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1.
Introduction
Angiolipomas are benign tumors usually manifested as subcutaneous nodules. Rarely they may form spinal extradural masses. These spinal cavernous angiolipomas have mostly been described in adults.Diagnosis
To our knowledge, spinal cavernous angiolipomas have been reported in nine pediatric patients.Clinical presentation
In this paper, we present a 1-year-old child presenting with a spontaneous spinal epidural hematoma from a spinal cavernous angiolipoma and highlight the importance of conducting a histopathological analysis of spontaneous hematomas in previously healthy children.2.
Loic Sigwalt Emeline Bourgeois Ahmad Eid Chantal Durand Jacques Griffet Aurélien Courvoisier 《Child's nervous system》2016,32(5):873-876
Purpose
Giant cell tumors (GCT) are benign primary bone tumors, locally aggressive, affecting in long bones in young adults during the third decade. It is rare to experience this lesion in skeletally immature patients. GCT are related to a risk of local recurrence and malignant transformation.Method
We report a rare case of a giant cell tumor of the thoracic spine in a skeletally immature girl presenting with a painful right scoliosis.Results
MRI, CT scan, and bone scintigraphy were discordant and the percutaneous biopsy non-contributive.Conclusion
A marginal “en bloc” resection was performed and revealed the GCT. Based on a literature review, the diagnosis and the surgical management of this case are discussed.3.
Jaspreet Johal Marios Loukas Christian Fisahn Rod J. Oskouian R. Shane Tubbs 《Child's nervous system》2016,32(9):1603-1606
Purpose
The purpose of this paper was to review the literature on Bergmann’s ossicle and provide an overview on its development, etiology, and clinical presentation while also differentiating it from similar structural anomalies.Methods
A thorough review of the literature available on Bergmann’s ossicle was performed.Results
Bergmann’s ossicle, also referred to as ossiculum terminale persistens, was defined as a developmental anomaly of the odontoid process in which an ossification center that gives rise to the tip of the dens fails to fuse properly with the body of the axis.Conclusion
Bergmann’s ossicle is most often a benign condition, although it rarely may present with clinical symptoms such as neck pain and neurological signs. It may be associated with Down’s syndrome and contribute to atlantoaxial instability.4.
Gemma Lombardi Cristina Polito Valentina Berti Camilla Ferrari Giulia Lucidi Silvia Bagnoli Irene Piaceri Benedetta Nacmias Alberto Pupi Sandro Sorbi 《Neurological sciences》2018,39(7):1203-1210
Background
An early differentiation between Alzheimer’s Disease (AD) and other dementias is crucial for an adequate patients’ management, albeit it may result difficult for the occurrence of “atypical presentations.” Current diagnostic criteria recognize the importance of biomarkers for AD diagnosis, but still an optimal diagnostic work-up isn’t available.Objective
Evaluate the utility and reproducibility of biomarkers and propose an “optimal” diagnostic work-up in atypical dementia.Methods
(1) a retrospective selection of “atypical dementia cases”; (2) a repetition of diagnostic assessment by two neurologists following two different diagnostic work-ups, each consisting of multiple steps; (3) a comparison between diagnostic accuracy and confidence reached at each step by both neurologists and evaluation of the inter-rater agreement.Results
In AD, regardless of the undertaken diagnostic work-up, a significant gain in accuracy was reached by both neurologists after the second step, whereas in frontotemporal dementia (FTD), adding subsequent steps was not always sufficient to increase significantly the baseline accuracy. A relevant increment in diagnostic confidence was detectable after studying pathophysiological markers in AD, and after assessing brain metabolism in FTD. The inter-rater agreement was higher at the second step for the AD group when the pathophysiological markers were available and for the FTD group when the results of FDG-PET were accessible.Conclusions
In atypical cases of dementia, biomarkers significantly raise diagnostic accuracy, confidence, and agreement. This study introduces a proof of diagnostic work-up that combines imaging and CSF biomarkers and suggests distinct ways to proceed on the basis of a greater diagnostic likelihood.5.
Purpose
Dural sinus malformations (DSMs) are rare pediatric vascular lesions that have variable presentations and outcomes. We present three cases of midline DSMs and discuss the treatment strategy employed for each lesion. A review of the literature was completed to summarize current literature and treatment practices.Methods
A retrospective review of the electronic medical record and all available imaging studies was performed for each of our patients.Results
Patient 1 had a prenatally diagnosed DSM which decreased in size despite no intervention. She was born without complication and continues to do well at 15 months of age. Patient 2 presented 2 weeks after birth with cardiac failure, intracranial hemorrhage, and seizures and imaging showed a large midline DSM with multiple high-flow shunts. She required multiple endovascular embolizations with complete occlusion of the lesion. At her 3-year follow-up, she was neurologically normal. The third patient was diagnosed prenatally with an enlarging DSM. Multiple endovascular embolizations, surgical decompression, cranial expansion, and CSF diversion were required for treatment. At her 2.5-year follow-up, she was meeting developmental milestones, with some motor delay.Conclusion
Early diagnosis and treatment, if necessary, of DSMs are critical to prevent cardiac failure or parenchymal injury from chronic venous hypertension. Management should be decided on individual case basis depending on the angioarchitecture and progression of the lesion and can involve observation, endovascular embolization, surgical interventions, or a combination of treatments. A personalized approach to treating these variable lesions can be associated with good outcomes.6.
Daniela Sammler 《Zeitschrift für Epileptologie》2016,29(1):16-20
Background
Language and music present numerous structural similarities. This suggests that both domains may be built on shared cognitive and neuroanatomical resources.Objectives
Here, discrepant results that either support or deny neurocognitive links between language and music are discussed. It is argued that the investigation of cognitive subprocesses and the consideration of neuropathology can reconcile the conflicting findings.Methods
Language–music links were tested in patients with temporal lobe epilepsy (TLE) by means of electrocorticography (study I) and functional magnetic resonance imaging (study II), with specific focus on grammar processing and memory building.Results
Study I showed a co-localization of grammar processing in language and music in bilateral temporal lobes. Study II yielded an atypical segregation of text and melody in song memory in patients with left TLE.Conclusions
These results lend evidence for neurocognitive links between language and music. Yet, they demonstrate the importance to focus on cognitive subprocesses and to take the neurological health of participants into account.7.
Todd Hollon Paul E. McKeever Hugh J. L. Garton Cormac O. Maher 《Child's nervous system》2015,31(7):1171-1174
Background
Delayed swelling after skull fractures is an uncommon complication following head trauma in children. Classically, growing skull fractures typically present in patients under 3 years of age with progressive subcutaneous fluid collections, or occasionally with neurologic symptoms. We present the case of a healthy 2-year-old boy with a lytic “punched-out” frontal skull lesion. The child presented 2 months after a minor forehead injury for which no medical attention was sought.Methods
The skull defect had no associated leptomeningeal cyst or brain herniation. Imaging and presentation were thought to be consistent with eosinophilic granuloma. Histologic findings demonstrated a healing skull fracture.Results
Cranioplasty was performed, and the patient had an uncomplicated postoperative course.Conclusions
In this report, we describe our experience with this atypical presentation of a healing skull fracture mimicking a typical eosinophilic granuloma.8.
Background
This study aimed to explore the resting-state fMRI changes in Chinese boys with low functioning autism spectrum disorder (LFASD) and the correlation with clinical symptoms.Methods
The current study acquired resting-state fMRI data from 15 Chinese boys with LFASD and 15 typically developing (TD) boys to examine the local brain activity using the regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) indexes; the researchers also examined these measures and their possible relationships with clinical symptoms using the autism behavior checklist.Results
Results indicated that boys with LFASD exhibited increased ReHo in the right precuneus and inferior parietal gyrus (IPG), increased ALFF in right middle temporal gyrus, angular gyrus and IPG. However, no correlation was found between the ALFF/ReHo score and clinical symptoms in the LFASD group.Conclusions
Some of the brain regions had ReHo/ALFF values that were higher in the boys with LFASD than the TD group and these differentiated brain areas in boys with LFASD were all on the right cerebrum, which supported ‘atypical rightward asymmetry’ in boys with LFASD.9.
Eloise Crush Louise Arseneault Helen L. Fisher 《Social psychiatry and psychiatric epidemiology》2018,53(12):1413-1417
Purpose
To investigate whether social support is protective for psychotic experiences similarly among poly-victimised adolescent girls and boys.Methods
We utilised data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative sample of 2232 UK-born twins. Participants were privately interviewed at age 18 about victimisation, psychotic experiences, and social support during adolescence.Results
Perceived social support (overall and from friends) was found to be protective against psychotic experiences amongst poly-victimised adolescent girls, but not boys. Though boys were similarly protected by family support.Conclusions
Social support-focused interventions targeting psychotic phenomena amongst poly-victimised adolescents may be more effective for girls.10.
Background
“Bath salts” or synthetic cathinone toxicity remains a potentially deadly clinical condition. We report a delayed leukoencephalopathy with persistent minimally conscious state.Methods
Case report.Results
A 36-year-old man presents with delayed encephalopathy, dysautonomia, fulminant hepatic failure, and renal failure from severe rhabdomyolysis after consuming bath salts. MRI showed diffusion restriction in the splenium of the corpus callosum and subcortical white matter.Conclusions
The combination of acute leukoencephalopathy, rhabdomyolysis and fulminant hepatic failure may point to bath salt inhalation and should be known to neurointensivists.11.
Hua Bai Sonja A. Wilhelm Stanis Andrew T. Kaczynski Gina M. Besenyi 《Annals of behavioral medicine》2013,45(1):39-48
Background
Parks are important resources for physical activity (PA), yet few studies have examined how perceptions of park characteristics relate to PA and health.Purpose
This study investigated associations between perceptions of neighborhood park quality and overall moderate-to-vigorous PA (MVPA), park-based PA, and body mass index (BMI).Methods
Data were collected via questionnaire from 893 households in Kansas City, Missouri.Results
The newly developed neighborhood park quality scale demonstrated good test–retest and internal reliability. Residents’ perceptions of neighborhood park quality were related to PA and health outcomes. Perceiving parks as a benefit was positively related to overall MVPA and park-based PA and negatively related to BMI. Perceptions of well-used parks were positively related to BMI, while perceived cleanliness was negatively related to park-based PA.Conclusions
Better measuring and understanding how perceptions of local parks are associated with PA and health can improve appreciation of how parks facilitate active living.12.
Background
We examined gender difference in QTc interval distribution and its related factors in people with mental disorders.Methods
We retrospectively reviewed medical charts of patients discharged from a university psychiatric unit between November 1997 and December 2000. Subjects were 328 patients (145 males and 183 females) taking psychotropics at their admission. We examined patient characteristics, medical history, diagnosis, and medication before admission.Results
Mean QTc interval was 0.408 (SD = 0.036). QTc intervals in females were significantly longer than those in males. QTc of females without comorbidity was significantly longer than that of males.Conclusion
The influence of gender difference on QTc prolongation in people with mental disorders merits further research.13.
Ming Wen Xingyou Zhang Carmen D. Harris James B. Holt Janet B. Croft 《Annals of behavioral medicine》2013,45(1):18-27
Background
Little national evidence is available on spatial disparities in distributions of parks and green spaces in the USA.Purpose
This study examines ecological associations of spatial access to parks and green spaces with percentages of black, Hispanic, and low-income residents across the urban–rural continuum in the conterminous USA.Methods
Census tract-level park and green space data were linked with data from the 2010 U.S. Census and 2006–2010 American Community Surveys. Linear mixed regression models were performed to examine these associations.Results
Poverty levels were negatively associated with distances to parks and percentages of green spaces in urban/suburban areas while positively associated in rural areas. Percentages of blacks and Hispanics were in general negatively linked to distances to parks and green space coverage along the urban–rural spectrum.Conclusions
Place-based race–ethnicity and poverty are important correlates of spatial access to parks and green spaces, but the associations vary across the urbanization levels.14.
Lara Hilton Susanne Hempel Brett A. Ewing Eric Apaydin Lea Xenakis Sydne Newberry Ben Colaiaco Alicia Ruelaz Maher Roberta M. Shanman Melony E. Sorbero Margaret A. Maglione 《Annals of behavioral medicine》2017,51(2):199-213
Background
Chronic pain patients increasingly seek treatment through mindfulness meditation.Purpose
This study aims to synthesize evidence on efficacy and safety of mindfulness meditation interventions for the treatment of chronic pain in adults.Method
We conducted a systematic review on randomized controlled trials (RCTs) with meta-analyses using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the GRADE approach. Outcomes included pain, depression, quality of life, and analgesic use.Results
Thirty-eight RCTs met inclusion criteria; seven reported on safety. We found low-quality evidence that mindfulness meditation is associated with a small decrease in pain compared with all types of controls in 30 RCTs. Statistically significant effects were also found for depression symptoms and quality of life.Conclusions
While mindfulness meditation improves pain and depression symptoms and quality of life, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the efficacy of mindfulness meditation for chronic pain.15.
Christopher P. Salas-Wright Michael G. Vaughn Trenette Clark Goings 《Social psychiatry and psychiatric epidemiology》2017,52(10):1325-1328
Purpose
To examine the prevalence of self-reported criminal and violent behavior, substance use disorders, and mental disorders among Mexican immigrants vis-à-vis the US born.Methods
Study findings are based on national data collected between 2012 and 2013. Binomial logistic regression was employed to examine the relationship between immigrant status and behavioral/psychiatric outcomes.Results
Mexican immigrants report substantially lower levels of criminal and violent behaviors, substance use disorders, and mental disorders compared to US-born individuals.Conclusion
While some immigrants from Mexico have serious behavioral and psychiatric problems, Mexican immigrants in general experience such problems at far lower rates than US-born individuals.16.
R. Shane Tubbs Amin Demerdash Anthony V. D’Antoni Marios Loukas Charles Kulwin Rod J. Oskouian Aaron Cohen-Gadol 《Child's nervous system》2016,32(11):2153-2157
Background
The middle meningeal artery (MMA) is often sacrificed during neurosurgical procedures in the region of the pterion. This maneuver, herein, is hypothesized to be a potential reason for the development of postoperative hydrocephalus by injuring the vascular supply to the arachnoid granulations near the vertex of the skull, and thus disrupting their ability to allow for transfer of CSF from the subarachnoid space to the venous system.Materials and methods
To test this theory, the middle meningeal artery was isolated at the skull base and injected with India ink. Next, the superior sagittal sinus was opened and the arachnoid granulations inspected.Results
All specimens demonstrated ink within the arachnoid granulations indicating that their blood supply is completely or at least partially via the middle meningeal artery. This finding with an illustrative case of surgical cautery of the middle meningeal artery at the skull base with subsequent development of hydrocephalus supports our hypothesis of potential role of iatrogenic MMA injury causing hydrocephalus.Conclusions
Our cadaveric study shows that the blood supply of the arachnoid granulations of the superior sagittal sinus is via the middle meningeal artery. Additional cases of postoperative hydrocephalus following middle meningeal artery sacrifice are needed to support our hypothesis.17.
Susan Beckwitt Turkel 《Current psychiatry reports》2017,19(12):101
Purpose of Review
This review seeks to provide an update on the diagnosis, management, and outcome of pediatric delirium.Recent Findings
Care of patients with delirium depends on correct diagnosis and treatment of its underlying cause. A variety of instruments are available to aid diagnosis. Management of delirium currently depends on atypical antipsychotics, while avoiding agents that may precipitate or exacerbate it.While most critically ill children survive delirium, many children die or have worsening function after their illness. The longer the duration of delirium, the more severe its subsequent problems including postintensive care syndrome and posttraumatic stress disorder.Summary
Possible serious long-term consequences emphasize the importance of efforts to improve diagnosis and outcome in critically ill children suffering from delirium.18.
F. Malbari T. R. Gershon J. H. Garvin J. C. Allen Y. Khakoo A. S. Levy I. J. Dunkel 《Child's nervous system》2016,32(8):1359-1362
Background
Central nervous system (CNS) germ cell tumors account for 3 % of all pediatric brain tumors in the USA. Presenting symptoms are typically location based with pineal tumors presenting with obstructive hydrocephalus and suprasellar tumors with hypothalamic/pituitary dysfunction and ophthalmologic abnormalities. Psychiatric manifestations such as psychosis and behavioral changes are atypical presentations of CNS germ cell tumors, with only 11 previously reported cases.Methods
This is a retrospective case series describing patients with CNS germ cell tumors with an atypical presentation including psychiatric manifestations. Information regarding clinical presentation, treatment course, and outcome were obtained.Results
We report seven patients who presented with psychiatric symptoms consisting of psychomotor delay as well as behavioral and mood changes. Six of the seven patients were diagnosed ≥6 months after onset of psychiatric symptoms. All of the seven are alive but five continue to have neurologic and psychiatric issues post treatment.Conclusions
Atypical presentations of CNS germ cell tumors can delay diagnosis and treatment and may be secondary to atypical locations as well as endocrine dysfunction manifesting as psychiatric symptoms. Delayed diagnosis did not appear to affect survival but earlier diagnosis may potentially be associated with better neurologic and psychiatric outcome. Patients who present with these symptoms and atypical neuroimaging should have a thorough evaluation for CNS germ cell tumors including serum and CSF markers. Clinicians should be aware of these less common presentations to aid in prompt diagnosis and treatment.19.
Background
Low childhood socioeconomic status (SES) is reliably associated with poor adult health. Social environments early in life and physiological stress responses are theorized to underlie this link; however, the role of attachment orientations is relatively unknown.Purpose
In this study, we examined whether attachment orientations (i.e., attachment anxiety and attachment avoidance) and self-reported stress were mediators of the association between childhood SES and self-reported health in adulthood. Furthermore, we examined whether parasympathetic nervous system functioning was a moderator of associations between attachment orientations and self-reported stress.Methods
Participants (N = 213) provided self-reports of childhood SES, attachment orientations, general stress, and self-rated health. Respiratory sinus arrhythmia (RSA) was measured at rest, as well as during an acute social stressor.Results
Low childhood SES was associated with poor self-reported health via the serial pathway from attachment anxiety to general stress. Moreover, attachment avoidance was associated with self-reported health via general stress, but only among those with high stress-induced RSA. Findings were independent of participant age, sex, race, body mass index, baseline RSA, and adult SES.Conclusions
Attachment theory is useful for understanding why those from low SES backgrounds are at greater risk of negative health outcomes in adulthood. Findings extend our knowledge of how interpersonal relationships in childhood can shape emotional and physical health outcomes in adulthood.20.
Stefan Duschek Alexandra Hoffmann Gustavo A. Reyes del Paso Ulrich Ettinger 《Annals of behavioral medicine》2017,51(3):442-453