scholarly journals Delayed subaponeurotic fluid collection on an infant’s head: Underreported case and review of the literature

2021 ◽  
Vol 12 ◽  
pp. 233
Author(s):  
Ahmad Faried ◽  
Akhmad Imron ◽  
Almira Aliyannissa ◽  
Dini Indrawati

Background: Delayed subaponeurotic fluid collection (DSFC) is a relatively uncommon problem, probably under reported soft swelling in the scalp which usually develops in infancy that occurs weeks to months after birth. Although the exact etiology remains unclear, several theories have been postulated such as (i) cerebrospinal fluids (CSF) leak from microfractures of the skull and (ii) disrupted lymphatic drainage, gradually liquefying subaponeurotic bleeding. Here, we reported typical clinical findings of DSFC and analysis of the fluid aspirate from our patient. To the best of our knowledge, this is the first case reported from Asia, particularly from Indonesia. Case Description: A healthy 2-month-old girl infant presented with 2 weeks history of occipital painless fluctuant scalp mass with no swelling. She was born at term from a nulliparous mother; by emergency cesarean delivery following failed induction of labor. There was no history of scalp injury at birth nor recent head trauma; ultrasonography showed translucent fluid in subaponeurotic or subgaleal space. The fluid collection was noted to be fluctuant, free-flowing across suture lines, without discoloration or bruising; when placed supine, the fluid collected at her midocciput. A diagnostic tap confirmed the presence of serosanguinous CSF led to a diagnosis of DSFC. Conclusion: Herein, we reported the first DSFC case from Indonesia. With no previous experience of the condition, a definitive diagnosis was possible through a very carefully physical examination and history taking, along with a good communication among the neurosurgeon, pediatrician, and the clinical pathologist.

2020 ◽  
Vol 11 ◽  
pp. 245
Author(s):  
Keiichiro Ohara ◽  
Tohru Terao ◽  
Shotaro Michishita ◽  
Kunitomo Sato ◽  
Yuichi Sasaki ◽  
...  

Background: Cerebrospinal fluid (CSF) leaks and pneumocephalus commonly occur due to head trauma or surgical procedures. Spontaneous CSF (sCSF) leaks, however, occur without any clear etiology and are relatively uncommon. Case Description: An 84-year-old woman presented with the right-sided otorrhea. The patient had a history of a ventriculoperitoneal shunt placement following a subarachnoid hemorrhage treated by clip ligation of a left-sided ruptured cerebral aneurysm 7 years before presentation, with shunt catheter ligation after evidence of intraventricular pneumocephalus 6 years before presentation. At admission, computed tomography (CT) imaging of the head showed enlargement of the lateral ventricles, a right mastoid fluid collection, and a defect of the superior wall of the right petrous bone. We performed a right temporal craniotomy for the repair of the CSF leak. Intraoperatively, it was noted that temporal lobe parenchyma herniated into the mastoid air cells through lacerated dura and a partially defective tegmen mastoideum. The leak point was successfully obliterated with a pericranial graft and reinforced by a collagen sheet and fibrin glue. There was no recurrence of otorrhea postoperatively. Conclusion: This report presents a very unique case of a patient with a CSF leak and pneumocephalus occurring on the contralateral side of a previous cranial surgery. We accurately identified the defect site with CT imaging and repaired the CSF leak by temporal craniotomy. Awareness of the mechanisms by which sCSF leaks can be caused by aberrant arachnoid granulations is imperative for neurosurgeons.


2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Shiva Poola ◽  
Arjun Mohan

Bladder injury is a rare condition mostly due to high-energy trauma. Bladder injury tends to be suspected during traumatic events in the setting of hematuria, pain, and voiding difficulty. Unfortunately, in end-stage renal disease patients who are oliguric or anuric these classic clinical findings would not be seen. We report a case of bladder rupture without a history of trauma or without a history of hematuria or voiding difficulties. To our knowledge this is the first case to describe such an injury with a lack of trauma history.


Background: Binasal Occlusion (BNO) is a clinical technique used by many neurorehabilitative optometrists in patients with mild traumatic brain injury (mTBI) and increased visual motion sensitivity (VMS) or visual vertigo. BNO is a technique in which partial occluders are added to the spectacle lenses to suppress the abnormal peripheral visual motion information. This technique helps in reducing VMS symptoms (i.e., nausea, dizziness, balance difficulty, visual confusion). Case Report: A 44-year-old AA female presented for a routine eye exam with a history of mTBI approximately 33 years ago. She was suffering from severe dizziness for the last two years that was adversely impacting her ADLs. The dizziness occurred in all body positions and all environments throughout the day. She was diagnosed with vestibular hypofunction and had undergone vestibular therapy but reported little improvement. Neurological exam revealed dizziness with both OKN drum and hand movement, especially in the left visual field. BNO technique resulted in immediate relief of her dizziness symptoms. Conclusion: To our knowledge, this is the first case that illustrates how the BNO technique in isolation can be beneficial for patients with mTBI and vestibular hypofunction. It demonstrates the success that BNO has in filtering abnormal peripheral visual motion in these patients.


Author(s):  
Kathryn M. de Luna

This chapter uses two case studies to explore how historians study language movement and change through comparative historical linguistics. The first case study stands as a short chapter in the larger history of the expansion of Bantu languages across eastern, central, and southern Africa. It focuses on the expansion of proto-Kafue, ca. 950–1250, from a linguistic homeland in the middle Kafue River region to lands beyond the Lukanga swamps to the north and the Zambezi River to the south. This expansion was made possible by a dramatic reconfiguration of ties of kinship. The second case study explores linguistic evidence for ridicule along the Lozi-Botatwe frontier in the mid- to late 19th century. Significantly, the units and scales of language movement and change in precolonial periods rendered visible through comparative historical linguistics bring to our attention alternative approaches to language change and movement in contemporary Africa.


Author(s):  
Alan Kelly

What is scientific research? It is the process by which we learn about the world. For this research to have an impact, and positively contribute to society, it needs to be communicated to those who need to understand its outcomes and significance for them. Any piece of research is not complete until it has been recorded and passed on to those who need to know about it. So, good communication skills are a key attribute for researchers, and scientists today need to be able to communicate through a wide range of media, from formal scientific papers to presentations and social media, and to a range of audiences, from expert peers to stakeholders to the general public. In this book, the goals and nature of scientific communication are explored, from the history of scientific publication; through the stages of how papers are written, evaluated, and published; to what happens after publication, using examples from landmark historical papers. In addition, ethical issues relating to publication, and the damage caused by cases of fabrication and falsification, are explored. Other forms of scientific communication such as conference presentations are also considered, with a particular focus on presenting and writing for nonspecialist audiences, the media, and other stakeholders. Overall, this book provides a broad overview of the whole range of scientific communication and should be of interest to researchers and also those more broadly interested in the process how what scientists do every day translates into outcomes that contribute to society.


Author(s):  
Natalie Frede ◽  
Jessica Rojas-Restrepo ◽  
Andrés Caballero Garcia de Oteyza ◽  
Mary Buchta ◽  
Katrin Hübscher ◽  
...  

AbstractHyper-IgE syndromes and chronic mucocutaneous candidiasis constitute rare primary immunodeficiency syndromes with an overlapping clinical phenotype. In recent years, a growing number of underlying genetic defects have been identified. To characterize the underlying genetic defects in a large international cohort of 275 patients, of whom 211 had been clinically diagnosed with hyper-IgE syndrome and 64 with chronic mucocutaneous candidiasis, targeted panel sequencing was performed, relying on Agilent HaloPlex and Illumina MiSeq technologies. The targeted panel sequencing approach allowed us to identify 87 (32 novel and 55 previously described) mutations in 78 patients, which generated a diagnostic success rate of 28.4%. Specifically, mutations in DOCK8 (26 patients), STAT3 (21), STAT1 (15), CARD9 (6), AIRE (3), IL17RA (2), SPINK5 (3), ZNF341 (2), CARMIL2/RLTPR (1), IL12RB1 (1), and WAS (1) have been detected. The most common clinical findings in this cohort were elevated IgE (81.5%), eczema (71.7%), and eosinophilia (62.9%). Regarding infections, 54.7% of patients had a history of radiologically proven pneumonia, and 28.3% have had other serious infections. History of fungal infection was noted in 53% of cases and skin abscesses in 52.9%. Skeletal or dental abnormalities were observed in 46.2% of patients with a characteristic face being the most commonly reported feature (23.1%), followed by retained primary teeth in 18.9% of patients. Targeted panel sequencing provides a cost-effective first-line genetic screening method which allows for the identification of mutations also in patients with atypical clinical presentations and should be routinely implemented in referral centers.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karen Bitton ◽  
J.-L. Bacquet ◽  
F. Amoroso ◽  
S. Mrejen ◽  
M. Paques ◽  
...  

Abstract Background Pathologic myopia is a major cause of visual impairment and blindness. Case presentation We report a case of an immediate post partum macular subretinal bleeding observed in a highly myopic patient. A 30-years-old woman presented two days after childbirth for sudden loss of vision in her right eye. Multimodal imaging showed macular hemorrhage masking a subtle yellowish linear lesion corresponding to lacker crack. Due to the lack of evidence for choroidal neovascularization, a simple clinical and imaging monitoring was recommended. Six weeks later, we noted an improvement in her best-corrected visual acuity and a decreased in size of the macular hemorrhage. Conclusions This is the first case reporting a macular subretinal bleeding on macular lacquer cracks in a highly myopic patient in immediate post partum. Valsalva maneuver associated with vaginal delivery could explain the occurrence of the hemorrhage associated with lacquer crack. However, natural history of pathological myopia could not be excluded.


ORL ◽  
2021 ◽  
pp. 1-3
Author(s):  
Krupa R. Patel ◽  
Ashton E. Lehmann ◽  
Aria Jafari ◽  
Daniel L. Faden

Although nasal polyposis is a common clinical entity, there is limited literature describing the rare presentation of sudden prolapse of a massive nasal polyp resulting in an airway emergency in an adult. We present the first case report to our knowledge of a patient without any preceding sinonasal symptoms or history of anticoagulation who experienced acute upper airway obstruction due to sudden hemorrhage and prolapse of a large nasal polyp. Based on our experience treating this patient, we discuss special considerations in all phases of care to ensure safe and effective management of such an exceptional clinical scenario.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Syeda Sahra ◽  
Abdullah Jahangir ◽  
Neville Mobarakai ◽  
Allison Glaser ◽  
Ahmad Jahangir ◽  
...  

Abstract Introduction Cronobacter sakazakii is an opportunistic Gram-negative, rod-shaped bacterium which may be a causative agent of meningitis in premature infants and enterocolitis and bacteremia in neonates and adults. While there have been multiple cases of C. sakazakii infections, there have been no acute cholangitis cases reported in humans. Case presentation An 81-year-old male with a past medical history of basal cell carcinoma, alcoholic liver cirrhosis, transjugular intrahepatic portosystemic shunt procedure, complicated by staphylococcus bacteremia, pituitary tumor, glaucoma, and hypothyroidism presented to the emergency room with the complaint of diffuse and generalized 10/10 abdominal pain of 1 day’s duration. There was a concern for pancreatitis, acute cholangitis, and possible cholecystitis, and the patient underwent a percutaneous cholecystostomy tube placement. Blood cultures from admission and biliary fluid cultures both grew C. sakazakii. The patient was treated with a carbapenem and clinically improved. Conclusions The case study described a patient with multiple medical comorbidities that presented with C. sakazakii bacteremia and cholangitis. While this bacterium has been implicated in other infections, we believe this is the first time the bacteria is being documented to have caused acute cholangitis.


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