Interhemispheric subdural haematomas: seven cases and review of the literature

Interhemispheric subdural haematoma (ISH) is a rare complication of head injury with only 19 cases reported since 1940, but it may also occur spontaneously (three cases). In both circumstances, clotting disorders are frequent (six cases). We have recorded seven cases (five traumatic, two spontaneous). Classically ISH is due to tearing of bridging veins or cortical contusions. In one of our cases, it was due to arterial bleeding from a pericallosal branch. CT scan shows that ISH may extend above the tentorium and on the hemispheric convexity. Mortality is high (35%). The best operative procedure is parasagittal craniotomy. Chronic interhemispheric subdural haematomas also occur.

Furosemide and bumetanide-sensitive Na+ fluxes in erythrocytes from genetically hypertensive rats (SHR)

Na+ and K+ fluxes from erythrocytes of SHR and WKY control rats have been studied. Fluxes were measured in both fresh and sodium-loaded (after exposure to ouabain or PCMBS) erythrocytes. Pump activity appears higher and furosemide or bumetanide sensitive Na+ efflux lower in SHR compared to WKY suggesting a similar abnormality in SHR genetic hypertension as in human hypertension.

Hydranencephaly in a Newborn: A Case Report and a Review of the Literature

Hydranencephaly (HE) is a severe and isolated malformation affecting the cerebral mantle. In this condition, the cerebral hemispheres are entirely or almost entirely absent, replaced by a membranous sac filled with cerebrospinal fluid, while the midbrain is usually preserved. Although HE is a relatively rare brain disorder, the differential diagnosis must include conditions such as severe hydrocephalus, porencephalic cysts, and alobar holoprosencephaly. This condition also raises ethical concerns, particularly regarding the criteria for surgical treatment. This case report, accompanied by a review of the literature, discusses the etiopathogenic and diagnostic aspects of HE, as well as its management, illustrated by the antenatal diagnosis of a newborn with HE, confirmed by brain MRI at four days of age.

Alobar Holoprosencephaly in a Newborn: A Case Report of Prenatal Diagnosis and a Review of the Literature

Holoprosencephaly (HPE) is a severe and complex congenital brain malformation caused by a defect in the midline cleavage of the prosencephalon during early embryonic development. It is the most common prosencephalic malformation in humans and is categorized into three classical forms based on the severity of this cleavage defect: alobar, semilobar, and lobar HPE. A milder interhemispheric variant, called syntelencephaly, is also considered a form of HPE. This condition may arise from genetic, environmental, or teratogenic factors. Patients with HPE often present with facial dysmorphia, with severity generally correlating with the extent of brain malformation. HPE is diagnosed prenatally through ultrasound and brain magnetic resonance imaging (MRI). Through this case report and a review of the literature, we discuss the etiopathogenic and diagnostic aspects of HPE, along with the management of this congenital malformation, illustrated by the antenatal diagnosis of a newborn with alobar HPE, confirmed by brain MRI at 32 days of age.

Essential Palatal Tremor Following COVID-19 Vaccine: A Case Report

Palatal tremor (PT) is an infrequent disorder characterized by abnormal movement distinguished into symptomatic palatal tremor (SPT) and essential palatal tremor (EPT). SPT can have various causes, including damage to the Guillain-Mollaret triangle and hypertrophy of the inferior olive. In contrast, EPT is often associated with clicking sounds in the ears with normal imaging results and may have a functional origin. We describe a case of a 20-year-old girl presenting with clinical symptoms of PT two days after receiving the SARS-CoV-2 AstraZeneca vaccine. The patient had persistent audible clicks associated with rhythmic contractions of the soft palate. Complete resolution of symptoms occurred two days after the administration of oral clonazepam. This is the first known case of PT caused by the SARS-CoV-2 AstraZeneca vaccine.

[Interference of ethylene glycol on lactate assays]

Ethylene glycol is broken down to three main organic acids: glycolic acid, glyoxylic acid and oxalic acid which cause severe metabolic acidosis. Effect of these three acids on lactate assays was evaluated in five blood gas analysers and two clinical chemistry analysers. For all systems, no influence of oxalic acid on lactate results could be demonstrated. No interference of glycolic acid could be observed on lactate assay performed with Rapid Lab 1265 (R: 104,9 +/- 12,1%), Vitros 950 (R: 105,7 +/- 5,3 %) and Architect ci8200 (R: 104,9 +/- 4,7%), but on the contrary, CCX 4, OMNI S, ABL 725 and 825 demonstrated a concentration-dependent interference. No interference of glyoxylic acid could be observed with Vitros 950, but a positive interference could be observed with ABL 725 and 825, OMNI S, CCX4 and Architect ci8200 A linear relationship between apparent lactate concentration found with ABL 725 and 825, OMNI S, CCX 4, and glyoxylic acid could be observed (0,94 < r < 0,99), a weaker interference being observed with Rapid Lab 1265 and Architect ci 8200. Our results demonstrated that in case of ethylene glycol poisoning, cautious interpretation of lactate assay should be done, since wrong results of lactacidemia could lead to misdiagnostic and delay patient treatment.