A post-traumatic ossified subdural chronic hematoma successfully managed in a 34-year-old woman: a case report.

Ossified or calcified subdural chronic hematoma is an uncommon condition with an incidence of 0.3-2% of all chronic subdural hematomas. It can cause significant mortality and morbidity, especially in young patients. Because of the rare incidence of this condition, its pathophysiology and management preferences have not yet been clearly established, which raises the importance of reporting such cases in order to add valuable databases to the literature. Case Presentation: A 34-year-old woman with a history of head trauma several years ago presented with refractory headaches, convulsions, and muscle weakness. Computed tomography showed an extra-axial calcified lesion in the frontal lobe. Surgical treatment was decided considering the patient's age, in addition to the presence of serious medically uncontrolled symptoms. The calcified lesion was successfully removed surgically, and the patient recovered completely. Pathological examination confirmed the diagnosis of ossified subdural chronic hematoma. Clinical Discussion: The symptoms of ossified subdural hematomas are not specific. However, the presence of a history of head trauma should raise suspicion of this condition. Computerized tomography is usually used as the diagnostic method. Nevertheless, it is unable to differentiate ossified chronic subdural hematomas from other intracranial extra-axial calcified lesions that need to be considered as a differential diagnosis. Pathologic investigations are needed to provide the final diagnosis. Conclusions: We highly recommend surgical therapy for ossified subdural hematomas that are symptomatic and persistent, especially in young patients. We further stress the significance of postsurgical anticonvulsant prophylaxis, particularly in patients presenting convulsions.

The Potential Use of Honey as a Neuroprotective Agent for the Management of Neurodegenerative Diseases.

As the global population ages, there is an increasing research on managing neurodegenerative diseases that mainly affect the elderly. Honey is one of the natural products and functional foods widely studied for its neuroprotective properties. This review investigates honey's effectiveness as a neuroprotective agent through in vitro, in vivo, and clinical research. The articles were browsed from three databases (PubMed, ScienceDirect, and Scopus) between the years of 2012 and 2022 using the keywords "honey" crossed with "neurodegenerative". Out of the 16 articles, six in vitro, eight in vivo, one combination study, and one clinical intervention were compiled. Among the various types of honey studied, the Tualang and Thyme honey exhibited the highest antioxidant, anti-inflammatory, and anticholinesterase activity, leading to the prevention and management of multiple neurodegenerative diseases such as Alzheimer's disease. The neuroprotective properties of honey are primarily attributed to its high polyphenol content, with quercetin and gallic acid being the most prominent. This review compiled considerable evidence of the anti-neurodegenerative properties of honey presented by in vitro and in vivo studies. However, more clinical intervention studies are required to support these findings further.

Internal rotation of the tibial component in total knee arthroplasty can lead to extension deficit.

PURPOSE: Stiffness is a common problem following total knee arthroplasty (TKA). Mal-rotated components have been claimed to be the major cause of pain and limited motion after TKA. The present study investigates whether intra-operative intentional malrotation of the tibial component would change in vivo kinematics. The hypothesis is excessive internal rotation of the tibial component would result in postoperative extension deficit. METHODS: Thirty-one patients were enrolled in this study. After completing bony cuts and proper soft tissue balancing, the femoral and tibial trials were impacted and fixed using small pins. Lateral radiographs were used to measure and compare intraoperative full knee extension during normal and after intentional internal rotation of the tibial component. The extension deficit angles were also compared between the posterior stabilised (PS) and cruciate retaining (CR) implants. RESULTS: For normal tibial component rotation, the median (interquartile range) extension deficit was 0° (4). The mean tibial trial intentional internal rotation was 21.2° (± 4.5). The median (interquartile range) extension deficit significantly increased to 6° (4) after tibial component internal rotation (p = 0.001). The use of PS spacers resulted in a significantly greater extension deficit after intentional internal rotation 9° (5) compared to that of the CR implant 1° (4) (p = 0.001). CONCLUSION: Internal rotation of the tibial component in total knee arthroplasty can lead to postoperative extension deficit. This could be attributed to interference with "screw home" mechanism that requires full external rotation of the tibia on the femur. Consequently, this deficit may cause pain and knee stiffness following TKA. LEVEL OF EVIDENCE: III.