Pattern of childhood neuronal migrational disorders in Oman

To record the pattern of different neuronal migrational disorders [NMD] and their associated neurological conditions. The data were collected at the Child Neurology Services of Sultan Qaboos University Hospital, Oman, from January 1993 to September 2006 from all children with psychomotor delay and epilepsy, who underwent brain imaging [mostly MRI]. The MR imaging was used for the diagnosis of a neuronal migration anomaly. There were 86 cases of NMD. Corpus callosum agenesis and lissencephaly/pachygyria formed the major group. There were 48 cases of corpus callosum agenesis, and 16 cases of lissencephaly/pachygyria. Other disorders were 10 cases of heterotopias, 5 schizencephaly, 3 holoprosencephaly, 2 polymicrogyria, and one each of hemimegalencephaly, and hydranencephaly. Developmental delay was the most common associated finding noted in 80 [93%] cases. Sixty-seven [77.9%] cases had motor deficit. Forty out of 86 [46.5%] cases had epilepsy. Partial/partial complex seizures were the most common at 13 out of 40 [32.5%]. Syndromic seizures were seen in 11 out of 40 [27.5%] cases. The seizures were controlled in only 3/40 [7.5%] cases. The NMD constitute a significant number of child neurology patients with psychomotor delay and intractable epilepsy. Exogenic and genetic factors affecting the early embryonic and fetal development from sixth to twenty-sixth weeks of gestation result in NMD. Recent genetic studies are defining the underlying mechanism and these studies will help in early diagnosis and possible prevention of NMD

Traumatic rupture of the right hemidiaphragm:diagnosis aided by computerized tomography and image reformation: a case report

Traumatic rupture of the diaphragm [TRD] poses a challenge to both radiologists and surgeons. They are uncommon and occur following blunt abdominal or lower thoracic trauma. The right side involvement is less common than the left side and is easily missed. Spiral computed tomography [Spiral CT] with image reformation is very useful in the diagnosis of TRD and in identifying associated injuries. Early diagnosis and repair reduces mortality and morbidity. We present the case of a 16 year old boy who was involved in a high speed traffic accident with blunt injury to his thorax and abdomen. He was referred from a peripheral hospital in Oman for further management at Sultan Qaboos University Hospital. A spiral CT scan of thorax and abdomen with image reformation helped in the early diagnosis and management of the traumatic rupture of his right hemidiaphragm