scholarly journals Post-traumatic tension pneumocephalus and cystic angiomatosis of the skull: case report

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Haythem H. Osman ◽  
Nazik E. Abdullah ◽  
Ghada S. Alhassan ◽  
Tarig A. Nafie ◽  
Murtada I. Abdellatief ◽  
...  
Keyword(s):  
Head Trauma ◽  
Soft Tissues ◽  
English Literature ◽  
Tension Pneumocephalus ◽  
Bony Lesions ◽  
History Of ◽  
Post Traumatic ◽  
Temporal Bones ◽  
Defective Bone ◽  
Cystic Angiomatosis

Abstract Background Tension pneumocephalus is an increasing air trapped intracranially. Either spontaneous, post-traumatic or iatrogenic in origin. Cystic angiomatosis is a benign vascular hamartoma of the skeleton, when acquired it is either due to trauma or infection. This is the second report in English literature of post-traumatic delayed tension pneumocephalus with the development of cystic angiomatosis of the skull bone. Case presentation A 55-year-old gentlemen, presented with scalp swelling of 6-month duration with history of head trauma 2 years back. The swelling was increasing and associated with progressive walking difficulties and left hearing loss. CT scan and MRI revealed extradural pneumocephalus, parietal and occipital pneumatocele, and multiple lytic bony lesions, left mastoid hyperpneumatization with inner table defect communicating with the extradural space. Diagnosis of delayed extradural tension pneumocephalus was made. Surgical exploration revealed multiple bony defects of parietal, temporal and squamous part of left temporal bones, confirmed extradural pneumocephalus with intact dura. Repair of mastoid defect of (0.5 × 0.5 cm), excision of pneumatocele and removal of lytic bones were performed. Defective bone “cribriform-like” was identified at occipital and parietal regions centrally with a defect of nearly 7 × 7 cm. Future cranioplasty was considered after 6 months. Histology of bony chips and surrounding soft tissues is recognized as cystic angiomatosis. Conclusions The present case developed two very rare complications, following trivial head trauma; the first complication was delayed extradural tension pneumocephalus with pneumatocele which presented 2 years after trauma, the origin of air was from a defect of the inner table of the mastoid, the second complication was cystic angiomatosis of the skull bones. Both complications were managed surgically in one operative session as a combined neurosurgery and otolaryngology teams approach.

Temporomandibular joint herniation and the foramen of Huschke: an unusual external auditory canal mass

2011 ◽  
Vol 125 (12) ◽  
pp. 1279-1281 ◽  
Author(s):  
S J Prowse ◽  
G Kelly ◽  
F Agada
Keyword(s):  
Temporomandibular Joint ◽  
External Auditory Canal ◽  
Soft Tissues ◽  
Anterior Wall ◽  
Ear Canal ◽  
Surgical Closure ◽  
Computed Tomographic ◽  
History Of ◽  
Temporal Bones ◽  
Foramen Of Huschke

AbstractObjectives:We describe a rare case of spontaneous temporomandibular joint herniation into the external auditory canal, and we also review the presentation, aetiology and management of such cases.Case report:An 87-year-old woman presented with a four-month history of left-sided otorrhoea and otalgia. Examination revealed a soft, polypoid mass in the left ear canal. When the patient opened her mouth the lesion disappeared. Subsequent computed tomographic imaging of the patient's temporal bones confirmed an 8.6 mm defect in the antero-inferior portion of the left ear canal, with herniation of retrodiscal soft tissues.Conclusion:The external auditory canal is intimately related to the temporomandibular joint, separated only by its bony anterior wall. Neoplasm, trauma or inflammation in this area can result in displacement of the temporomandibular joint into the ear canal; however, spontaneous herniation is rare. Persistence of the primitive foramen of Huschke can result in dehiscence of the anterior canal wall, allowing articular tissue to prolapse into the ear canal. Surgical closure of these defects is known to be effective in ameliorating symptomatic cases.

scholarly journals Post-Traumatic Meningitis: Case-Based Review of Literature from Internists’ Perspective

2021 ◽  
pp. 41-49
Author(s):  
Shubhabrata Das ◽  
Tanmoy Pal
Keyword(s):  
Head Trauma ◽  
Antimicrobial Treatment ◽  
Neurosurgical Procedures ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Holistic Management ◽  
History Of ◽  
Post Traumatic ◽  
Closed Head Trauma ◽  
Timely Referral

Most cases of post-traumatic meningitis (PTM) occur following immediate head trauma or neurosurgical procedures. Hence, internists do not often come across these patients. However, closed-head trauma can be associated with community-acquired meningitis (CAM), and this history can often be missed especially if it is remote or trivial in nature. Therefore, meticulous clinical assessment is necessary to identify cases of community-acquired PTM. Knowledge about pathophysiological, anatomical, and microbiological context of community-acquired PTM is required in order to manage these patients. The role of internist is to provide holistic management in these patients which includes not only antimicrobial treatment but also timely referral to surgical specialties if required as well as vaccination to prevent further episodes. Here, we present a case of CAM with remote history of close head trauma and cerebrospinal fluid rhinorrhea for years who was found to have base of skull (BOS) defect on imaging of skull. He was treated with antibiotics and referred to surgical specialties for repair of BOS defect as well as given pneumococcal vaccine to prevent further episodes of meningitis.

Poetics of the Pillory

2019 ◽  
Author(s):  
Thomas Keymer
Keyword(s):  
English Literature ◽  
Extended Period ◽  
Government Control ◽  
History And Criticism ◽  
Romantic Period ◽  
Restoration Measure ◽  
History Of ◽  
The Government ◽  
Argument Proceeds ◽  
Prior Restraint

On the lapse of the Licensing Act in 1695, Thomas Macaulay wrote in his History of England, ‘English literature was emancipated, and emancipated for ever, from the control of the government’. It’s certainly true that the system of prior restraint enshrined in this Restoration measure was now at an end, at least for print. Yet the same cannot be said of government control, which came to operate instead by means of post-publication retribution, not pre-publication licensing, notably for the common-law offence of seditious libel. For many of the authors affected, from Defoe to Cobbett, this new regime was a greater constraint on expression than the old, not least for its alarming unpredictability, and for the spectacular punishment—the pillory—that was sometimes entailed. Yet we may also see the constraint as an energizing force. Throughout the eighteenth century and into the Romantic period, writers developed and refined ingenious techniques for communicating dissident or otherwise contentious meanings while rendering the meanings deniable. As a work of both history and criticism, this book traces the rise and fall of seditious libel prosecution, and with it the theatre of the pillory, while arguing that the period’s characteristic forms of literary complexity—ambiguity, ellipsis, indirection, irony—may be traced to the persistence of censorship in the post-licensing world. The argument proceeds through case studies of major poets and prose writers including Dryden, Defoe, Pope, Fielding, Johnson, and Southey, and also calls attention to numerous little-known satires and libels across the extended period.

scholarly journals R1352Q CACNA1A Variant in a Patient with Sporadic Hemiplegic Migraine, Ataxia, Seizures and Cerebral Oedema: A Case Report

2021 ◽  
pp. 123-130
Author(s):  
Anker Stubberud ◽  
Emer O’Connor ◽  
Erling Tronvik ◽  
Henry Houlden ◽  
Manjit Matharu
Keyword(s):  
Mental Retardation ◽  
Case Report ◽  
Genetic Testing ◽  
Head Trauma ◽  
Cerebral Oedema ◽  
De Novo ◽  
Minor Head Trauma ◽  
Hemiplegic Migraine ◽  
Wide Range ◽  
History Of

Mutations in the <i>CACNA1A</i> gene show a wide range of neurological phenotypes including hemiplegic migraine, ataxia, mental retardation and epilepsy. In some cases, hemiplegic migraine attacks can be triggered by minor head trauma and culminate in encephalopathy and cerebral oedema. A 37-year-old male without a family history of complex migraine experienced hemiplegic migraine attacks from childhood. The attacks were usually triggered by minor head trauma, and on several occasions complicated with encephalopathy and cerebral oedema. Genetic testing of the proband and unaffected parents revealed a de novo heterozygous nucleotide missense mutation in exon 25 of the <i>CACNA1A</i> gene (c.4055G&#x3e;A, p.R1352Q). The R1352Q <i>CACNA1A</i> variant shares the phenotype with other described <i>CACNA1A</i> mutations and highlights the interesting association of trauma as a precipitant for hemiplegic migraine. Subjects with early-onset sporadic hemiplegic migraine triggered by minor head injury or associated with seizures, ataxia or episodes of encephalopathy should be screened for mutations. These patients should also be advised to avoid activities that may result in head trauma, and anticonvulsants should be considered as prophylactic migraine therapy.

scholarly journals Leiomyosarcoma of the Tracheostomy Site in a Patient with History of Laryngeal Squamous Cell Carcinoma

2021 ◽  
pp. 912-917
Author(s):  
Zainub Ajmal ◽  
Abdul Moiz Khan ◽  
Lezah McCarthy ◽  
Allison Lupinetti ◽  
Syed Mehdi
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
English Literature ◽  
Neck Region ◽  
Multiple Risk Factors ◽  
History Of ◽  
Rare Malignancy

Leiomyosarcoma (LMS) of the trachea is an extremely rare malignancy with only a few reported cases in English literature. As such the diagnosis can be frequently missed or delayed. We present a case of a 69-year-old male who underwent tracheostomy for airway obstruction secondary to glottic squamous cell carcinoma and treated definitely with radiation therapy. Subsequently, the patient developed LMS of the tracheostomy site. The case further details multiple risk factors that could contribute to development of LMS including radiation exposure, prior malignancy, and chronic inflammation. These risk factors have been well established for LMS in other sites but less so in the head and neck region, which is the subject of our discussion. We also review the current guidelines for head and neck as well as limb sarcomas and discussed role of surgery or radiation and their accompanying challenges in management of this rare malignancy.

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