OSTEOMA OF EXTERNAL AUDITORY CANAL: CASE REPORT

ABSTRACT An osteoma of the external auditory canal is an uncommon benign tumor with an incidence estimated to be 0.05% of total otologic surgery. In head and neck, they most often arise in the frontoethmoidal region and rarely temporal bone. Osteomas usually asymptomatic and discovered incidentally. A 35 male presented with swelling in right posterior superior part of EAC, without any history of ear picking , swimming or trauma. CT temporal bone revealed a solitary osteoma, with was excised surgically. Histopathological examination confirmed Osteoma.

Dissociative-Traumatic Dimension and Triple Network: An EEG Functional Connectivity Study in a Sample of University Students

<b><i>Aims:</i></b> We investigated the association among triple network electroencephalographic (EEG) functional connectivity, dissociative symptoms, and childhood trauma (CT) in a sample of university students. <b><i>Sampling and Methods:</i></b> Seventy-six participants (30 males and 46 females; mean age 22.12 ± 2.35) completed self-report measures investigating dissociative symptoms, CT, and depressive symptoms. Participants also performed an eyes-closed resting-state EEG recording. EEG analyses were conducted through the exact low-resolution electromagnetic tomography (eLORETA) software. <b><i>Results:</i></b> A 2-step cluster analysis revealed 2 groups: participants (<i>N</i> = 23) with high dissociative-traumatic dimension symptoms (DTD+) and participants (<i>N</i> = 53) with low DTD symptoms (DTD−). Compared to DTD− subjects, DTD+ participants showed decreased theta connectivity between the salience network (SN) and central executive network (CEN), specifically between the right anterior insula and the left posterior parietal cortex. No significant correlation was detected between EEG data and clinical variables. <b><i>Conclusion:</i></b> Our results raise the possibility of a dysfunctional connectivity pattern occurring between the SN and CEN in individuals with high DTD symptoms. Such connectivity pattern might reflect the neuropsychophysiological disintegration related to pathological dissociation.

Trauma Computed Tomography in the Modern Era: Not Always Quick and Safe

Background Computed tomography (CT) has emerged as the diagnostic modality of choice in trauma patients. Recent studies suggest its use in hemodynamically unstable patients is safe and potentially lifesaving; however, the incidence of adverse events (AE) during the trauma CT scanning process remains unknown. Study Design Over a 6-month period at a Level 1 trauma center, data on patients undergoing trauma CT (whole-body CT (WBCT) +/− additional CT studies) were prospectively collected. All patients requiring a trauma team activation (TTA) were included. Adverse events and specific time intervals were recorded from the time of TTA notification to the time of return to the resuscitation bay from the CT suite. Results Of the 94 consecutive patients included in the study, 47.9% experienced 1 or more AE. Median duration away from the resuscitation bay for all patients was 24 minutes. Patients with AE spent a significantly longer time away from the resuscitation bay and had longer scan times. Vasopressor support and ongoing transfusion requirement at the time of CT scanning were associated with AE. Conclusion Adverse events of varying clinical significance occur frequently in patients undergoing emergent trauma CT. A standard trauma CT protocol could improve the efficiency and safety of the scanning process.

Post-Traumatic Hydrocephalus - A Retrospective Study

BACKGROUND Post-traumatic hydrocephalus (PTH) can occur as an outcome of moderate and severe traumatic head injury. It is one of the causes of delayed worsening of the early symptoms of head injury. A total of 18 cases of PTH diagnosed and treated at tertiary care hospitals from 2012 to 2015 were studied. The purpose of the study was to evaluate the clinicoradiological profile of patients diagnosed with posttraumatic hydrocephalus and determine the outcome of ventriculoperitoneal (VP) shunting in cases of post-traumatic hydrocephalus. METHODS A retrospective study was conducted in the Department of Neurosurgery in a teaching medical college. The clinicoradiological profile of patients diagnosed with PTH was studied. These cases were treated conservatively as well as by surgery. The demography, cause of trauma, GCS score and response rates were studied. RESULTS Among the 18 reviewed patients, 61.1 % were males, fall and RTA constituted the major cause of trauma. Craniotomy was done in 50 % of the patients, 88.89 % of the patients recovered and the mortality rate was 11.11 %. CONCLUSIONS Post-traumatic hydrocephalus is a consequence of traumatic head injury and can occur with various neurological symptoms after the initial trauma. CT scan of the brain is considered the choice of investigation to early diagnose PTH and the patient outcome after VP shunting is good. KEY WORDS Hydrocephalus, Head Injury, Trauma

How to deliver an effective primary survey report for the trauma CT: A radiological and surgical perspective

Whole body contrast-enhanced multidetector CT (WB-CE MDCT) is integral to the assessment of the severely injured patient with stable haemodynamic parameters or in those who respond to resuscitation with blood products. WB-CE MDCT is able to identify the number and severity of injuries sustained by the patient and enable time critical intervention. In this narrative review article we discuss how communication within the trauma team, including the radiologists and appropriate clinicians is crucial in optimizing the effectiveness of WB-CE MDCT. We review the time critical imaging findings and their clinical relevance, which should be included in a succinct CT primary survey report. We also discuss the process through which the effectiveness of the trauma report may be maximised and how non technical factors including teamwork may be optimised to facilitate decision making in this high pressure environment.

Cervical Myelopathy Caused by a Split Atlas Anomaly: A Case Report

An 18-year-old male presented with a 6-month history of paresthesia of both arms and legs after a minor neck trauma. CT scan revealed a partial aplasia of the anterior and posterior arches of the C1 vertebra resulting in a split atlas. MRI showed an intramedullary high-signal area. We performed a posterior decompressive laminectomy and occipitocervical fusion. The bony defect into the posterior arch was replaced by a connective tissue cord, resulting in a compression of the dural sheath. The symptoms recovered completely 1 month after surgery. Knowledge of this rare malformation is crucial to the correct management of these cases.