This technical case report describes a novel definitive surgical treatment of venous sinus aneurysms. This technique does not necessitate long-term anticoagulation, has a low likelihood of reintervention, and provides immediate resolution of pulsatile tinnitus.

Background:Increasing efforts have been made to reduce the incidence and severity of concussion in high-contact sports. Despite these efforts, a relative lack of knowledge is available regarding modulating factors affecting concussion injury.Purpose:To analyze the potential influence of game characteristics and outcomes on concussion incidence and severity in professional football.Study Design:Descriptive epidemiology study.Methods:PBS Frontline Concussion Watch was used to collect concussion injury data from regular-season games of 32 National Football League (NFL) teams from 2012 to 2015. Game characteristic variables such as rushing and passing attempts, turnovers, and margin of victory were collected from ESPN. Analysis included descriptive statistics, analysis of variance, t tests, and correlation tests.Results:Away teams demonstrated a significantly greater concussion incidence per game than home teams. Losing teams had a significantly greater concussion incidence per game than winning teams. Being both the away team and the losing team appeared to have an additive effect. The home-versus-away and win-versus-loss effects were significant for offensive but not defensive positions. Within individual positions, significantly greater concussion incidence was associated with tight ends, running backs, wide receivers, and cornerbacks. When running versus passing positions were compared, passing positions (wide receiver, tight end, cornerback, safety) had significantly greater concussion incidence. A total of 626 games were missed as a result of reported concussions. Away teams had significantly more games missed due to concussion when they lost. Play time did not significantly differ before or after concussion injury. Other game characteristic variables did not significantly affect concussion frequency or intensity.Conclusion:Position, game location, and game outcome affect concussion incidence for professional football players. In a subset of analyses, the number of games missed aligned with concussion incidence, but this appeared to be an imperfect measure. These findings highlight new factors that may modulate concussion incidence and merit further study on how they may influence concussion evaluation.

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Background: Thoracic spine fracture-dislocations due to motor vehicle accidents (MVAs) rarely involve double- level, noncontiguous lesions. Case Description: A 19-year-old male following an MVA was paraplegic; he exhibited full motor/sensory loss below the T4 level (i.e., ASIA scale Grade A). The chest X-ray, magnetic resonance, and computed tomography studies confirmed T3–T5 and T11–12 fractures, warranting T3–L3 thoracolumbar decompression and fusion. Despite surgical intervention, the patient’s neurological status remained unchanged. Conclusion: This case illustrates the rare presentation of noncontiguous, posttraumatic thoracic spinal lesions requiring simultaneous decompression/fixation.

BackgroundSports-related concussion is a major cause of mild traumatic brain injury (mTBI). It is possible that environmental factors, such as temperature, humidity, and stadium's altitude, may influence the overall incidence of concussions during a game.PurposeTo examine the impact of environmental factors, such as temperature, humidity, barometric pressure, and dew point, on concussion incidence.MethodsPublic Broadcasting Service (PBS) FRONTLINE Concussion Watch was used to collect injury data on 32 NFL teams during regular season games from 2012 to 2015. Weather data points were collected from Weather Underground. Concussion incidence per game, the probability of a concussion during a game, and a difference in mean game-day temperature, humidity, dew point, and barometric pressure between concussion and concussion-free games were calculated. Our analysis included t-tests, analysis of variance (ANOVA), multivariate correlation tests, and logistic and Poisson regression. ResultsOverall, 564 concussions were reported. There were 411 games with concussions and 549 games without concussions. We observed a significant decrease in concussion incidence with increasing temperature, both when the temperature was divided into 20oF increments or into quartiles (p = 0.005 and p = 0.002, respectively). We identified a statistically significant lower mean-game day temperature in concussion games compared to concussion-free games (p < 0.0006). We also observed a significant decrease in the incidence of concussion per game with increasing dew point. There was no significant difference in concussion incidence in barometric pressure and humidity. The logistic regression model predicted a decrease in the probability of a concussion in games with higher temperatures and dew points.ConclusionsNational Football League (NFL) players experienced an increased risk of concussion during football games played in colder temperatures and at lower dew points. Further research on environmental effects on concussions may aid in improving player safety in football leagues.

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IntroductionIn the past few years, there has been a rising interest in both the prevalence and the short- and long-term consequences of concussions. While the main focus of concussion-based research revolves around the National Football League (NFL), attention is now shifting to other high contact leagues like the National Hockey League (NHL), where there is constant player-to-player contact as well as collisions with the perimeter boards. While the body of evidence surrounding injury and concussion rates in the NHL has substantially grown in size over the previous few years, there is still a void pertaining to the in-game effects that could modulate concussion incidence. Our study takes a novel approach to evaluate several “style of play” factors such as home/away perspective, win/loss outcome, points scored, real time length of game, time of season, and player position in modulating concussion rates.MethodsData on concussion incidence for the 2013-2017 National Hockey League seasons was collected utilizing FOX Sports injury tracker. Only injuries specifically diagnosed as concussions during regular and postseason games were utilized in our data set. A Google search on the reported injury was performed in order to correlate the concussion to the correct game in which the player sustained it. NHL season schedules were acquired through the online source “Hockey Reference.” There were a total of 5281 games when considering the regular and postseason games between the 2013-2017 seasons. Concussions sustained during team practices and preseason contests were not accounted for in our data set to control for inconsistent reporting. Our data set does not account for the current 2017-2018 NHL expansion with the addition of a Las Vegas team to the league.ResultsStatistical analysis of several "Style of Play" factors such as home/away perspective, win/loss outcome, points scored, real time length of game and time of season produced non-significant results pertaining to modulating concussion rate during the 2013-2017 NHL seasons. When evaluating on-ice position we noted offensive players combined to have the highest rate of concussion. Forwards (left wing (LW), right wing (RW)) demonstrated similar concussion rates, while goalies encountered the lowest concussion rate.ConclusionThe results of our analysis demonstrated non-significance for home/away effects, win/loss results, average points scored, real time length of game, and time of season on influencing concussion rates. We noted offensive players combined to have the highest rate of concussions, while goalies encountered the least. The key limitation in our data set is the lack of reliable and publicly available data surrounding concussion incidence in the National Hockey League. Due to this drawback, our data set should be considered as an under-reported representation of the total amount of concussions spanning the 2013-2017 seasons.

XB130 is an adaptor protein that functions as a mediator of multiple tyrosine kinases important for regulating cell proliferation, survival, migration and invasion. Formerly predicted as an oncogene, alterations of its expression are documented in various human cancers. However, the exact role of XB130 in tumorigenesis is unknown. To address its function in skin tumorigenesis, a two-stage dimethylbenzanthracene (DMBA)/12-O-tetradecanoylphorbol 13-acetate (TPA) study was performed on XB130 knockout (KO), heterozygous (HZ) and wild-type (WT) littermate mice. DMBA/TPA-treated XB130 KO and HZ males developed a significantly higher number of epidermal tumors that were notably larger in size than did WT mice. Interestingly, DMBA/TPA-treated female mice did not show any difference in tumor multiplicity regardless of the genotypes. The skin tumor lesions of XB130 KO males were more progressed with an increased frequency of keratoacanthoma. Deficiency of XB130 dramatically increased epidermal tumor cell proliferation. The responses to DMBA and TPA stimuli were also individually investigated to elucidate the mechanistic role of XB130 at different stages of tumorigenesis. DMBA-treated male XB130 KO mice showed compensatory p53-mediated stress response. TPA-treated XB130 KO males demonstrated more skin ulceration with more severe edema, enhanced cell proliferation, accumulation of infiltrating neutrophils and increased production of pro-inflammatory cytokine genes compared with WT mice. Enhanced activities of nuclear factor-kappa B pathway, increased protein expression of metalloproteinase-9 and ERK1/2 phosphorylation were found in these KO mice. These findings demonstrate that XB130 acts as a tumor suppressor in carcinogen-induced skin tumorigenesis that may be mediated through inhibiting inflammation.