Isolated Demyelination of Corpus Callosum Following Hypoxia

Corpus callosum includes a large amount of axons with various degrees of myelination, interconnecting cerebral hemispheres. Tumors, demyelinating diseases, infections, trauma and metabolic diseases as well as vascular lesions may affect corpus callosum, often extending to other white matter areas of the brain. We describe the case of a 76 years old male patient with history of arterial hypertension, diabetes mellitus and normal pressure hydrocephalus, developing dysphagia during hospitalization. Ab-ingestis pneumonia caused brain hypoxia and coma; brain magnetic resonance disclosed isolated demyelination of corpus callosum that was not present before hypoxia. Compared to neurons and astrocytes, oligodendrocytes are reported as particularly sensitive to hypoxia. Respiratory involvement without blood flow impairment could have lead to a prevalent oligodendrocytes damage, resulting in a selective demyelination of corpus callosum. Our patient indeed evolved into persistent vegetative state and died five months after hypoxic episode. This case report could give some insight about in vivo brain susceptibility to hypoxic damage

Comprehending socio-relational factors of mental wellbeing in the oldest old within Nordic and Mediterranean countries

Socio-relational aspects are essential for mental wellbeing (MWB), especially in the oldest old age. Our study aims to explore the socio-relational aspects related to MWB in accord ance with the experiences of the oldest old of four European countries; and to examine how these differ between Mediterranean and Nordic people. A total of 117 participants aged 80+ years old were recruited, and 23 focus groups were performed. Qualitative con tent analysis identified five main themes. Family seemed to be the most important driver of the MWB of the oldest old, followed by relationships with close friends. Participants felt better when they had a sense of being needed, cared for, and connected. Loneliness and isolation negatively affected MWB, although solitude was appreciated. Differences appeared between Mediterranean and Nordic regions. Initiatives to promote positive interactions with family and friends, as well as social activities within the community, may contribute to strengthening MWB in the oldest ol

A fatal and unusual iatrogenic fourth right lumbar artery injury complicating wrong-level hemilaminectomy: a case report and literature review

The authors describe an unusual case of a fatal iatrogenic fourth lumbar artery injury during left hemilaminectomy in a 38-year-old woman. At autopsy, gross inspection revealed hemoperitoneum with 1,800\ue2\u80\u89ml of free blood and massive retroperitoneal extravasation. A laceration with irregular and jagged margins was detected on the wall of the fourth right lumbar artery. The autopsy and the post-mortem TC investigations demonstrated that wrong-level hemilaminectomy was performed for the herniated disc

A rare isolated unilateral myositis ossificans traumatica of the lateral pterygoid muscle: a case report

Introduction. Myositis ossificans traumatica is a pathological condition characterized by the extraskeletal formation of bony tissue, induced by violent or repeated trauma. Case presentation. A 30-year-old Italian man, after surgical treatment for multiple facial fractures, presented with a progressive limitation of mouth opening. A computed tomography scan showed a significant calcification of the fibers of the left lateral pterygoid muscle. The working diagnosis was myositis ossificans traumatica of the left lateral pterygoid muscle. Surgical excision was suggested but not performed. Our patient underwent physiotherapy treatment resulting not in a complete restoration of mandibular movements but in an acceptable recovery of mouth opening. Conclusions: Myositis ossificans is a rare complication that can be caused by muscle trauma. Therefore, special attention should be paid to surgical trauma. In the present case, surgical excision was considered, in accordance with the literature, and suggested to our patient, but he declined due to the absence of any pain or any significant limitation to his daily life activities. He therefore underwent physiotherapy treatment, in line with our unit's guidelines, resulting not in a complete restoration of mandibular movements but in an acceptable recovery of mouth opening. © 2014 Spinzia et al.; licensee BioMed Central Ltd

Intra-operative vertebroplasty combined with posterior cord decompression: A report of twelve cases

Percutaneous vertebroplasty (VP) is a minimally invasive technique for the treatment of vertebral pathology providing early vertebral stabilization and pain relief. In cases of vertebral pathology complicated by spinal cord compression with associated neurological deficits, VP alone cannot be performed free of risks. We describe a combined approach in which decompressive laminectomy and intra-operative vertebroplasty (IVP) are performed during a single session. Among the 252 VP performed in our centre in the past three years, 12 patients (12 vertebral levels) with different pathologies (six symptomatic haemangiomas, two metastatic fractures, four osteoporotic fractures) were treated with an open procedure combined with surgery. All cases were treated with decompressive laminectomy and IVP (mono/bipeduncular or median-posterior trans-somatic access). Five patients with symptomatic haemangiomas were treated with endovascular embolization prior to the combined approach. A visual analogue scale (VAS) was applied to assess pain intensity before and after surgery. The neurological deficits were evaluated with an ASIA impairment scale. In all cases benefit from pain and neurological deficits was observed. The mean VAS score decreased from 7.8 to 2.5 after surgery. The ASIA score improved in all cases (five cases from D to E and five cases from C to D). No clinical complications were observed. In one case a CT scan performed after the procedure showed a foraminal accumulation of PMMA, but the patient referred no symptoms. IVP can be successfully applied in different pathologies affecting the vertebrae. In our limited series this approach proved safe and efficient to provide decompression of spinal cord and dural sac and vertebral body stabilization in a single session

Connecting and feeling : associations between social factors and emotions in nine countries

We aimed to explore the distribution of positive and negative emotions across nine low-, middle- and high-income countries; and the association between social factors and these emotions. Data were drawn from the SAGE and the COURAGE studies, with 52,553 participants. Emotions were assessed through the day reconstruction method.Sociodemographic characteristics and social factors were also measured. Multiple linear regressions were performed. Finland, China and African countries showed significantly lower scores on the negative emotions, whereas positive emotions were more homogeneous across countries. Loneliness was positively associated with negative. emotions and negatively associated with positive ones; frequent social participation was related with higher scores in positive emotions; and lower trust with higher levels of feeling rushed, irritated, depressed and less calm. The extent to which each emotion was felt varied across countries, but there seems to exist an association of social factors with the emotionsThe research leading to these results has received funding from the US National Institute on Ageing Interagency Agreements (OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005-01 and R01-AG034479) and research grant (R01-AG034479), the European Community’s Seventh Framework Programme (grant agreement 223071 - COURAGE in Europe), the Instituto de Salud Carlos III (FIS research grants PS09/00295, PS09/01845, PI12/01490, PI13/00059, PI16/00218, PI16/01073 and PI16/00177), the Spanish Ministry of Economy and Competitiveness ACI Promociona (ACI2009–u201310101010) and the Centro de Investigación Biomédica en Red de Salud Mental (DOI: 10.13039/501100006751). Elvira Lara’s work is supported by the “Juan de la Cierva” postdoctoral program (IJC2019-041846-I) of the Spanish Ministry of Science and Innovation. Beatriz Olaya’s work is supported by the Miguel Servet (CP20/00040) contract, funded by the Instituto de Salud Carlos III and co-funded by the European Union (ERDF/ESF, “Investing in your future”). Chiara Castelletti’s work is supported by the programme “Contratos predoctorales para Formación de Personal Investigador, FPI-UAM,” Universidad Autónoma de Madrid, Spain