Subcallosal haemorrhage as a sign of diffuse axonal injury in patients with traumatic brain injury.

AIM: To identify the relationship between subcallosal haemorrhage and diffuse axonal injury (DAI) grading. MATERIALS AND METHODS: Computed tomography (CT) and magnetic resonance imaging (MRI) images of all patients with traumatic brain injury over the past 5 years were reviewed. Subcallosal haemorrhage was defined as the presence of haemorrhage on admission CT underneath the corpus callosum. Grading of DAI was performed using MRI or CT exclusive of subcallosal haemorrhage status. The association of demographic factors, mechanism of injury, Glasgow Coma Scale (GCS) on admission, and positive subcallosal haemorrhage status with the presence of moderate-severe DAI was assessed. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of subcallosal haemorrhage status in predicting DAI severity. Median modified Rankin Scale (mRS) scores were compared between subcallosal haemorrhage positive and negative cases. RESULTS: The images of 1,150 patients were reviewed with 301 patients showing DAI. Of those, 64 patients (21.2%) and 237 patients (78.7%) were positive and negative for subcallosal haemorrhage, respectively. Isolated subcallosal haemorrhage was noted in 15 patients (23.4%). A subcallosal haemorrhage positive status (OR=5.16, p < 0.001) was statistically significantly associated with moderate-severe DAI. The ROC curve for predicting moderate-severe DAI with subcallosal haemorrhage status showed an area under the curve of 0.625 (95% confidence interval [CI]: 0.561-0.688, p < 0.001). The median mRS score was significantly higher (p < 0.001) in the subcallosal haemorrhage positive group (median 4.5, interquartile range [IQR] 2-6) versus the negative group (median 2, IQR 2-3). Isolated subcallosal haemorrhage group showed moderate-severe DAI in 80% (12/15) of cases. CONCLUSION: Subcallosal haemorrhage is a highly specific radiographic predictor of moderate-severe DAI (grade 2-3).

Modalidades de imagen en la evaluación de enfermedad inflamatoria intestinal / Imaging techniques in the evaluation of inflammatory bowel disease

La enfermedad inflamatoria intestinal es una patología crónica, con una incidencia cada vez mayor. Dentro de este grupo de afecciones, la enfermedad de Crohn y la colitis ulcerosa son las más frecuentes. La enterografía por tomografía computada (ETC) y por resonancia magnética (ERM) son las modalidades de elección para la evaluación y seguimiento de la entidad, permitiendo examinar la apariencia de la mucosa, la pared intestinal, las manifestaciones extraintestinales y las complicaciones asociadas. La elección del estudio debe hacerse de acuerdo con la condición clínica de cada paciente

Inflammatory bowel disease is a chronic condition with increasing incidence. Crohn's disease and ulcerative colitis are the most common pathologies. Computed tomography (CT) enterography and magnetic resonance (MR) enterography are the methods of choice for evaluating and monitoring this entity, assessing the appearance of intestinal wall, mucosa, extra-intestinal manifestations, and associated complications. The preferred imaging methods must be selected according to the clinical conditions of the patient

[Interobserver reliability among neurology resident physicians in the diagnosis of primary headaches according to the 2004]. / Concordancia interobservador entre médicos residentes de neurología en el diagnóstico de las cefaleas primarias según la clasificación de la IHS 2004.

INTRODUCTION: We determine the interobserver reliability among neurology resident physicians when diagnosing primary headaches using the 2004 International Headache Classification (IHC) compared to that obtained when compared with these observers and those of a consensus group (CG) made up of investigators and observers. PATIENTS AND METHODS: The study was performed in an adult and pediatric population from a 4th level Colombian hospital out-patient neurology clinic. After informed consent was obtained from each patient, a video was recorded, eliminating the facial images in order to prevent patient identification. Two same level residents (observer 1 and observer 2) with previous training in the international classification of headache disorders (IHD-2) examined the video. Each video was examined separately with the classification in hand, making the diagnoses. The diagnoses obtained were compared between the observers and with the CG. RESULTS: We obtained a kappa index: 0.64 comparing residents, k: 0.66 comparing resident 1 to CG and kappa index 0.70 comparing resident 2 to CG in the level of groups. The kappa value obtained for the headache type level was 0.51 interobservers, 0.61 on comparing observer one with CG and 0.65 on comparing observer two with CG. CONCLUSION: Our results indicate that there is adequate reliability in the application of the 2004 IHC classification in the diagnosis of primary headaches among neurology resident physicians.

[Supernumerary nostril]. / Tercera ventana nasal.

Supernumerary nostril is an extremely rare congenital anomaly as a result of aberrant embryological development. Frequently it leads to a narrow cavity; in the end, opening into the nearest nasal cavity or just stops blindly after a short course. It can appear isolated or in association with other anomalies. Treatment is always surgical. We present a case of a triple nostril, associated to a congenital auricular hypoplasia and we also review the existing literature.

Tercera ventana nasal / Supernumerary nostril

La tercera ventana nasal es una anomalía congénita muy rara que resulta de un desarrollo embriológico aberrante. La mayor parte de las veces se continúa hacia atrás en una cavidad nasal que a su vez puede comunicar con la fosa natural más cercana o acabar en fondo de saco. Puede aparecer aislada o asociada a otras anomalías. El tratamiento es quirúrgico. Presentamos un caso de tercera ventana nasal con hipoplasia de pabellón auricular derecho asociada, revisando la literatura existente (AU)

Supernumerary nostril is an extremely rare congenital anomaly as a result of aberrant embryological development. Frequently it leads to a narrow cavity; in the end, opening into the nearest nasal cavity or just stops blindly after a short course. It can appear isolated or in association with other anomalies. Treatment is always surgical. We present a case of a triple nostril, associated to a congenital auricular hypoplasia and we also review the existing literature (AU)

[Subjective satisfaction among patients with endoscopic surgery of paranasal sinuses]. / Satisfacción subjetiva en pacientes intervenidos de cirugía endoscópica nasosinusal. Nuestra experiencia.

The analysis of the subjective satisfaction degree in patients following endoscopic sinus surgery is a very important data to be studied in a ENT Hospital Departments. In a very high percentage of cases, the result was good or very good. No cases were reported as worse. Statistically the relationship between non-existence of post surgery complications and the rate of symptoms of smaller importance was logical. We would like to point out the importance in the meaningful association between the high degree of satisfaction with the presence of significant postoperative endoscopic findings.

Satisfacción subjetiva en pacientes intervenidos de cirugía endoscópica nasosinusal. Nuestra experiencia / Subjective satisfaction degree in patients following endoscopic sinus surgery: our experience

Del estudio general de esta técnica quirúrgica en nuestro hospital hemos destacado, por su importancia creciente, el análisis del grado de satisfacción subjetiva de los pacientes tras ser sometidos a una CENS. En un porcentaje muy elevado de opiniones el grado de satisfacción era bueno, no encontrando ningún caso en que fuera peor. La relación estadisticamente significativa de la inexistencia de complicaciones postoperatorias y los síntomas residuales de menor importancia es coherente. Destacamos la paradoja de la asociación de un grado de satisfacción muy bueno con la presencia de hallazgos endoscópicos postoperatorios significativos (AU)

The analysis of the subjective satisfaction degree in patients following endoscopic sinus surgery is a very important data to be studied in a ENT Hospital Departments. In a very high percentage of cases, the result was good or very good. No cases were reported as worse. Statistically the relationship between non-existence of post surgery complications and the rate of symptoms of smaller importance was logical. We would like to point out the importance in the meaningful association between the high degree of satisfaction with the presence of significant postoperative endoscopic findings (AU)

Autoinjerto subcutáneo de cartílago neosintetizado utilizando el polímero ethisorb® en conejos / Subcutaneous autograft of neo-synthetic cartilage using the ethisorb® polymer in rabbits

Realizamos un autotransplante subcutáneo, en animales inmunocompetentes (24 conejos), de cartílago extraído del pabellón auricular, tratado mediante técnicas de ingeniería tisular y embebidos en un polímero reabsorbible (Ethisorb®) que le sirve de sostén. Encontramos que se produce un cartílago de buena calidad, con la expresión del colágeno tipo II y sin observar fenómenos de rechazo del injerto (AU)

We perform a subcutaneous autograft, in animals with preserved immunity (24 rabbits), of cartilage taken from the auricle, treated with tissue engineering thecnics and embeded in a reabsorbable polimer (Ethisorb) that acts as base. We observed a good quality cartilage with the expression of collagen type II and without graft rejection phenomenon (AU)

[Subcutaneous autograft with newly synthesized cartilage using ethisorb polymer in rabbits]. / Autoinjerto subcutáneo de cartílago neosintetizado utilizando el polímero ethisorb en conejos.

We perform a subcutaneous autograft, in animals with preserved immunity (24 rabbits), of cartilage taken from the auricle, treated with tissue engineering thecnics and embeded in a reabsorbable polimer (Ethisorb) that acts as base. We observed a good quality cartilage with the expression of collagen type II and without graft rejection phenomenon.

Neumatocele traqueal postraumático. Un caso de fístula traqueal y enquistamiento aéreo paratraqueal / Postraumatic tracheal pneumatocele. A case of aerialtracheal fistula and paratracheal encysted

Presentamos un caso de neumatocele traqueal postraumático tras una herida cervical abierta. Aportamos un tratamiento conservador a tener en cuenta como es la punción simple del quiste aéreo y el vendaje compresivo cervical (AU)

[Bilateral carotid chemodectoma on the external carotid arteries. A case report]. / Quemodectoma carotídeo bilateral dependiente de la arteria carótida externa. A propósito de un caso.

Tumors of the carotid body are rare neoplasms that arise from neuroectodermic tissues. They are located in the fork of the primitive carotid artery. They are benign, slow-growing, and asymptomatic, and predominate in women. We present a case of bilateral carotid chemodectoma on the external carotids. These tumors were diagnosed by CT, MRI and superselective angiography. The treatment of choice is surgical after arteriographic embolization. Exeresis is curative in most cases, but some cases require radiotherapy.

[Familial mixed hearing loss associated with X chromosome and stapedial gusher]. / Hipoacusia mixta familiar asociada al cromosoma X con gusher estapedial.

Perilymphatic and/or CSF loss through the oval window during stapedectomy is called a gusher. This rare disorder is associated with X-linked progressive mixed hearing loss. It is related with mutations in the POU3F4 gene at locus DFN3 on Xq21. Our study of the cases seen in our department yielded information and clinical and radiological findings that could be useful for the clinical management, early diagnosis, and prevention of erroneous therapeutic indications.