A new multichannel broadband NIRS system for quantitative monitoring of brain hemodynamics and metabolism during seizures

We present a newly developed multichannel broadband NIRS (or bNIRS) system that has the capacity to measure changes in light attenuation of 308 NIR wavelengths (610nm to 918nm) simultaneously over 16 different brain locations. To achieve this the instrument uses a lens based spectrometer with a front-illuminated CCD that has a sensor size of 26.8x26mm. This large CCD detector allows the simultaneous binning of 16 detector fibres. The software uses the UCLn algorithm to quantify the changes in oxy-, deoxy- haemoglobin concentration (HbO2, HHb) and oxidised cytochrome-coxidase (oxCCO) simultaneously over 16 different brain locations with 1second sampling rate. We demonstrate the use of the instrument in quantifying brain tissue oxygenation and metabolic activity simultaneously with electrical changes as measured with EEG in children with seizures

Two different causes of acute respiratory failure in a patient with diffuse idiopathic skeletal hyperostosis and ankylosed cervical spine

We report a case of 73-year-old man with massive hyperostosis of the cervical spine associated with diffuse idiopathic skeletal hyperostosis (DISH), resulting in dysphagia, hoarseness and acute respiratory insufficiency. An emergency operation was performed, which involved excision of osteophytes at the level of C6–C7, compressing the trachea against enlarged sternoclavicular joints, also affected by DISH. Approximately 3 years later, the patient sustained a whiplash injury in a low impact car accident, resulting in a C3–C4 fracture dislocation, which was not immediately diagnosed because he did not seek medical attention after the accident. For the next 6 months, he had constant cervical pain, which was growing worse and eventually became associated with dysphagia and dyspnoea, ending once again in acute respiratory failure due to bilateral palsy of the vocal cords. The patient underwent a second operation, which comprised partial reduction and combined anteroposterior fixation of the fractured vertebrae. Twenty months after the second operation, mild hoarseness was still present, but all other symptoms had disappeared. The clinical manifestations, diagnosis and treatment of the two unusual complications of DISH are discussed