scholarly journals A Naso-Orbito-Ethmoid (NOE) Fracture Associated with Bilateral Anterior and Posterior Frontal Sinus Wall Fractures Caused by a Horse Kick—Case Report and Short Literature Review

Medicina ◽  
2019 ◽  
Vol 55 (11) ◽  
pp. 731 ◽  
Author(s):  
Florin Onișor-Gligor ◽  
Paul Andrei Țenț ◽  
Simion Bran ◽  
Mihai Juncar

Naso-orbito-ethmoid (NOE) fractures associated with anterior and posterior frontal sinus wall fractures are among the most challenging cranio-maxillofacial injuries. These represent a major emergency, having a potentially severe clinical picture, with intracranial hemorrhage, cerebrospinal fluid (CSF) leak, meningeal lesions, pneumocephalus, contusion or laceration of the brain matter, coma, and in some cases death. In this article, we present the case of a 30-year-old patient with the diagnosis of NOE fracture associated with bilateral anterior and posterior frontal sinus wall fractures caused by a horse kick, with a fulminant post-traumatic alteration of the neurological status and major impairment of the midface bone architecture. Despite the severity and complexity of the case, early initiation of correct treatment both in terms of intensive care and cranio-maxillofacial surgery led to the successful rehabilitation of the neurological status, as well as to the reconstruction and redimensioning of midface architecture and, not least, to the restoration of the patient’s physiognomy.

2013 ◽  
Vol 6 (2) ◽  
pp. 72-76
Author(s):  
Raghunath Shanbag ◽  
Vijay Bidkar ◽  
Ashok Naik ◽  
Roshan Jalisatgi

ABSTRACT Background Lesions of the frontal sinus (FS) are always a surgical challenge. Conventional endonasal endoscopic techniques do not provide complete access inside the FS. This is especially true with laterally placed lesions like mucocele or post-traumatic cerebrospinal fluid (CSF) leak from FS. Standard procedures like osteoplastic flap and endoscopic modified Lothrop are not feasible for these smaller unilateral lesions with normally functioning contralateral sinus. Study design Retrospective case study of laterally placed posterior table CSF leak and frontal mucocele were evaluated for their clinical presentation, radiological, operative findings and follow-up. Conclusion Complete external approaches to the lateral lesion of FS are associated with high morbidity. Ability of the endoscopes to visualize lateral and posterior extents of the FS directly through the brow incision helps in complete repair/ excision of these lesions without any difficulty. How to cite this article Shanbag R, Bidkar V, Naik A, Jalisatgi R. Endoscope-assisted External Approach for Lateral Lesions in Frontal Sinus. Clin Rhinol An Int J 2013;6(2):72-76.


2016 ◽  
Vol 4 (1) ◽  
pp. 139-141
Author(s):  
Ali Yilmaz ◽  
Zahir Kizilay ◽  
Ayca Ozkul ◽  
Bayram Çirak

BACKGROUND: The recurrent Heubner's artery is the distal part of the medial striate artery. Occlusion of the recurrent artery of Heubner, classically contralateral hemiparesis with fasciobrachiocrural predominance, is attributed to the occlusion of the recurrent artery of Heubner and is widely known as a stroke syndrome in adults. However, isolated occlusion of the deep perforating arteries following mild head trauma also occurs extremely rarely in childhood.CASE REPORT: Here we report the case of an 11-year-old boy with pure motor stroke. The brain MRI showed an acute ischemia in the recurrent artery of Heubner supply area following mild head trauma. His fasciobrachial hemiparesis and dysarthria were thought to be secondary to the stretching of deep perforating arteries leading to occlusion of the recurrent artery of Heubner.CONCLUSION: Post-traumatic pure motor ischemic stroke can be secondary to stretching of the deep perforating arteries especially in childhood.


2021 ◽  
Vol 79 (4) ◽  
pp. 1723-1734
Author(s):  
Shlomo Sragovich ◽  
Michael Gershovits ◽  
Jacqueline C.K. Lam ◽  
Victor O.K. Li ◽  
Illana Gozes

Background: We recently discovered autism/intellectual disability somatic mutations in postmortem brains, presenting higher frequency in Alzheimer’s disease subjects, compared with the controls. We further revealed high impact cytoskeletal gene mutations, coupled with potential cytoskeleton-targeted repair mechanisms. Objective: The current study was aimed at further discerning if somatic mutations in brain diseases are presented only in the most affected tissue (the brain), or if blood samples phenocopy the brain, toward potential diagnostics. Methods: Variant calling analyses on an RNA-seq database including peripheral blood samples from 85 soldiers (58 controls and 27 with symptoms of post-traumatic stress disorder, PTSD) was performed. Results: High (e.g., protein truncating) as well as moderate impact (e.g., single amino acid change) germline and putative somatic mutations in thousands of genes were found. Further crossing the mutated genes with autism, intellectual disability, cytoskeleton, inflammation, and DNA repair databases, identified the highest number of cytoskeletal-mutated genes (187 high and 442 moderate impact). Most of the mutated genes were shared and only when crossed with the inflammation database, more putative high impact mutated genes specific to the PTSD-symptom cohorts versus the controls (14 versus 13) were revealed, highlighting tumor necrosis factor specifically in the PTSD-symptom cohorts. Conclusion: With microtubules and neuro-immune interactions playing essential roles in brain neuroprotection and Alzheimer-related neurodegeneration, the current mutation discoveries contribute to mechanistic understanding of PTSD and brain protection, as well as provide future diagnostics toward personalized military deployment strategies and drug design.


1979 ◽  
Vol 51 (6) ◽  
pp. 870-871 ◽  
Author(s):  
L. Anne Hayman ◽  
Alfonso E. Aldama-Luebbert ◽  
Robert A. Evans

✓ A large air-filled intracranial extradural diverticulum of the frontal sinus mucosa was removed from the anterior cranial fossa of a 47-year-old man 2 years after fracture of the posterior sinus wall during craniotomy.


2021 ◽  
pp. neurintsurg-2021-017900
Author(s):  
Michal Zawadzki ◽  
Jerzy Walecki ◽  
Boguslaw Kostkiewicz ◽  
Kacper Kostyra ◽  
Piotr Walczak ◽  
...  

This case report shows that real-time MRI may aid in the precision of intra-arterial delivery of bevacizumab to butterfly glioblastoma. Fast clinical improvement, decrease of contrast enhancing status, and no serious adverse effects were observed at discharge from hospital. The patient regained pre-recurrent neurological status for 2 months with a subsequent fast clinical decline and an increase in tumor volume. The patient underwent a second procedure of intra-arterial delivery of bevacizumab to the brain, with substantial clinical and radiological improvement, but not the level of improvement observed after the first procedure. Another clinical decline occurred with an increase in tumor size and the patient was treated 2 months later with a third intra-arterial infusion of bevacizumab. While another positive effect was achieved, it was less pronounced than before, and the patient died 1.5 months later. There were no technical, ischemic or other complications during the procedures. The patient survived 218 days from the first symptoms of tumor recurrence, 190 days from the first MRI, and 175 days from the first intra-arterial treatment of bevacizumab.


2011 ◽  
Vol 33 (1) ◽  
pp. 59-68 ◽  
Author(s):  
Maricla Tavanti ◽  
Marco Battaglini ◽  
Federico Borgogni ◽  
Letizia Bossini ◽  
Sara Calossi ◽  
...  

2015 ◽  
Vol 96 (5) ◽  
pp. 806-810
Author(s):  
R V Deev ◽  
Yu M Shatrova ◽  
A I Sinitskiy ◽  
N S Molchanova ◽  
A K Yunusova ◽  
...  

Aim. To study the changes in levels of biogenic amines-neurotransmitters in the brain at experimental post-traumatic stress disorder development in rats. Methods. Post-traumatic stress disorder was modeled by keeping 48 outbred male rats in under constant and inescapable strong unconditioned stimulus. The control group included 16 intact animals, not exposed to stress influences. The levels of 3,4-dihydroxyphenylalanine, dopamine, norepinephrine, epinephrine and gamma-aminobutyric acid were determined by fluorometric methods. Behavioral activity of animals was evaluated on the day 3, 7, 10 and 14 by «open field» and «elevated plus maze» actinographs. Results. When comparing the concentrations of studied neurotransmitters in the brain of control animals with experimental groups, reflecting the development of post-traumatic stress disorder at the time, adrenaline and 3,4-dihydroxyphenylalanine levels were increased on the third day, level of norepinephrine was reduced on the seventh day, 3,4-dihydroxyphenylalanine, dopamine, norepinephrine levels were elevaled, gamma-aminobutyric acid level was reduced on the tenth day, gamma-aminobutyric acid level was increased on the fourteenth day after the stress. Conclusion. According to the results of the correlation analysis, the largest contribution to the development of behavioral disorders are made by altered brain level of gamma-aminobutyric acid at the time of post-traumatic stress disorder formation (tenth and fourteenth day). At the earlier stages (third and seventh day), the relationship of rats behavioral activity and altered 3,4-dihydroxyphenylalanine and norepinephrine brain levels was shown.


2020 ◽  
Author(s):  
Arina Viacheslavovna Balan

All components of anaesthesia have a direct or indirect depressing effect on the myocardium and functional activity of the brain. Given the initial failure of the coronary blood flow, life-threatening disorders of the heart are possible. The higher the severity of the underlying disease, the greater the risk of transient neurological deficit, stroke. Extended continuous monitoring of vital functions, careful assessment of the neurological status of the patient with special attention to the level of consciousness, the presence or absence of symptoms of increased ICP is necessary. The purpose of this study is to evaluate the beneficial effect of cardioprotectors Mexicor, Meldonium in the fight against ischemia in patients with CHD, GB in the department of surgical profile. The following methods have been used: review of literature, previously published research papers. Results: this article discusses the main drugs with cardioprotective properties, describes the positive experience of using them by specialists, and proves the effectiveness of using drugs in the long term.


2020 ◽  
pp. 1-14
Author(s):  
Michal K. Stachowiak ◽  
D. Freedman ◽  
N. Nived ◽  
B. Decker ◽  
S. Narla ◽  
...  

Neurological manifestations of blast-induced Post Traumatic Stress Disorder (PTSD) extend long after the initial injury indicating lasting changes in brain function. In this study, we characterized brain injury, changes in neurogenesis and oligodendrogenesis in an adult murine blast model following a short (5 days) and long (21 days) post-blast recovery. Acoustic blasts led to an initial, activation of microglia and astrogliosis and a widespread cortical and subcortical apoptosis. The loss of myelinated cortical axons at 5 days was followed by the reappearance of abnormal misdirected fibers at 21 days. At 21 days post-blast, we observed increases in doublecortin-positive (DCX+ ) neuroblasts in the subventricular zone (SVZ) and hippocampal subgranular zone (SGZ) indicating increased neurogenesis. No changes in DCX+ cells were found in the brain cortex. In the cortex, the early disappearance of myelinated neuronal fibers was accompanied by a loss of O4+ oligodendrocytes and their Ki67-expreasing (Ki67+ ) oligodendrocyte precursor cells (OPC). However, at 5 days we observed a robust appearance of cells expressing Olig2 (O2+ ), an early determinant of oligodendrocyte lineage. At 21 days post-blast, the population of OPC increased and the mature O4+ oligodendrocytes were restored to control levels. In contrast, in the SVZ and SGZ, O4+ cells were not affected by the blast suggesting a local cortical origin for cortical oligodendrogenesis. These results suggest that blast-induced activation of SVZ and SGZ neurogenesis and cortical oligodendrogenesis could have long-lasting impact on brain function including memory disorders observed in both animal models and human’s PTSD.


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