Romantic Name for a Deadly Condition: Kissing Aneurysms of the Pericallosal Artery – A Case Report

Background: Kissing aneurysms are two independent but adjacent aneurysms protruding from two contralateral arterial locations. This report describes a successfully treated case of kissing aneurysms at the Department of Neurosurgery, Medical University of Gdansk. Case: A 45-year-old asymptomatic woman was diagnosed with unruptured bilateral aneurysms located in the pericallosal-callosomarginal division. Her medical history included a previous intracranial aneurysm and arterial hypertension. The patient underwent a successful treatment by surgical clipping and was discharged in good condition; neither disability nor neurologic deficit was noticed upon discharge. Surgical wound healing was complicated by an infection and resulted in a reoperation for the patient. Conclusion: The etiology of kissing aneurysms is still unknown and the best treatment method stills remains unclear. Thus, every case has to be carefully and individually assessed by an interdisciplinaryteam. As a result, patient transfer to an experienced neurosurgical center could be beneficial

Spinal Cord Stimulation in Failed Back Surgery Syndrome: Review of Clinical Use, Quality of Life and Cost-Effectiveness

Failed back surgery syndrome (FBSS) is complex and recurrent chronic pain after spinal surgery. Several important patient and surgery related risk factors play roles in development of FBSS. Inadequate selection of the candidates for the spinal surgeries is one of the most crucial causes. The guidelines suggest that conservative management featuring pharmacologic approaches and rehabilitation should be introduced first. For therapy-refractory FBSS, spinal cord stimulation (SCS) is recommended in selected patients. Treatment efficacy for FBSS has increased over the years with the majority of patients experiencing pain relief and reduced medicinal load. Improved quality of life can also be achieved using SCS. Cost-effectiveness of SCS still remains unclear. However evidence for SCS role in FBSS is controversial, SCS can be beneficial for carefully classified patients

The effect of salinity levels on the structure of zooplankton communities

The objective of this study was to determine the qualitative and quantitative structure of zooplankton communities in the Vistula Lagoon and to establish whether zooplankton abundance and biodiversity are affected by salinity levels. Samples for biological analyses were collected in the summer (June-September) of 2007-2011 at eleven sampling sites. Statistical analysis revealed a significant correlation between salinity levels and the number of species (r= -0.2020), abundance (r= 0.1967) and biomass (r= 0.3139) of zooplankton. No significant correlations were found between salinity and the biodiversity of zooplankton. The results of the study suggest that salinity affects the abundance and structure, but not the diversity of zooplankton communities in the Vistula Lagoon

Effect of physicochemical parameters on zooplankton in the brackish, coastal Vistula Lagoon

This paper analyzes whether physicochemical properties significantly influence the occurrence of zooplankton in a brackish reservoir. The studies were carried out on the Vistula Lagoon in August and September from 2006 to 2009 at 32 research sites. The environmental conditions in the Vistula Lagoon varied widely. At the time of the investigation, 17 species of rotifers, six species of Cladocera, and ten species of Copepoda were noted, and the total density of plankton fauna ranged from 145 to 765 ind. dm−3. Statistical analysis demonstrated a significant correlation between the occurrence of some zooplankton species and certain environmental parameters, whereas the sampling sites were grouped according to study years. The zooplankton systems recorded at the research sites in 2006 constitute the most disparate group. Thus, it can be concluded that physicochemical properties might significantly impact both individual species (depending on their environmental demands) and entire zooplankton clusters

Late diagnosis of cerebral palsy in a 16-year-old girl – a case report

Cerebral palsy is the most common cause of motor disability in children. Cerebral palsy is a static encephalopathy with a variable clinical picture and multifactorial aetiology. Disorders arise from disturbances in the early development of the brain in the foetal, perinatal or postnatal period. The disease affects around 17 million people worldwide; its incidence is estimated to be 1.5–3 per 1,000 live births. A slight male predominance is observed. The disease has a multifactorial aetiology, with prematurity being the most important risk factor. There are four types of cerebral palsy: spastic (the most common – (70%), dystonic (10%), mixed (15%) and ataxic (5%). In addition to motor disability of varying severity, the majority of patients present with other accompanying deficits, such as mental retardation, epilepsy, dysphagia, impaired hearing and vision. The diagnosis of cerebral palsy should be based on detailed medical history, including pregnancy and childbirth as well as a regular assessment of the child’s development from the first months of life. In the case of clinical doubts, the diagnosis is extended to include magnetic resonance imaging, electroencephalography, metabolic and genetic tests. Children with cerebral palsy require a comprehensive, multidisciplinary care, including physical therapy and rehabilitation. Bobath and Vojta concepts are the most common rehabilitation approaches. Early diagnosis and regular rehabilitation are crucial to ensure adequate quality of life for a child with cerebral palsy. The paper presents a case of a 16-year-old girl with a long history of pain in the lower limbs, spine and temporomandibular joints. The symptoms were accompanied by chest pain as well as numbness and weakness of the left upper limb.W krajach wysokorozwiniętych mózgowe porażenie dziecięce stanowi najczęstszą przyczynę niepełnosprawności ruchowej występującej w dzieciństwie. Jest to stałe, choć zmieniające się w czasie zaburzenie ruchu i postawy, wynikające z trwałego i niepostępującego uszkodzenia mózgu w stadium jego niezakończonego rozwoju. Choroba dotyczy około 17 milionów ludzi na całym świecie, a zapadalność wynosi 1,5–3 na 1000 żywych urodzeń. Obserwuje się niewielką przewagę zachorowań wśród chłopców. Etiologia choroby jest zróżnicowana, jednak najważniejszy czynnik ryzyka stanowi wcześniactwo. Wyróżnia się cztery postaci mózgowego porażenia dziecięcego: spastyczną (70%), dystoniczną (10%), ataktyczną (5%) i mieszaną (15%). Towarzyszą mu również inne zaburzenia, w tym upośledzenie umysłowe, padaczka oraz zaburzenia wzroku, słuchu i połykania. Podstawą diagnozy są szczegółowy wywiad lekarski, uwzględniający przebieg ciąży i porodu, oraz regularna ocena rozwoju dziecka od pierwszych miesięcy życia. W przypadku wątpliwości klinicznych diagnostykę uzupełnia się o badanie rezonansu magnetycznego głowy, elektroencefalografię, testy metaboliczne i genetyczne. Dzieci z mózgowym porażeniem dziecięcym wymagają kompleksowej, wielodyscyplinarnej opieki. Najczęściej są rehabilitowane według metody Bobath lub Vojty. Wczesna i systematyczna rehabilitacja jest niezbędna do tego, by zmniejszyć trwałe następstwa choroby i poprawić jakość życia pacjenta. W pracy przedstawiono opis przypadku 16-letniej dziewczynki z obciążonym wywiadem okołoporodowym, konsultowanej przez licznych specjalistów z powodu długotrwałego bólu kończyn dolnych, kręgosłupa i stawów skroniowo-żuchwowych. Objawom towarzyszyły ból w klatce piersiowej oraz drętwienie i osłabienie lewej kończyny górnej