Erratum to: 508 Narcolepsy Associated With a History of Head Injury: A Retrospective Review

Abstract Introduction Head injuries are becoming much more prevalent and may be secondary to sports injuries, motor vehicle accidents, falls, domestic violence, assault, and military blast explosions. Sleepiness may occur acutely and/or chronically after a head injury. Chronic hypersomnia may be overlooked or under-reported in those with a history of head injury, and the association may not be made. Hypersomnia can occur in those with mild, moderate, and severe head injuries, with or without loss of consciousness. The pathophysiology/neuropathology of sleep-wake disturbances after Traumatic Brain Injury was discussed by Lim and Baumann 2020 in their Up To Date review entitled “Sleep-wake disorders in patients with traumatic brain injury”. They reported possible abnormalities in orexin/hypocretin, decreased histaminergic neurons, melatonin abnormalities, decreased serotonergic neurons, decreased noradrenergic neurons, and structural brain changes that can play a role. It is also possible that a head injury occurs in someone predisposed to the development of narcolepsy or that the sleepiness of undiagnosed narcolepsy leads to increased injuries. Methods A retrospective review of charts from 2013 to 2020 revealed 176 patients diagnosed with narcolepsy in our psychiatric/sleep outpatient practice. Information on head injuries was obtained by questionnaires completed by the patient and/or interview with staff. Narcolepsy was diagnosed by PSG/MSLT and/or DSM-V criteria of narcolepsy. Results Of the 176 patients diagnosed with narcolepsy, 125 were female (71%) and 51 were male (29%). The age range was 11 to 75 years, with an average age of 39 years old. Cataplexy was present in 117 patients (66.8%). A history of a head injury was reported at intake by 50 patients (28.4%). Of the patients with a history of a head injury, 34 (68%) were female, 16 (32%) were male, and 36 (72 %) had a history of cataplexy. Conclusion This study revealed 28.4% of patients diagnosed with narcolepsy reported a history of a head injury of varying degrees of severity. While direct causation cannot be declared, the association of a head injury and continued hypersomnia suggests further evaluation of narcolepsy may be beneficial. Support (if any) **No support for this study was given.

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Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1716857 ◽

2020 ◽

Author(s):

Adam Lee ◽

Adam Bajinting ◽

Abby Lunneen ◽

Colleen M. Fitzpatrick ◽

Gustavo A. Villalona

Keyword(s):

Literature Review ◽

Retrospective Review ◽

Review Of The Literature ◽

Rare Presentation ◽

Spontaneous Pneumomediastinum ◽

Nonaccidental Trauma ◽

Comprehensive Literature Review ◽

Healthy Infants ◽

History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

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Retrospective Review of Multitarget Stool DNA as a Screening Test for Colorectal Cancer

The American Surgeon ◽

10.1177/00031348211031844 ◽

2021 ◽

pp. 000313482110318

Author(s):

Thomas K. Kleinschmidt ◽

Austin Clements ◽

Mark A. Parker ◽

Steven D. Scarcliff

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Retrospective Review ◽

Screening Test ◽

Hyperplastic Polyps ◽

Dna Testing ◽

History Of ◽

Stool Dna ◽

Stool Dna Testing ◽

Advanced Adenomas

Objectives To review the effectiveness of noninvasive multitarget stool DNA testing as a screening test for colorectal cancer. Methods We performed a retrospective review of patients referred to 2 high volume outpatient procedural centers for colonoscopy for positive Cologuard test. Positive findings for colorectal cancer based on pathologic findings and also advanced adenomas were recorded. Positive predictive value (PPV) was assessed. Results Of the 1585 patients evaluated and referred for colonoscopy from January 1, 2018 to November 1, 2019, for ICD-10 codes R19.5 (other fecal abnormalities) and K92.1 (melena), 84 were referred for a positive Cologuard test. Out of the 84, 6 were excluded based on family history of colon cancer in first degree relative or personal history of inflammatory bowel disease. Of the remaining 78 patients, 1 patient (1.3%) had colorectal cancer and 5 (6.4%) had advanced adenomas (>1 cm size, high grade dysplasia or villous). Postive predictive value for colorectal cancer was 1.3% and for precancerous lesions plus colorectal cancer was 7.7%. A total of 53 (68.0%) patients had either totally normal colonoscopy or hyperplastic polyps. Out of the 78 individuals in our study, 70 (89.7%) had normal findings, hyperplastic polyps, or non-advanced adenomas. Conclusions Multitarget stool DNA testing carries an unacceptably low PPV to be utilized as a screening test for colorectal cancer. The study fails to detect both adenomas and colon cancer at a higher rate than screening colonoscopy in selected studies. The advantage of being noninvasive has been noted to increase colorectal cancer screening in otherwise non-compliant Medicare patients.

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Cognitive reserve in neuropsychiatry

Psychological Medicine ◽

10.1017/s0033291706007501 ◽

2006 ◽

Vol 36 (8) ◽

pp. 1053-1064 ◽

Cited By ~ 159

Author(s):

J. H. BARNETT ◽

C. H. SALMOND ◽

P. B. JONES ◽

B. J. SAHAKIAN

Keyword(s):

Bipolar Disorder ◽

Cognitive Function ◽

Head Injury ◽

Cognitive Reserve ◽

Protective Factor ◽

Psychiatric Symptoms ◽

Neuropsychiatric Disorders ◽

Future Studies ◽

Cognitive Failure ◽

History Of

Background. The idea that superior cognitive function acts as a protective factor against dementia and the consequences of head injury is well established. Here we suggest the hypothesis that cognitive reserve is also important in neuropsychiatric disorders including schizophrenia, bipolar disorder and depression.Method. We review the history of passive and active models of reserve, and apply the concept to neuropsychiatric disorders. Schizophrenia is used as an exemplar because the effects of premorbid IQ and cognitive function in this disorder have been extensively studied.Results. Cognitive reserve may impact on neuropsychiatric disorders in three ways: by affecting the risk for developing the disorder, in the expression of symptoms within disorders, and in patients' functional outcome. Cognitive failure below a certain threshold may alone, or in combination with common psychiatric symptoms, produce neuropsychiatric syndromes.Conclusions. Consideration of cognitive reserve may considerably improve our understanding of individual differences in the causes and consequences of neuropsychiatric disorders. For these reasons, the concept of cognitive reserve should be incorporated in future studies of neuropsychiatric disorder. It may be possible to enhance cognitive reserve through pharmacological or non-pharmacological means, such as education, neurocognitive activation or other treatment programmes.

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Prevalence of Post-Headshake Nystagmus in Patients with Caloric Deficits and Vertigo

Otolaryngology ◽

10.1177/019459989210600201 ◽

1992 ◽

Vol 106 (2) ◽

pp. 121-127 ◽

Cited By ~ 14

Author(s):

Joel A. Goebel ◽

Philip Garcia

Keyword(s):

Retrospective Review ◽

Clinical Observation ◽

Physical Sign ◽

Sudden Stop ◽

Eyes Closed ◽

Peripheral Vestibulopathy ◽

Eyes Open ◽

History Of ◽

Caloric Deficit

Post-headshake nystagmus (PHN) has recently been described as a clinically useful physical sign implying uncompensated asymmetric input from the vestibular end organs. A rapid 20-second headshake and sudden stop produces a jerk nystagmus of 5- to 20-second duration in certain individuals with symptoms suggestive of a peripheral vestibulopathy. This retrospective review of 214 patient evaluations was undertaken to study the associations between post-headshake nystagmus, caloric deficits after bi-thermal binaural irrigation, and the presence of vertigo. Both clinical observation of the nystagmus with eyes open (PHN-OBS) and routine EOG recording with eyes closed (PHN-EOG) were used. In patients with unilateral caloric deficits, 42% (18 of 43) had PHN-EOG, compared with 18% (3 of 17) in patients with bilateral dysfunction and 15% (23 of 154) in patients with normal calorics (p < 0.001H). In similar fashion, 26% (32 of 124) of patients with vertigo (recent or past) had PHN-EOG compared to 13% (12 of 90) of patients without vertigo (p < 0.03). Finally, of 110 cases with both PHN-EOG and PHN-OBS performed, 45% (9 of 20) with PHN-EOG also had PHN-OBS, as opposed to only 4% (4 of 90) without PHN-EOG displaying PHN-OBS (p < 0.0001). We conclude that the prevalence of post-headshake nystagmus is increased in patients with either a unilateral caloric deficit or a history of true vertigo, and is best detected in the absence of vision.

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Association of post-traumatic communication of endocranium and nasal cavity with recurrent meningoencephalitis without rhinorrhea

Vojnosanitetski pregled ◽

10.2298/vsp1011945d ◽

2010 ◽

Vol 67 (11) ◽

pp. 945-948 ◽

Cited By ~ 1

Author(s):

Djula Djilvesi ◽

Petar Vulekovic ◽

Tomislav Cigic ◽

Zeljko Kojadinovic ◽

Vladimir Papic ◽

...

Keyword(s):

Case Report ◽

Head Injury ◽

High Resolution ◽

Ct Scans ◽

Direct Impact ◽

Skull Base Fracture ◽

Therapeutic Procedures ◽

History Of ◽

Post Traumatic ◽

Transnasal Endoscopic Surgery

Introduction. A gunshot head injury, characterized by a huge intensity of mechanical force, in addition to the direct tissue damage at the location of direct impact, may cause a skull and skull base fracture, distant from the the point of direct impact, which could be further complicated by creating a communication between endocranium and nasal/paranasal cavities. Such cases pose a great diagnostic and therapeutic challenge for every clinician. Case report. The patient is presented with the history of a perforating gunshot head injury six years ago, with recurrent attacks of meningoencephalitis subsequently, without rhinorrhea. By using high resolution CT scans, previous traumatic skull injury was verified and a fissure in the frontoethmoidal region, far from the point of direct impact, was detected. The patient underwent transnasal endoscopic surgery, in order to seal the communication on skull basis. The patient did not suffer from meningoencephalitis during the next two years. Conclusion. In the cases with late occurrence of posttraumatic meningoencephalitis with no signs of rhinorrhea, a possibility of an existing communication between intracranial and nasal cavities should be considered, as well. By applying modern diagnostic and therapeutic procedures such communication should be precisely located and sealed.

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Brain SPECT and Neuropsychological Examination in Patients with a History of Minor Craniocerebral Trauma Nine Years after Head Injury

The Neuroradiology Journal ◽

10.1177/197140091002300103 ◽

2010 ◽

Vol 23 (1) ◽

pp. 15-27

Author(s):

S. Dawid ◽

W. Marks ◽

J. Lasek ◽

Z. Witkowski ◽

K. Gołąbek-Dropiewska ◽

...

Keyword(s):

Head Injury ◽

Craniocerebral Trauma ◽

Brain Spect ◽

Neuropsychological Examination ◽

History Of

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The Natural History of Raised Intracranial Pressure After Head Injury in Man

Intracranial Pressure V ◽

10.1007/978-3-642-69204-8_94 ◽

1983 ◽

pp. 554-557 ◽

Cited By ~ 1

Author(s):

S. Galbraith ◽

E. Cardoso ◽

J. O. Rowan ◽

G. Teasdale

Keyword(s):

Head Injury ◽

Intracranial Pressure ◽

Natural History ◽

Raised Intracranial Pressure ◽

History Of

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Overdosing the Overdosed

The Cognitive Autopsy ◽

10.1093/med/9780190088743.003.0032 ◽

2020 ◽

pp. 211-218

Author(s):

Pat Croskerry

Keyword(s):

Emergency Department ◽

Head Injury ◽

Medication Error ◽

General Hospital ◽

Middle Aged ◽

Fundamental Attribution Error ◽

Inappropriate Use ◽

Laboratory Error ◽

Toxic Drug ◽

History Of

In this case, a middle-aged male presents to the emergency department (ED) of a general hospital with dizziness and weakness and a history of falling the previous day associated with seizures. There is also a possibility of head injury. He is well known to the department and has been seen previously by the head of the department regarding inappropriate use of the ED. Some difficulty ensues in terms of whether he has been having seizures or not, which, combined with a medication error and a laboratory error, results in him being overdosed with a significantly toxic drug. The case is an example of groupthink as well as fundamental attribution error.

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Incidental Finding of Posterior Fossa Epidermoid, In a Head Trauma Patient: A Case Report

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v17i1.25321 ◽

2019 ◽

Vol 17 (1) ◽

pp. 56-57

Author(s):

Narendra Prasad Baskota ◽

K. Singh

Keyword(s):

Case Report ◽

Head Injury ◽

Posterior Fossa ◽

Head Trauma ◽

Incidental Findings ◽

Incidental Finding ◽

Brain Lesions ◽

Minor Head Trauma ◽

Post Operative Period ◽

History Of

Incidental findings of brain lesions in head injury are seen frequently. In our region NCC is common, but in literature meningioma andarachnoid cyst are common. Here we report a case of incidental finding of posterior fossa epidermoid in a 25 years old male patient who had history of minor head trauma which was operated with relatively uneventful post operative period.

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