Depression and anxiety are mood disorders that are commonly related to chronic illnesses. The overall frequency in hospitalized patients has an index of variation between 20 and 60% 1-3 , and they are not recognized in one third of patients 4 . Their frequency can be higher in patients without mood disorders presenting symptoms caused by physical illness or preoperative anxiety, which range from 11 to 80% in adults 5 . This variation is related to the sociodemographic characteristics of the population studied, type of disease, degree of involvement, chronicity, and variability of the methodological definitions used in the studies, such as the cutoff point, the search tools, and the case definition. The literature offers different scales for the assessment of anxiety and depression, such as Beck Depression Inventory (BDI), Hospital Palavras-Chave: cirurgia da coluna, depressão,
Arteriovenous malformations (AVMs) of the scalp are rare lesions. The clinical picture presents with complaints of increased scalp, scalp disfigurement, pain and neurological symptoms. Its origin can be congenital or traumatic. We present a case of giant scalp AVMs and its management, followed by a brief literature review on the subject. The diagnosis of scalp AVMs is based on physical examination and confirmed by internal and external carotid angiography or computed tomographic angiography (CTA). Surgical excision is especially effective in scalp AVMs, and is the most frequently used treatment modality.
In patients with presumed idiopathic syringomyelia, imaging studies should be closely inspected for the presence of transverse arachnoid web. This extramedullary transverse band of arachnoid tissue extends to dorsal surface of the spinal cord, resulting in mass effect and dorsal indentation, known as scalpel sign because of its apparent resemblance to a scalpel on sagittal imaging. Early diagnosis with early intervention may benefit greatly patients. Surgical resection of transverse arachnoid web is a minimally invasive procedure with low morbidity, and can result in resolution of syringomyelia and improvement in neurological function.
According to our research, this is the first case described in the literature of spontaneous intracranial epidural hematoma secondary to the use of Xarelto ® . Spontaneous intracranial epidural hematomas are rarely described in the literature. They are associated with infectious diseases of the skull, coagulation disorders, vascular malformations of the dura mater and metastasis to the skull. Long-term post-marketing monitoring and independent reports will probably detect the full spectrum of hemorrhagic complications of the use of rivaroxaban.
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