiospores in pigeon droppings. The patient described had a history of contact with free-living pigeons, making it a risk factor for the occurrence of cryptococcosis, being the possible cause of the infection. In dogs, the disease is mainly described in immunosuppressed animals, which was not the case of the patient, who presented clinical and laboratory results within the normal range and without a previous history of use of immunosuppressants. The alterations described in the computed tomography, such as destruction of the cribriform plate adjacent to the dorsal region of the left orbital wall and the presence of slight contrast uptake in the left olfactory bulb lobe region, are compatible with the main entry point for propagules of Cryptococcus sp. In the present case, no periocular and ocular alterations were observed as described in the literature, and the lesion was restricted to the retrobulbar space. Ultrasonography and computed tomography revealed a neoformation mimicking a malignant neoplasm and the diagnosis of cryptococcoma was revealed by histopathology.  Based on the present case, cytology through aspiration of retrobulbal neoformations is imperative as a diagnostic method, especially in endemic areas for fungal diseases that can mimic ocular neoplasms. Keywords: cryptococcosis, fungus, Cryptococcus sp., dog. Descritores: criptococose, fungo, Cryptococcus sp., cão.

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