Intracranial hypotension as a unique complication of the rupture of an anterior sacral meningocele into a recurrent pilonidal cyst.

BACKGROUND: Intracranial hypotension (IH) is an underdiagnosed, but important cause of new-onset, daily persistent headache, especially among the young- and middle-aged population. It results from a cerebrospinal fluid (CSF) leak with subsequent lowered CSF pressure. CASE DESCRIPTION: A 37-year-old female presented to the emergency department with sudden onset severe headaches. Two years earlier, she had undergone surgery for resection of a pilonidal cyst (PC). The night before admission, she had watery discharge from the recurrent PC and severe diffuse positional headaches associated with photophobia and neck pain. The head computed tomography showed pneumocephalus in the posterior fossa and a spine magnetic resonance imaging revealed an anterior sacral meningocele (ASM) in close contact with the recurrent PC. A final diagnosis was made of headaches due to IH. The leakage site was the rupture of the ASM in the PC. The surgical repair of the ASM was achieved suturing two overlapping dural flaps. There was no more CSF leakage from the PC and the headaches disappeared. CONCLUSION: This is a unique case of IH due to the rupture of an ASM into a recurrent PC. The association of an ASM and PC, at the best of our knowledge, is unique. Moreover, the fistulation of the ASM to the PC is exceptional. ASM can be successfully closed with a posterior approach, using two overlapping dural flaps.

Furuncular myiasis of the scalp associated with pigmented basal cell carcinoma: First case diagnosed in Albania.

We are reporting a case of myiasis associated with pigmented basal cell carcinoma. This is the first reported case from Albania and Balkan peninsula. Correct diagnosis and prompt treatment may prevent a disastrous and destructive course of the disease and may lead to improved quality of life.

Electrical Burns and Their Treatment in a Tertiary Hospital in Albania.

INTRODUCTION: The electrical current burns represent a very aggressive pathology that leaves many functional and aesthetic consequences. AIM: To evaluate the epidemiology of electrical burn injury and its associated complications and treatment. MATERIAL AND METHODS: Demographic data, aetiology, burn percentage and other measures related to electrical burn injury of 33 electrical burn patients in a tertiary hospital during the years 2015-2017. RESULTS: The mean age of patients is 31 (± 8.3) years old with a predominance of males (94%). The vast majority of injuries occurred at work (p < 0.01), superior extremities were more affected with hand (21.2%) and fingers (18.2%) being the main point of contact (p < 0.01). Muscular fasciotomy was performed in all patients who were treated surgically (n = 27), amputation was performed in 11 (40.7%) of cases, but amputated sites were more than the number of patients affected. Myoglobinuria (39.4%), cardio-respiratory distress (12.1%) contusion cerebri (6.1%), were the complication encountered in patients. CONCLUSIONS: Electrical burn injuries are still amongst the highest accident-related morbidities. Educating the population about the dangers and hazards associated with improper use of electrical devices and instruments is imperative.

Epidemiology of Hand Burn in Albania 2011-2016.

INTRODUCTION: Hand burns occur commonly both as part of larger burn injuries as well as isolated injuries. AIM: To give an overview of epidemiologic features and outcome of burn hand patients who admitted to our Service. This study was performed at University Hospital Center "Mother Teresa" Tirana which is the only tertiary hospital in Albania. MATERIAL AND METHODS: This prospective study included all patients who had combustion of the hands solely or hands accompanied with burns to other areas of the body, treated and followed up at our service during the years 2011-2016. RESULTS: Of the 333 included burn patients, 64% were males. The median age of patients is 25.9 years. About half of patients belong to the age group 20-60 years (49.5%) and only 10.2% belong to the age of 60 years. In most of the cases (73.6%), the burn of hands is associated with the burn of the other anatomical region, mostly forearm. CONCLUSION: The surgical treatment is used for less 30% that of patients. The undesirable results of the burn of hands are presented in the 33% of the patients. The contractures were the main unfavourable outcome of the burned hand.