The author present a rare case of rapid ossification of epidural hematoma (EDH) in a 5-year-old boy. At admission, the computed tomography (CT) revealed an EDH on left temporoparietal region. On the follow-up CT scan doing 14 days after traffic accident, the expansion of the former hematoma was not visible, but the hematoma accompanied by the thin hyperdense layer on the dura. On follow-up CT scans, the hematoma was decreased but the ossified layer progressing. After 6 months of conservative therapy, the hematoma was fully absorbed and the ossified lesion merged to inner table of the skull. Hence, rapid ossification of an EDH should be considered in children and serial follow-up CT scans must be conducted.
Metronidazole may produce a number of neurologic side effects including peripheral neuropathy, seizure, encephalopathy. We experienced neurological side effects of metronidazole. The 32-year-old female patient with spinal cord injury was diagnosed as encephalophathy and peripheral polyneuropathy resulting from complication of metronidazole. It was difficult to diagnose at first glance using clinical findings because of paraplegia due to spinal cord injury. But through magnetic resonance imaging with diffusion weighted imaging and electrophysiologic study, the patient showed to have characteristic abnormalities that of a person suffering from metronidazole-induced encephalopathy and peripheral polyneuropathy. Whether the symptoms were caused by a peripheral nerve lesion or MIE, the patient's paraplegia prevented to appear other symptoms, such as ataxic gait and seizure, from manifesting. In such case as this, an active differentiated diagnosis is crucial.
Objective: A development of intracranial lesions in patients with head trauma is one of the most important prognostic factor. The brain CT scanning plays a vital role in early diagnosis of traumatic intracranial lesions. But all patients with head trauma are not evaluated with brain CT scaninning, and skull x-ray have a valuable role as a screening procedure in patients with head trauma. The presence of a skull fracture has been thought to correlate with occult intracranial lesions that may result in delayed neurological deterioration. We have undertaken a retrospective study to evaluate the development of intracranial lesions and the significance of skull fracture in patients with head trauma.Methods: A analysis of 80 cases with skull fractures who were admitted to our department from January 2002 to December 2004 was made according to their clinical informations, skull x-ray films, initial and repeated brain CT scans and prognosis.
Results:In the results, a linear skull fracture was the most common type in 54 cases(67.5%), and the most common site of fracture was temporo-parietal skull in 20 cases(25%). Intracranial lesions were identified in 52 cases(65%) on initial brain CT scan and types of intracranial lesions were epidural hematoma in 23 cases(28.8%), hemorrhagic cerebral contusion in 22 cases(27.5%), subdural hematoma in 14 cases(17.5%) and intracerebral hematoma in 10 cases(12.5%). Repeated brain CT scanning was performed in 68 cases and delayed lesions were identified in 26 cases(38.2%).
Conclusions:The presence of skull fracture is a important and valuable indicator for development of intracranial lesions and skull x-ray film is a good screening evaluation method in patients with head trauma.
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