Spontaneous acute subdural haematoma caused by tension pneumocephalus.

We describe the first case of spontaneous acute subdural haematoma (SASH) caused by tension pneumocephalus in a patient who had undergone surgery for sinusitis followed by meningitis many years previously. The patient presented with a seizure and epistaxis. The haematoma was caused by a torn bridging vein. Tension pneumocephalus has to be added to the list of possible causes for SASH.

Structural cost of shoot modules and its implications on plant potential fitness in a Mediterranean perennial shrub, Retama sphaerocarpa (L.) Boiss.

This paper introduces a methodology to analyse the structural costs on plant potential fitness, empirically exemplified in the hierarchical shoot system of a Mediterranean perennial plant, Retama sphaerocarpa (L.) Boiss. During growing season every year (March-August), the terminal shoot (which is the basic unit of growth) develops inflorescences, flowers and fruits, as well as new shoots (first-, second- and third-order branching shoots) which have the potential to "behave" as terminal shoots in the following year. Different morphological and demographical aspects of the modules within the terminal shoot were measured in 100 terminal shoots selected from different plants of a natural population of R. sphaerocarpa. Complementary samples of 100 shoots of different branching orders were collected to obtain biomass estimations of the terminal shoots. We propose a simple procedure to estimate structural cost (biomass investment) on plant potential fitness (flowering buds) as a methodology for interpreting and comparing the consequences on fitness of different plant growth patterns. The results of this study exemplify how differential allocation patterns among plant structural modules, depending on their position within the shoot system, can be quantified to estimate their influence upon plant potential fitness.

Cervicothoracolumbar spinal epidural abscess with tetraparesis. Good recovery after non-surgical treatment with antibiotics and dexamethasone. Case report and review of the literature.

We report the conservative treatment of a spinal epidural abscess (SEA) caused by escherichia coli and affecting the anterior epidural space from C2 to L4 in a diabetic, obese patient presenting with tetraparesis. The favourable clinical response to the administration of dexamethasone and antibiotics is described. We review the literature on non-surgical treatment of SEA with special regard to the use of corticosteroids.

Lymphoma of the breast: clinical and radiologic features with pathologic correlation in 28 patients.

The objective of this study was to determine the clinical and radiologic findings of lymphoma involving the breast, separately evaluating primary and secondary forms. We retrospectively reviewed the medical reports of 28 patients with lymphoma of the breast: 12 patients with primary lymphoma and 16 with secondary lymphoma. In primary lymphoma, mammography revealed a solitary mass (58.3%), multiple unilateral masses (8.3%), unilateral diffuse involvement (25%), and bilateral diffuse involvement (8.3%). The margins of masses were irregular (50%), partially defined (37.5%), and well defined (12.5%). The mean diameter of the masses was 4.6 cm. In secondary lymphoma, mammography revealed multiple masses (56.2%), solitary masses (12.5%), and diffuse unilateral breast involvement (31.2%). Their margins were irregular (18.1%), partially defined (27.2%), and well-defined (54.5%). The mean diameter of the masses was 2.8 cm. Cytologic examination (n = 13) was demonstrative of lymphomatous involvement in all cases. We observed an association between high-grade types of malignancy and a diffuse pattern of radiologic breast involvement. Masses in primary disease tended to have less-defined margins and greater diameters than those observed in secondary cases. Cytologic examination proved to be a useful diagnostic procedure in the evaluation of secondary disease. The involvement of the breast in extranodal lymphomas does not seem to affect the prognosis of the disease.

[Anatomic considerations in relation to the importance of the external branch of the spinal nerve in surgery on the posterior cervical triangle]. / Consideraciones anatómicas sobre la importancia de la rama externa del nervio espinal en la cirugía del triángulo posterior del cuello.

The integrity of the spinal accessory nerve plays an important role in cervicofacial surgery since the majority of surgical approaches involve this structure. The resection of the spinal accessory nerve leads to the so-called <> mainly due to the denervation of the trapezius. This syndrome is characterised by the onset of regional pain, functional deficit and deformation of the shoulder joint. The anatomy of the accessory nerve is defined in the light of 93 functional neck dissections with particular regard to the following aspects: its relation with the internal jugular vein, its relation with the sternocleidomastoid muscle (ECM) and mastoid tip and its anastomoses with the cervical plexus.

[Liver actinomycosis: diagnosis using fine-needle punction-aspiration]. / Actinomicosis hepática: diagnóstico mediante punción-aspiración con aguja fina.

Hepatic actinomycosis is very rare. Usually, the specific diagnosis is only made after exploratory laparotomy and surgical drainage. We present a case diagnosed by cytologic study after fine needle aspiration biopsy. The treatment consisted of longterm antibiotic therapy, at high doses, without surgical drainage.

Febarbamate-induced pulmonary eosinophilia: a case report.

Subacute pulmonary hypersensitivity to febarbamate is reported, manifested by peripheral eosinophilia, skin rash and pulmonary bilateral infiltrates. Bronchoalveolar lavage showed an increased eosinophil count, and transbronchial biopsy an intraalveolar and interstitial eosinophil infiltration. The reaction cleared on cessation of the drug, and a rechallenge test with febarbamate induced peripheral eosinophilia and skin rash.