Quantitative analysis of the olfactory system in pediatric epilepsy: a magnetic resonance imaging study

PURPOSE: Olfactory dysfunction is a well-known complication in epilepsy. Studies have demonstrated that olfactory bulb volume (OBV), olfactory tract length (OTL), and olfactory sulcus depth (OSD) can be reliably evaluated using magnetic resonance imaging (MRI). In this study, we compared the OBV, OTL, and OSD values of children with epilepsy and those of healthy children (controls) of similar age. Our aim was to determine the presence of olfactory dysfunction in children with epilepsy and demonstrate the effects of the epilepsy type and treatment on olfactory function in these patients. METHODS: Cranial MRI images of 36 patients with epilepsy and 108 controls (3-17 years) were evaluated. The patients with epilepsy were divided into groups according to the type of disease and treatment method. Subsequently, OBV and OSD were measured from the coronal section and OTL from the sagittal section. The OBV, OTL, and OSD values were compared between the epilepsy group, subgroups, and controls. RESULTS: OBV was significantly reduced in the children with epilepsy compared with the control group (P < 0.001). No significant difference between the healthy children and those with epilepsy was determined in terms of OTL and OSD. Although OBV was moderately positively correlated with age in the control group (r = 0.561, P < 0.001), it was poorly correlated with age in children with epilepsy (r = 0.393, P = 0.018). CONCLUSION: The results of our study indicate that OBV decreases in children with epilepsy, but epilepsy type and treatment method do not affect OBV, OTL, or OSD (P > 0.05).

Is Increased Intracranial Pressure a Factor in Persistent Headache After Coronavirus Disease 2019?

ABSTRACT: This study aimed to determine pain characteristics in patients with persistent headache after COVID-19 and to investigate the role of increased intracranial pressure (ICP) in the pathogenesis of this headache. This is a case-control study comparing the parameters and measurements indicating increased ICP based on magnetic resonance imaging between COVID-19-diagnosed patients with persistent headache and a control group. Optic nerve sheath diameter (ONSD) and eyeball transverse diameter (ETD) were performed on the left eye of each participant. Seventeen of the patients (53.12%) met the diagnostic criteria for new daily persistent headache. Seven patients (21.87%) had migraine, and eight (25%) had tension headache characteristics. No significant difference was observed between the patient and control groups in terms of the ONSD and ETD values. It is possible that the etiopathogenesis is multifactorial. We consider that future studies that will evaluate ICP measurements in large patient groups can present a different perspective for this subject.

Torsion of Wandering Spleen: A Case Report.

BACKGROUND: Wandering spleen is defined as the localization of the spleen in the lower parts of the abdomen or the pelvic region, rather than the left upper quadrant. The torsion of wandering spleen is a rare clinical condition. CASE REPORT: We evaluate a case diagnosed with torsion of wandering spleen and underwent splenectomy in our hospital and discuss it in light of the literature. A 26-year-old man presented to the emergency department with abdominal pain and abdominal distention. The patient was diagnosed with the torsion of wandering spleen based on computed tomography scan results. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The torsion of wandering spleen is rare in patients presenting with acute abdominal pain, but it is an important condition that should be considered in the differential diagnosis. The diagnosis of wandering spleen should be made before the development of potentially life-threatening complications. Emergency surgery should be undertaken in patients with splenic infarction.

Brucella and non-Brucella epididymo-orchitis: comparison of ultrasound findings.

AIM: In brucellosis the male genitourinary system can be affected in a small number of patients. In this study we aimed to identify, discuss and compare the radiologic findings of 24 cases with Brucella epididymo-orchitis (BEO) and 285 cases with non-Brucella epididymis orchitis (NBEO). MATERIAL AND METHODS: The study had a retrospective design. The area of involvement, side of involvement (left, right or bilateral), presence of abscess, hydrocele and testicular involvement pattern were analyzed and compared between the BEO and NBEO cases. RESULTS: The median age of the included cases was 33 years, with a minimum of 0 and maximum of 89. Epididymo-orchitis and isolated orchitis were more frequent in BEO cases while isolated epididymis involvement was more common in patients with non-BEO (p=0.0117). Bilateral involvement was present in 20.8% and 4.6% cases in the BEO and non-BEO groups, respectively (p=0.008). The frequency of abscess was significantly higher in BEO cases (p=0.003). CONCLUSION: Although the radiological indications of BEO are similar to those of other types of epididymo-orchitis, abscess formation, bilateral involvement and testicular involvement contribute significantly to diagnosis.

The value of susceptibility weighted magnetic resonance imaging in evaluation of patients with familial cerebral cavernous angioma.

OBJECTIVES: We investigated the imaging features of Cavernous angioma (CA) lesions and the value of Susceptibility-weighted imaging (SWI) by comparing with T2*-weighted gradient echo (GRE) sequences in patients with familial CA disease. MATERIAL AND METHODS: We retrospectively evaluated 19 familial CA patients (8 men, 11 women; mean age, 36 years). T1-weighted, T2-weighted, T2*-weighted GRE, and SWI sequences were performed to all patients. The numbers of CA lesions seen on T2*-weighted GRE and SWI sequences were analyzed. The correlations between the numbers of lesions on both sequences with age were evaluated. CA lesions were classified according to the classification of Zabramski et al. RESULTS: The number of CA lesions was higher on SWI than T2*-weighted GRE significantly (P<.001). There was a significant strong correlation between the age of the patients and number of lesions in the cohort on T2*-weighted GRE (r = 0.81, P<0.001) and SWI (r = 0.85, P<0.001) sequences. Approximately 44% of the CA lesions which were detected only by SWI could not be categorized according to the classification of Zabramski et al. CONCLUSION: SWI can provide helpful additional information by determining the CA lesions more accurately than T2*-weighted GRE. Thus, routine clinical neuroimaging protocols should contain SWI to assess the true prevalence of lesions for optimal diagnosis and treatment. Moreover, this study show that the Zabramski classification is insufficient to identify all CA lesions, and a new type (type V) should be added to represent lesions that are seen on SWI but not on T2*-weighted GRE.

Hydatid cyst of paravertebral muscle mimicking disc herniation.

STUDY DESIGN: Case report. OBJECTIVE: To present a case of primary hydatid cyst in the lumbar subcutaneous tissue affecting posterior paravertebral muscle and mimicking disc herniation. SUMMARY OF BACKGROUND DATA: Cystic hydatid disease is a rare but significant parasitic disease in endemic areas. Musculoskeletal or soft tissue hydatidosis accounts for about 0.5% to 5% of all echinococcal infections in endemic areas and is almost secondary to the hepatic or pulmonary disease. Primary lumbar subcutaneous hydatid cyst affecting paravertebral muscle and extending to neural foramina is a very rare condition even in endemic areas. METHODS: A 25-year-old-female patient was admitted with swelling and pain in the right lumbar region for 3 months. The pain was reflecting in the right gluteal region and the right leg. Lumbar extension and right lateral flexion was painful and straight leg raising test was positive at right side. There was a mild hypoesthesia at L5 dermatome. According to the magnetic resonance image that the clinician obtained for initial diagnosis of lumbar disc herniation, we found multi-cystic masses located at the right paravertebral muscle at the level of L3-L5 which extended to L4-L5 neural foramina and at subcutaneous tissue at the right gluteal region. RESULTS: The patient was operated for the purpose of removal of cysts. Postoperatively, diagnosis of hydatid cyst was confirmed by histopathology. CONCLUSION: By this case, we emphasize that cystic hydatid disease should be taken into consideration in the differential diagnosis of low back pain and could mimic disc herniation. LEVEL OF EVIDENCE: N/A.