Subaponeurotic Fluid Collection (SFC) in an Infant

Subaponeurotic fluid collection is an infrequent cause of scalp swelling in infants. We report a 10-week-old male who had a scalp swelling for five days without any recent history of head injury. There was a soft, mobile, non-tender, transilluminating, fluctuant swelling over posterior parieto-occipital area and it was not limited by suture lines. Cranial ultrasonography showed a subaponeurotic collection at the posterior parieto-occipital area without definite communication with the intracranial space or the brain parenchyma. This infant was treated conservatively. The swelling resolved spontaneously after 4 weeks. The lack of awareness of some doctors in the Emergency Department about this condition may lead to unnecessary investigations, ward admission and intervention. It is hoped that this case report will provide emergency health care professionals the confidence to make accurate diagnosis and treat patient with subaponeurotic fluid collection optimally.

Trichoscopy (Hair and Scalp Videodermoscopy) in the Healthy Egyptians Female. Norms for Measurable Parameters

Background Trichoscopy is a noninvasive diagnostic tool that allows the recognition of morphologic structures not visible by the naked eye. The aim of this study was to standardize the videodermoscopy method and to establish the norms for measurable parameters of normal Egyptian hair in females. The current study included 90 healthy Egyptian females between 18 and 50 years of age. Objective Our study revealed that there was a highly statistically significant difference between average number of hair in each of frontal and occipital areas and number of hairs in temporal area. The difference between number of hairs in frontal and occipital area was statistically significant. Patients and Methods The study included 90 volunteer Egyptian females with age ranging from 18-50 years, during the period between February 2018 till May 2019. The study protocol Was approved by Faculty of Medicine, Ain Shams University, Research Ethics Committee (FWA 000017585). The volunteers gave a written consent to participate in the work after explanation of the technique and study performed. Volunteers The group under study was selected from patients visiting dermatology clinic at Ain Shams University hospital due to nonhair related conditions, who never complained of excessive hair shedding and who had no early hair loss cases by family history. They were subjected to careful clinical inspection and pull test. Results Average hair shaft thickness showed a highly statistically significant difference between frontal area and each of temporal and occipital areas. Percentage of thin, mediumsized and thick hairs in frontal, occipital and temporal areas revealed that there was a highly statistically significant difference between percentage of thin hairs in each of frontal and temporal areas and in occipital area, a highly statistically significant between percentage of mid hairs in frontal area and in each of temporal and occipital areas, and a highly statistically significant difference between percentage of thick hairs in frontal area and in temporal area. Conclusions Norms of measurable parameters can be established using trichoscopy (hair and scalp videodermoscopy). Our results indicate that for healthy adult Egyptian females, not only are the average hair diameters and densities different in the different scalp regions, but also the contribution of thin and thick hairs, as well as follicular units. Better understanding of the norms in clinical practice will help to detect what is abnormal in hair and scalp videodermoscopy.

STURGE WEBER SYNDROME- A RARE CASE REPORT ORIGINAL

Sturge-Weber Syndrome (SWS) is one of the encephalotrigeminal angiomatosis and one of the important segmental vascular neurocutaneous disorders .The occurrence is not very uncommon and the prevalence is 1:20000 to 1:50000.(1) SWS occurs due to the presence of residual embryonic vessels . The various signs and symptoms include capillary malformation in the face a port wine birthmark and similar malformation in the brain involving leptomeniges as well as blood vessels of the eye causing glaucoma. The patient presents with seizures , hemiparesis and stroke like symptoms, headaches and developmental delay.(2) The imaging nding in SWS children is the calcication in the parietal and occipital area of the brain. The EEG ndings in SWS are the attenuation and the excess of slow activities.We are presenting here a rare case of , a fourteen year old male child who presented to our emergency department with status epilepticus. The aim of presenting this case is to share the classical presentation and the challenges involved in the management

CORRELATING DESIGN PERFORMANCE TO EEG ACTIVATION: EARLY EVIDENCE FROM EXPERIMENTAL DATA

This paper presents an EEG (Electroencephalography) study that explores correlations between the neurophysiological activations, the nature of the design task and its outputs. We propose an experimental protocol that covers several design-related tasks: including fundamental activities (e.g. idea generation and problem-solving) as well as more comprehensive task requiring the complex higher-level reasoning of designing. We clustered the collected data according to the characteristics of the design outcome and measured EEG alpha band activation during elementary and higher-level design task, whereas just the former yielded statistically significant different behaviour in the left frontal and occipital area. We also found a significant correlation between the ratings for elementary sketching task outcomes and EEG activation at the higher-level design task. These results suggested that EEG activation enables distinguishing groups according to their performance only for elementary tasks. However, this also suggests a potential application of EEG data on the elementary tasks to distinguish the designers' brain response during higher-level of design task.

Female Pattern Hair Loss in Female and Male: A Quantitative Trichoscopic Analysis in Chinese Han Patients

Objectives: To investigate the trichoscopic features of female pattern hair loss (FPHL) in Chinese Han patients and analyze the difference between male and female patients with FPHL.Materials and Methods: Trichoscopic images were taken in four different scalp areas, including right frontal hairline, vertex, right parietal and occipital areas. Hair density, hair shaft diameter, vellus hair ratio and single hair follicle unit ratio were counted manually and analyzed.Results: Seventy-three subjects were enrolled in this study, including 38 patients with FPHL (28 females and 10 males) and 35 normal controls without hair loss. The hair density and hair shaft diameter of FPHL patients reduced in the whole scalp. Vellus hair ratio and single hair follicle unit ratio were both increased in FPHL compared to normal controls. The vertex was the most affected area and the hair shaft diameter showed the most significant difference. Parietal and occipital area were also affected in FPHL. The reduction or increase was correlated with the severity of Ludwig staging. Very few gender differences were detected in male and female FPHL patients.Conclusion: FPHL patients showed decreased hair density and hair shaft diameter, accompanied by increased vellus hair ratio and single hair follicle unit ratio. Parietal and occipital area can be also affected in FPHL, though not as severe as in vertex area. FPHL in male basically has the same characteristic as those in female patients.Limitation: The main limitation of the study is the small sample size which only enrolled 10 male FPHL patients, in comparison to the female cases. The findings could not be representative of the normal population with the limited sample size.

Single-Case Neuropsychological Assessment of a Patient with a Posterior Parietal Lesion Using Behavioral Testing and Resting-State fMRI

This study integrated functional connectivity measures using resting-state fMRI and behavioral data from a single-case observation of patient (PER) one year after right-hemispheric hemorrhage in the intraparietal sulcus and superior parietal lobule (IPS/SPL). PER showed no sign of clinical neglect. Her behavioral performance in the visuo-manual pointing task and in the letter discrimination task under conditions of endogenous and exogenous attentional cueing was compared between the left (affected) and right (unaffected/control) peripheral visual fields. The resting-state fMRI demonstrated an imbalance between the right and left hemispheric frontoparietal functional connectivity within the dorsal attentional and motor networks. Although the frontal and occipital cortices were not structurally damaged, specific fronto-occipital functional connectivity was imbalanced, which was strongly associated with the behavioral changes. First, the activity in the right frontal eye field showed weaker correlations with the activity in the right inferior occipital area compared to the correlation with the activity in the left inferior occipital area. This imbalanced fronto-occipital functional connectivity was accompanied by a specific impairment in endogenous covert attention in the left visual field. Second, the activity within M1 in both hemispheres showed weaker correlations with the activity of the right cuneus compared to the correlation with the activity in the left cuneus. The imbalanced fronto-occipital functional connectivity was associated with the impairment of the reaching movement of the left and right hands towards the left visual field (optic ataxia). Altogether, our results showed that a lesion to the posterior parietal cortex affects the relationship between distal regions underlying the sensorimotor and attentional abilities

Event-Related Alpha-Band Power Changes During Self-reflection and Working Memory Tasks in Healthy Individuals

Dysfunctional attentional control is observed in patients with mental disorders. However, there is no established neurophysiological method to assess attention in such patients. We showed a discrepancy in alpha-band power in the tasks that evoked internal and external attention event-related alpha-band power changes in healthy subjects during self-reflection (SR) and working memory (WM) tasks in a preliminary study. In this study, we aimed at elucidating event-related alpha-band power changes in healthy subjects during the tasks, addressing the shortcomings of the previous study. Sixteen healthy volunteers were examined for the event-related power (ERpow) change during the tasks. The results demonstrated the discrepancy of alpha-band ERpow at 8, 10, and 12 Hz in the parieto-occipital area between the WM and SR tasks for a period between a target stimulus and a command stimulus, where a participant switched to internal attention from external attention according to the SR task and remained at external attention according to the WM task. The results suggest that alpha-band ERpow in this area is associated with the direction of attention in response to cognitive stimuli, indicating that the findings of ERpow during the two tasks would potentially aid in the clarification of the pathophysiology of the dysfunctional change in attention in patients with psychiatric disorders.

Imagination in Autism: A Chance to Improve Early Language Therapy

Children with autism often have difficulties in imaginative play, Theory of Mind, and playing out different scenarios in their minds. Research shows that the root of these problems may be the voluntary imagination network that involves the lateral prefrontal cortex and its long frontoposterior connections to the temporal-parietal-occipital area. Previously disconnected visuospatial issues (stimulus overselectivity and tunnel vision) and language issues (lack of comprehension of spatial prepositions and complex recursive sentences) may be explained by the same voluntary imagination deficit. This review highlights the new insights into the mechanism of voluntary imagination, its difference from involuntary imagination, and its unusually strong critical period. Clearer developmental terminology and a better understanding of voluntary imagination have the potential to facilitate communication between therapists and parents, and improve therapy outcomes in children.

A Dramatic Relief from Cluster Headache by Classic Bloodletting Acupuncture Evidenced by Thermography Analysis: A Case Report

Background: Cluster headache is a severe headache, which causes severe impairment in the quality of life of the patients. Here, we report a successful experience of relieving cluster headache by puncturing the superficial engorged venules of the ipsilateral leg. Case presentation: This 72-year-old female with severe refractory cluster headache came from the United States to Taiwan to search for alternative therapy. Her headache was characterized by excruciating, stabbing pain on the left head, primarily around the orbital area with extension to temporal and occipital area, and accompanied with left nasal obstruction. Based upon the classic acupuncture method, her headache was dramatically and totally relieved by puncture upon superficial engorged venules of ipsilateral leg. Conclusion: This case reminded us that classic bloodletting acupuncture could be an alternative strategy for cases with refractory cluster headache. Besides, the connection between leg engorged venules and head suggesting the existence of some novel reflex, worthy of investigation in the future.