Spinal arteriovenous shunts presenting as intracranial subarachnoid haemorrhage

Item does not contain fulltextBACKGROUND: In approximately 5% of patients with intracranial subarachnoid haemorrhage (SAH), the cause is another than a ruptured aneurysm or perimesencephalic haemorrhage. One of these causes is a spinal arteriovenous shunt (SAVS). The aim of this study was to investigate the characteristics of patients with SAVS who present with intracranial SAH without symptoms and signs suggesting a spinal cause. METHODS: We systematically reviewed the literature and searched the SAH database of the University Medical Center Utrecht, The Netherlands, for patients with SAVS presenting with intracranial SAH and studied the characteristics of patients with SAVS whose clinical presentation mimicked intracranial SAH caused by rupture of a saccular aneurysm. RESULTS: Thirty-five patients were identified after a review of the literature. In our SAH database, comprising 2142 patients included in the period 1985-2004, we found one patient (0.05%, 95 % CI 0.006- 0.3%). SAH due to SAVS occurred at any age (4-72 years). The SAVS was located at the craniocervical junction in 14 patients, at the cervical level in 11, and at the thoracolumbar level in the remaining 11 patients. The majority of patients (n = 26, 72%) had no disabling deficits at discharge or follow-up. CONCLUSION: Rupture of a SAVS presenting as intracranial SAH is rare and can occur at any age. The SAVS can be located not only at the craniocervical junction or cervical level but also in the thoracolumbar region. Most patients with SAVS presenting as intracranial SAH have a good recovery

Cooking pots, tableware, and the changing sounds of sociability in Italy, 1300–1700

This article considers how the sounds produced by the preparation and consumption of meals in Italy changed between around 1300 and 1700. It argues that by focusing on sound, and by using ecological approaches, we can rediscover obscured connections between different categories of material objects. By examining material and textual evidence for three categories of objects associated with cooking and dining – metalwork, ceramics, and glass – the article traces changes in the material cultures of kitchen and table, and the clear impact these changes had on domestic soundscapes. It considers these sound-producing objects as agents of social interaction, exploring the social relationships they constructed, and the role sound played in those relationships. The article then focuses on the practices of cooking and dining, and the way they shaped the sound of objects. Finally, the article situates objects and social practices within the spatial context of the home, tracing an increasing impetus to manage and control specific types of sound in relation to gender. In the discourse on hospitality, noise came to signify a badly-managed, and therefore morally dubious, household, while silence testified to decorous and authoritative domestic management