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Sobouti F, Dadgar S, Salehabadi N, Lotfizadeh A, Mazandarani A, Aryana M. An Adult Case of Crouzon Syndrome: Diagnostic Features and Treatment Modalities. Cureus 2024; 16:e59605. [PMID: 38832196 PMCID: PMC11144547 DOI: 10.7759/cureus.59605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 06/05/2024] Open
Abstract
Craniosynostosis syndromes are birth defects characterized by the premature fusion of one or more cranial sutures before the completion of brain growth and development. Crouzon syndrome (CS) is the most common craniosynostosis condition. The CS manifestations result from the early fusion of superior and posterior sutures of the maxilla along the orbital wall and affect the cranial vault, base, orbital, and maxillary regions. This report presents a rare case of a 25-year-old male CS patient referred for orthodontic treatment with the chief complaint of severe irregularities in the arrangement of teeth and abnormal facial appearance. In this report, the clinical, cephalometric features, and initial orthodontic management of this patient are discussed as part of multidisciplinary management.
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Affiliation(s)
- Farhad Sobouti
- Department of Orthodontics, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, IRN
| | - Sepideh Dadgar
- Department of Orthodontics, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, IRN
| | - Negareh Salehabadi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, IRN
| | - Anahita Lotfizadeh
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, IRN
| | - Ali Mazandarani
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, IRN
| | - Mehdi Aryana
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, IRN
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Spekker O, Kiss P. A, Kis L, Király K, Varga S, Marcsik A, Schütz O, Török T, Hunt DR, Tihanyi B. White plague among the "forgotten people" from the Barbaricum of the Carpathian Basin-Cases with tuberculosis from the Sarmatian-period (3rd-4th centuries CE) archaeological site of Hódmezővásárhely-Kenyere-ér, Bereczki-tanya (Hungary). PLoS One 2024; 19:e0294762. [PMID: 38198442 PMCID: PMC10781108 DOI: 10.1371/journal.pone.0294762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/07/2023] [Indexed: 01/12/2024] Open
Abstract
Tuberculosis (TB) is a bacterial infection that is well-known in the palaeopathological record because it can affect the skeleton and consequently leaves readily identifiable macroscopic alterations. Palaeopathological case studies provide invaluable information about the spatio-temporal distribution of TB in the past. This is true for those archaeological periods and geographical regions from when and where no or very few TB cases have been published until now-as in the Sarmatian period (1st-5th centuries CE) in the Barbaricum of the Carpathian Basin. The aim of our paper is to discuss five newly discovered TB cases (HK199, HK201, HK225, HK253, and HK309) from the Sarmatian-period archaeological site of Hódmezővásárhely-Kenyere-ér, Bereczki-tanya (Csongrád-Csanád county, Hungary). Detailed macromorphological evaluation of the skeletons focused on the detection of bony changes likely associated with different forms of TB. In all five cases, the presence of endocranial alterations (especially TB-specific granular impressions) suggests that these individuals suffered from TB meningitis. Furthermore, the skeletal lesions observed in the spine and both hip joints of HK225 indicate that this juvenile also had multifocal osteoarticular TB. Thanks to the discovery of HK199, HK201, HK225, HK253, and HK309, the number of TB cases known from the Sarmatian-period Carpathian Basin doubled, implying that the disease was likely more frequent in the Barbaricum than previously thought. Without the application of granular impressions, the diagnosis of TB could not have been established in these five cases. Thus, the identification of TB in these individuals highlights the importance of diagnostics development, especially the refinement of diagnostic criteria. Based on the above, the systematic macromorphological (re-)evaluation of osteoarchaeological series from the Sarmatian-period Carpathian Basin would be advantageous to provide a more accurate picture of how TB may have impacted the ancestral human communities of the Barbaricum.
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Affiliation(s)
- Olga Spekker
- Ancient and Modern Human Genomics Competence Centre, University of Szeged, Szeged, Hungary
- Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, Hungary
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
| | - Attila Kiss P.
- Department of Early Hungarian and Migration Period Archaeology, Pázmány Péter Catholic University, Budapest, Hungary
| | - Luca Kis
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
- Department of Archaeogenetics, Institute of Hungarian Research, Budapest, Hungary
| | - Kitty Király
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
- Department of Archaeology, Móra Ferenc Museum, Szeged, Hungary
| | - Sándor Varga
- Department of Archaeology, Móra Ferenc Museum, Szeged, Hungary
| | - Antónia Marcsik
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
| | - Oszkár Schütz
- Department of Archaeogenetics, Institute of Hungarian Research, Budapest, Hungary
- Department of Genetics, University of Szeged, Szeged, Hungary
| | - Tibor Török
- Ancient and Modern Human Genomics Competence Centre, University of Szeged, Szeged, Hungary
- Department of Archaeogenetics, Institute of Hungarian Research, Budapest, Hungary
- Department of Genetics, University of Szeged, Szeged, Hungary
| | - David R. Hunt
- Virginia Office of the Chief Medical Examiner, Northern District, Manassas, Virginia, United States of America
| | - Balázs Tihanyi
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
- Department of Archaeogenetics, Institute of Hungarian Research, Budapest, Hungary
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Hanford J, Anders A, Vachharajani AJ. A Neonate with an Abnormally Shaped Head. Neoreviews 2021; 22:e351-e355. [PMID: 33931482 DOI: 10.1542/neo.22-5-e351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jennifer Hanford
- Women's and Children's Hospital, and University of Missouri School of Medicine, Columbia, MO
| | - Anjali Anders
- Women's and Children's Hospital, and University of Missouri School of Medicine, Columbia, MO
| | - Akshaya J Vachharajani
- Women's and Children's Hospital, and University of Missouri School of Medicine, Columbia, MO
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Spekker O, Hunt DR, Berthon W, Paja L, Molnár E, Pálfi G, Schultz M. Tracking down the White Plague. Chapter three: Revision of endocranial abnormally pronounced digital impressions as paleopathological diagnostic criteria for tuberculous meningitis. PLoS One 2021; 16:e0249020. [PMID: 33740029 PMCID: PMC7978373 DOI: 10.1371/journal.pone.0249020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/10/2021] [Indexed: 11/26/2022] Open
Abstract
Abnormally pronounced digital impressions (APDIs) on the endocranial surface develop secondary to a prolonged rise in the intracranial pressure. This can result from a number of pathological conditions, including hydrocephalus due to tuberculous meningitis (TBM). APDIs have been described with relation to TBM not only in the modern medical literature but also in several paleopathological studies. However, APDIs are not pathognomonic for TBM and their diagnostic value for identifying TBM in past human populations has not been evaluated in identified pre-antibiotic era skeletons. To assess the diagnostic value of APDIs for the first time, a macroscopic investigation was performed on skeletons from the Terry Collection (Smithsonian Institution, Washington, DC, USA). Our material consisted of 234 skeletons with tuberculosis (TB) as the cause of death (TB group) and 193 skeletons with non-tuberculous (NTB) causes of death (NTB group). The macroscopic examination focused on the stage of the prominence and frequency of APDIs in the TB group and NTB group. To determine the significance of difference (if any) in the frequency of APDIs between the two groups, χ2 testing of our data was conducted. We found that APDIs were twice as common in the TB group than in the NTB group. The χ2 comparison of the frequencies of APDIs revealed a statistically significant difference between the two groups. In addition, APDIs with more pronounced stages were recorded more frequently in the TB group. Our results indicate that APDIs can be considered as diagnostic criteria for TBM in the paleopathological practice. With suitable circumspection, their utilization provides paleopathologists with a stronger basis for identifying TB and consequently, with a more sensitive means of assessing TB frequency in past human populations.
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Affiliation(s)
- Olga Spekker
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
| | - David R. Hunt
- Department of Anthropology, National Museum of Natural History, Smithsonian Institution, Washington, District of Columbia, United States of America
| | - William Berthon
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
- Chaire d’Anthropologie Biologique Paul Broca, École Pratique des Hautes Études (EPHE), PSL University, Paris, France
| | - László Paja
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
| | - Erika Molnár
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
| | - György Pálfi
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
| | - Michael Schultz
- Institut für Anatomie und Embryologie, Zentrum Anatomie, Universitätsmedizin Göttingen, Göttingen, Germany
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Affiliation(s)
- Abraham M Ittyachen
- Department of Medicine, Malankara Orthodox Syrian Church Medical College, Kolenchery, Ernakulam District, Kerala, India
| | - Rajeev Anand
- Department of Radiodiagnosis, Malankara Orthodox Syrian Church Medical College, Kolenchery, Ernakulam District, Kerala, India
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A systematic approach in the diagnosis of paediatric skull lesions: what radiologists need to know. Pol J Radiol 2019; 84:e92-e111. [PMID: 31019602 PMCID: PMC6479152 DOI: 10.5114/pjr.2019.83101] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 12/03/2018] [Indexed: 12/14/2022] Open
Abstract
Paediatric skull lesions are commonly identified on imaging. They can be challenging to image, given their location and size, and often require several imaging modalities to narrow down the differential diagnosis. Accurate diagnosis of these lesions is paramount because the clinical therapy can vary tremendously. In this review, we provide a simple and systematic approach to clinical-radiological features of primary skull lesions. We highlight the imaging characteristics and differentiate pathologies based on imaging appearances. We also accentuate the role of cross-sectional imaging in lesion identification and management implications.
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Primary normocephalic pancraniosynostosis detected incidentally after an accidental head injury: a case report and review of the literature. Childs Nerv Syst 2018. [PMID: 29536179 DOI: 10.1007/s00381-018-3768-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Majority of multi-suture craniosynostosis are related to single-gene disorders or chromosomal abnormalities. Children with craniosynostosis usually present at an early age due to the presence of an abnormal head shape, with the exception of a unique entity termed primary normocephalic pancraniosynostosis. The objective of this article is to describe an unusual case of primary normocephalic pancraniosynostosis, detected incidentally following an accidental head injury. A comprehensive review of the literature will also be included. To the best of our knowledge, only eight cases of primary normocephalic pancraniosynostosis have been reported thus far. CASE DESCRIPTION A 3-year 2-month-old child presented to the emergency department after a fall with severe scalp swelling. The child was noted to have mild frontal bossing and bilateral exophthalmos. Head size was normal but bilateral mild papilloedema was noted. CT scan was performed and demonstrated pancraniosynostosis and diffuse subgaleal hematoma. Patient underwent fronto-orbital advancement and total cranial vault reconstruction with favorable outcome. CONCLUSION Our reported case adds to the current limited knowledge of this rare entity and emphasized the importance of a high index of suspicion in children with apparently normal head size and shape but show subtle evidence of raised intracranial pressure.
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