Cystic meningioma is an uncommon form of meningioma and the radiological appearance and location of the cystic/solid components of the mass may create a diagnostic dilemma. We report on the case of an 80-year-old left-handed man who presented with recurrent focal motor seizures and secondary generalisation. A large left-sided parieto-occipital cystic mass was detected on contrast CT of the brain. The appearance suggested a malignant tumour. However, brain MRI with gadolinium delineated the solid and cystic component precisely. A provisional diagnosis of cystic meningioma was made and this was confirmed histologically after resecting the tumour surgically. It was a benign WHO Grade I fibroblastic meningioma. The preoperative diagnosis of cystic meningioma is not that straightforward. Brain MRI with gadolinium has a better diagnostic yield than CT scanning. Histopathological examination of the tumour cells should always be performed to confirm the category and subtype of the tumour.
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Aims: The relationship between hypocholesterolemia and increased incidence of intracerebral hemorrhage (ICH) remains controversial. Several studies have resulted in contradicting outcomes. We tried to find whether hypocholesterolemia confers an increased risk of ICH or not. Methods: This cross-sectional and observational study was carried out at the Shorsh Military General Hospital, Iraq. From April 1, 2014, to October 31, 2016, 93 consecutive patients who had developed their first-ever hypertensive ICH were included in the study. Patients were age and gender-matched with the control group. Serum lipid levels assessment was done in all patients within 24 hours of hospital admission. Results: Out of the 93 patients with ICH, 71 (76%) were male. Females were younger than males (mean age, years: 54±12.4 vs. 59±9.2). In the intracerebral hemorrhagic stroke group (ICHSG), hypocholesterolemia (serum total cholesterol <131 mg/dl) was found in 5 out of 71 males as well as 3 out of 22 females, whereas 3 males and 3 females were hypocholesterolemic in the control group (CG). Serum total cholesterol level showed no significant difference between the ICHSG and CG. There was no statistically significant difference between males or females who had hypocholesterolemia. All hemorrhagic stroke patients were receiving a statin with an average duration of 4.2 years. Conclusions: In our study, the presence of ICH in hypertensive patients was not associated with hypocholesteremia. Further analytic studies are required to confirm this observation.
Background: In elderly people, falls have been recognized as one of the major causes of disability and potentially preventable mortality. Authors analyzed the incidence of falls in elderly diabetic people who have been receiving insulin therapy versus those on oral hypoglycaemic agents (OHGAs).Methods: This observational study was conducted at the department of neurology of Shorsh military general teaching hospital and its outpatients’ department, Iraq, from April 1st to September 30st, 2016. A total of 100 diabetic patients older than 65 years of age, who had a history of one or more falls, were included in the study. The duration of diabetes, mode of its treatment, and its complications all were analyzed in addition to the risk factors for falls.Results: Females (n=57) outnumbered males (n=43) and the mean age of the patients was (71.2±3.6) years. Increasing patient’s age, long-standing diabetes, poor glycaemic control, insulin therapy, and polypharmacy (of 3 and more antidiabetic agents) were significantly and statistically encountered and associated parameters for the risk of falls. The presence of additional risk factors for falls (e.g., previous stroke, alcoholism, cardiac dysrhythmia, and osteoarthrosis) augmented this risk.Conclusions: Diabetes and its treatment render older people more liable for falls. The longer duration of the disease and the higher patients’ age (which were the commonest risks) are irreversible and non-correctable parameters for falls. Further analytic studies are required to unveil the role of each risk factor authors have detected.
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