Cerebellar Infarction in Childhood: Delayed-Onset Complication of Mild Head Trauma

How to Cite This Article: Oz II, Bozay Oz E, Şerifoğlu I, Kaya N, Erdem O. Cerebellar Infarction in Childhood: Delayed-Onset Complication of Mild Head Trauma. Iran J Child Neurol. Summer 2016; 10(3):82-85.Objective Cerebellar ischemic infarction is a rare complication of minor head trauma. Vertebral artery dissection, vasospasm or systemic hypo perfusion can cause infarct. However, underlying causes of the ischemic infarct cannot be explained in nearly half of cases. The accurate diagnosis is essential to ensure appropriate treatment. Here we report a five yr old boy patient of cerebellar infraction after minor head trauma, admitted to emergency serves of Bulent Ecevit University, Turkey in 2013. We aimed to remind minor head trauma that causes cerebellar infarction during childhood, and to review the important points of the diagnosis, which should be keep in mind. ReferencesSchutzman SA, Greenes DS. Pediatric minor head trauma. Ann Emerg Med 2001;37(1):65-74.Shaffer L, Rich PM, Pohl KR, Ganesan V. Can mild head injury cause ischaemic stroke? Arch Dis Child 2003;88(3):267-9.Lin JJ, Lin KL, Chou ML, Wong AM, Wang HS. Cerebellar infarction in the territory of the superior cerebellar artery in children. Pediatr Neurol 2007;37(6):435-7.Matsumoto H, Kohno K. Posttraumatic cerebral infarction due to progressive occlusion of the internal carotid artery after minor head injury in childhood: a case report. Childs Nerv Syst 2011;27(7):1169-75.Williams LS, Garg BP, Cohen M, Fleck JD, Biller J. Subtypes of ischemic stroke in children and young adults. Neurology 1997;49(6):1541-5.Kieslich M, Fiedler A, Heller C, Kreuz W, Jacobi G. Minor head injury as cause and co-factor in the aetiology of stroke in childhood: a report of eight cases. J Neurol Neurosurg Psychiatry 2002;73(1):13-6.O’Brien NF, Reuter-Rice KE, Khanna S, Peterson BM, Quinto KB. Vasospasm in children with traumatic brain injury. Intensive Care Med 2010;36(4):680-7.Barkovich A, Schwartz E. Brain and Spine Injuries in Infancy and Childhood. In: Barkovich A, Raybaud C, editors. Pediatric Neuroimaging. 5th ed. Philidelphia, PA: Lippincott Williams & Wilkins; 2012. p. 335-8.Lansberg MG, Albers GW, Beaulieu C, Marks MP. Comparison of diffusion-weighted MRI and CT in acute stroke. Neurol 2000;54(8):1557-61. 

Unilaterally posterior lumbar interbody fusion with double expandable peek cages without pedicle screw support for lumbar disc herniation

Objectives Posterior lumbar interbody fusion (PLIF) is usually bilateral procedure, and it is combined with posterior by bilateral pedicle screw support or with fixation. The purpose of this retrospective study was to compare the surgical outcomes of simple discectomy and PLIF without pedicle screw support in patients with lumbar disc herniation (LDH). Patients and methods 60 patients with single segment LDH were operated between February 2010 and June 2013. 40 patients were treated with simple discectomy (Group 1) and 20 patients were treated with PLIF using double expandable polyetheretherketone (PEEK) cages without instrumentation (Group 2) unilaterally. Pain and function were evaluated by the visual analog scale (VAS) and Oswestry disability index (ODI) before and 18 months after surgery. Besides, PLIF patients were evaluated with computerized tomography (CT) scan of lumbar vertebra for the evaluation of the height of the disc, instability and fusion. Results Both leg and low back pain VAS scores were significantly improved 18 months after surgery in both of the groups (p<0.001). Significant decrease in VAS low back pain scores was seen in group 2 when compared to group 1 (p<0.001). Height of the intervertebral disc space was preserved and no instability was detected in group 2. No recurrence and 80% fusion rate was achieved in group 2. Conclusion This study showed that unilateral PLIF intervention with double expandable PEEK cages without pedicle screw support would be sufficient in the management of single segment lumbar disc herniation in patients whom are thought to have lumbar stabilization

The Adrenal Gland Volume Measurements in Manifestation of the Metabolic Status in Type-2 Diabetes Mellitus Patients

Objectives. The aim of our study was to investigate the differences in adrenal gland volume between nondiabetic controls and Type-2 diabetic patients and to examine the influence of glycemic control in diabetes mellitus on adrenal gland volume. Methods. From March 2 to November 25, 2015, 62 consecutive patients with Type-2 DM along with 62 nondiabetics matched by age, gender, and BMI were enrolled in this prospective study. Our diabetes patients were categorized into two groups, well-controlled and poorly controlled diabetes groups. Adrenal volumetric measurements were performed by two radiologists, prospectively and independently, with semiautomatic software. Interobserver reliability was studied using the interobserver correlation coefficient (ICC). Results. The total adrenal volume (TAV) was significantly higher in Type-2 diabetic patients when compared with nondiabetic patients (p<0.05). When we investigated diabetic patients according to glycemic controls, the TAVs in controlled diabetic patients were significantly higher than in those of the poorly controlled or uncontrolled diabetic patients (p<0.05). Nondiabetic control patients have significantly smaller TAVs when compared to controlled and poorly or noncontrolled diabetic patients (p<0.05). Conclusion. Our study suggests that adrenal gland volume measurement may be used as an indirect marker of glycemic control in patients with diabetes

Diffusion-weighted imaging in the head and neck region: usefulness of apparent diffusion coefficient values for characterization of lesions

PURPOSEWe aimed to evaluate the role of apparent diffusion coefficient (ADC) values calculated from diffusion-weighted imaging for head and neck lesion characterization in daily routine, in comparison with histopathological results.METHODSNinety consecutive patients who underwent magnetic resonance imaging (MRI) at a university hospital for diagnosis of neck lesions were included in this prospective study. Diffusion-weighted echo-planar MRI was performed on a 1.5 T unit with b factor of 0 and 1000 s/mm2 and ADC maps were generated. ADC values were measured for benign and malignant whole lesions seen in daily practice.RESULTSThe median ADC value of the malignant tumors and benign lesions were 0.72×10-3 mm2/s, (range, 0.39–1.51×10-3 mm2/s) and 1.17×10-3 mm2/s, (range, 0.52–2.38×10-3 mm2/s), respectively, with a significant difference between them (P < 0.001). A cutoff ADC value of 0.98×10-3 mm2/s was used to distinguish between benign and malignant lesions, yielding 85.3% sensitivity and 78.6% specificity. The median ADC value of lymphomas (0.44×10-3 mm2/s; range, 0.39–0.58×10-3 mm2/s) was significantly smaller (P < 0.001) than that of squamous cell carcinomas (median ADC value 0.72×10-3 mm2/s; range, 0.65–1.06×10-3 mm2/s). There was no significant difference between median ADC values of inflammatory (1.13×10-3 mm2/s; range, 0.85–2.38×10-3 mm2/s) and noninflammatory benign lesions (1.26×10-3 mm2/s; range, 0.52–2.33×10-3 mm2/s).CONCLUSIONDiffusion-weighted imaging and the ADC values can be used to differentiate and characterize benign and malignant head and neck lesions

The Role of Radiology in Perivesical Invasion of Muscle-Invasive Bladder Cancer

WOS: 000407103300007Bladder cancer is the most common cancer of the urinary tract. At the initial diagnosis of bladder cancer, approximately 30% of the cases are diagnosed as muscle-invasive bladder cancer (MIBC). Metastases and depth of invasion are directly related to survival. In patients with MIBC, multimodal bladder-sparing treatments with chemotherapy and radiotherapy reveal comparable survival rates with radical cystectomy. Therefore, accurate and reliable staging of bladder cancer is of paramount importance in choosing the most appropriate treatment method. In patients with confirmed MIBC, computed tomography (CT) or magnetic resonance imaging of abdomen and pelvis and the unenhanced CT of the chest is recommended for the optimal staging. The aim of this review was to evaluate imaging of perivesical invasion in MIBC and their clinical usage

The role of computerized tomography in the assessment of perivesical invasion in bladder cancer

BACKGROUND: The aim of the present study was to identify the contrast patterns of a tumor, and to evaluate the possibility of assessing the invasion of the perivesical fatty tissue in bladder cancer. MATERIAL AND METHODS: In this study, 26 patients with bladder cancer were included. Multiphasic CT examination was performed to determine the stage of the disease before radical cystectomy. RESULTS: There were statistically significant differences in tumor and perivesical fatty tissue densities between pre- and post-contrast phases (p<0.05). CONCLUSIONS: Increases in focal density suspected of being invasion of the perivesical fatty tissue can show perivesical invasion with high specificity

Gluteal compartment syndrome secondary to superior gluteal artery injury following pelvis fracture: A case report and review of literature

Acute gluteal artery syndrome secondary to superior gluteal artery injury following pelvic fracture is a rare entity with potential for significant morbidity and mortality. In this report we present such a case resulting with a favorable outcome with prompt diagnosis and appropriate treatment. Keywords: Angiography, Compartment syndrome, Pelvis fracture, Surgery, Superior gluteal arter

Clips migration to duodenum as a rare complication of laparoscopic cholecystectomy

WOS: 000404541200016Endoclip migration into the duodenum is an extremely rare complication of laparoscopic cholecystectomy. The patients usually present with bleeding ulcer. Here we report a 65-year-old female patient with a complaint of abdominal pain and dyspepsia due to clip migration into the duodenum after laparoscopic cholecystectomy secondary to symptomatic cholelithiasis 15 months previously. Ultrasonography and liver function tests were normal. Endoscopy showed metal clips in the second part of duodenum. The clips were removed endoscopically. No active bleeding was noted. In this case report, we present diagnosis and management of clips migration into wall of duodenum as a complication of laparoscopic cholecystectomy

Sphenoid Sinus in Relation to Age, Gender, and Cephalometric Indices

The sphenoid sinus is located in the center of the cranial base and is surrounded by numerous neurovascular structures. The aim of this study was to determine sphenoid sinus types and subtypes, dimensions of the sinus and cranium, and the relations of these to age and gender

Dumbbell Shaped Transforaminal Paravertebral Meningioma

WOS: 000360662000010Dumbbell tumors are tumors of two or more regions of the spinal column. The majority of the dumbbell tumors are schwannomas. The presentation of spinal meningiomas as a dumbbell tumors are very rare. The diagnosis of Dumbbell-shaped meningiomas with imaging methods is important for preoperative accurate treatment planning and to prevent its postsurgical recurrences