ABSTRACT
Objective: to investigate the frequency of white matter abnormalities [WMAs] in patients with migraine and their relationship to type, duration, and frequency of migraine attacks
Methods: eighty four patients with migraine whose ages ranged between 16 and 50 years were evaluated. Twenty four patients had migraine with aura and 60 had migraine without aura, according to the diagnostic criteria of the International Headache Society. Patients with known vascular risk factors were excluded. Twenty age and sex matched healthy subjects were used as a control group. MRI brain was done in all patients and control group and evaluated for the presence of white matter lesions
Results: in 15 [17.9%] of 84 patients, white matter abnormalities were present on magnetic resonance imaging. Ten of these patients [66.7%] had migraine with aura, and 5 patients [33.3%] had migraine without aura. The presence of white matter foci was significantly higher in patients with aura than in those without aura [p<0.001]. Patients with WMAs were significantly older than those without [p<0.05]. Frequency of WMAs was significantly higher in those with history of more than two attacks per month [P<0.05]. The presence of WMAs was not significantly related to sex, disease duration or ergotamine consumption
We conclude that patients with migraine may have non-specific WMAs. Detection of white matter foci should be interpreted with particular caution before diagnosing other conditions since these lesions could be ischemic in origin and related to age, migraine with aura and attack frequency
ABSTRACT
Major fat necrosis [more than 5 cm] is a complication rarely reported following abdominoplasty though it may be frequently seen in patients with wound dehiscence and cutaneous necrosis. In this paper, the authors report 12 cases of abdominoplasty with post-operative wound dehiscence who needed secondary skin grafting to close the wound. A review of these cases showed that extensive subcutaneous fat necrosis was a prominent feature and all the patients were obese. It appears that obese individuals are prone to develop fat necrosis postoperatively in cases where the classic abdominoplasty is used. It is important that patients reduce their weight preoperatively and avoid considering abdominoplasty as a form of weight reduction. Fat necrosis, its occurrence and the various factors that could have contributed to major wound dehiscence in these patients are discussed. The authors caution surgeons against the use of the classic abdominoplasty procedure in obese patients and s t ress minimal undermining and the use of limited dermolipectomy or apronectomy along with judicious liposuction to avoid this complication of fat necrosis