A middle-aged patient presented with persistent purulent discharge from a scalp incision five years after undergoing craniotomy with artificial dura mater implantation. The wound showed no significant improvement despite a month of systemic antibiotic therapy and local debridement. Subsequent superficial ultrasonography revealed complete separation of the artificial dura mater implant area from the surrounding flap tissue, with a loss of local blood supply. Based on these findings, the artificial dura mater was surgically removed, and a free skin flap transplantation was performed to successfully cover the wound. The wound was well-healed at the 10-month postoperative follow-up.
Humans ; Scalp/diagnostic imaging* ; Middle Aged ; Male ; Epidural Abscess/etiology* ; Ultrasonography ; Surgical Flaps ; Surgical Wound Infection/surgery* ; Dura Mater/surgery*

PURPOSE: Child head injury under impact scenarios (e.g. falls, vehicle crashes, etc.) is an important topic in the field of injury biomechanics. The head of piglet was commonly used as the surrogate to investigate the biomechanical response and mechanisms of pediatric head injuries because of the similar cellular structures and material properties. However, up to date, piglet head models with accurate geometry and material properties, which have been validated by impact experiments, are seldom. We aim to develop such a model for future research. METHODS: In this study, first, the detailed anatomical structures of the piglet head, including the skull, suture, brain, pia mater, dura mater, cerebrospinal fluid, scalp and soft tissue, were constructed based on CT scans. Then, a structured butterfly method was adopted to mesh the complex geometries of the piglet head to generate high-quality elements and each component was assigned corresponding constitutive material models. Finally, the guided drop tower tests were conducted and the force-time histories were ectracted to validate the piglet head finite element model. RESULTS: Simulations were conducted on the developed finite element model under impact conditions and the simulation results were compared with the experimental data from the guided drop tower tests and the published literature. The average peak force and duration of the guide drop tower test were similar to that of the simulation, with an error below 10%. The inaccuracy was below 20%. The average peak force and duration reported in the literature were comparable to those of the simulation, with the exception of the duration for an impact energy of 11 J. The results showed that the model was capable to capture the response of the pig head. CONCLUSION This study can provide an effective tool for investigating child head injury mechanisms and protection strategies under impact loading conditions.
Animals ; Swine ; Finite Element Analysis ; Skull/injuries* ; Craniocerebral Trauma/diagnostic imaging* ; Brain ; Biomechanical Phenomena ; Scalp

Angiosarcoma is an uncommon malignancy, which spread out from the endothelial cells of vessels. Scalp angiosarcoma with cervical lymph node metastasis is particularly rare. This article describes a rare case of angiosarcoma of the scalp, presenting as neck inflammation. Imaging procedures such as computed tomography (CT), magnetic resonance image (MRI) and ultrasonography (US) were not sufficient to diagnose this case. A needle biopsy provided an effective and accurate diagnosis of cervical lymph node metastasis. Additional observation and physical examination was required to diagnose the origin of the primary cancerous lesion. Once the angiosarcoma diagnosis was confirmed histologically, sequential weekly and monthly docetaxel (DTX) treatment was effective in preventing reoccurrence. Nonetheless, the optimization of angiosarcoma treatment remains a future goal. Although patients generally describe pain and swelling at the primary lesion site, this patient complained only of painful neck inflammation, without any indication of pain or swelling of the scalp. A revised diagnostic protocol should note that cervical lymph node metastasis of unknown primary origin may result from angiosarcoma of the scalp.
Aged ; Antineoplastic Agents ; therapeutic use ; Cranial Irradiation ; Head and Neck Neoplasms ; diagnostic imaging ; pathology ; therapy ; Hemangiosarcoma ; diagnostic imaging ; pathology ; therapy ; Humans ; Lymphatic Metastasis ; Male ; Neck ; pathology ; Positron-Emission Tomography ; Radiography ; Scalp ; pathology ; Skin Neoplasms ; diagnostic imaging ; pathology ; therapy ; Taxoids ; therapeutic use ; Ultrasonography

OBJECTIVETo observe the effect of scalp acupuncture (SA) on the glucose metabolism in different regions of brain in patients with depression by positron emission computed tomography (PET).

METHODSTwelve depressive patients were treated by scalp acupuncture on middle line of vertex (MS5), middle line of forehead (MS1) and bilateral lateral line 1 of forehead (MS2), once a day for six days per week, and received PET detection on different region of brain before and after 6 weeks acupuncture treatment. Semiquantitative analysis was used to compare the average values of radioactive count gotten from various brain regions before and after treatment, which could reflect the condition of glucose metabolism at the brain region detected.

RESULTSSA could increase the glucose metabolism at bilateral frontal lobes, bilateral parietal lobes, right occipital lobe, right caudate nucleus, right cingulated gyrus and left cerebellum and decrease that at right temporal lobe and bilateral thalamus.

CONCLUSIONSA on MS5, MS1 and MS2 in depressive patients could influence the glucose metabolism in various brain regions. It primarily illustrated that the mechanism of SA in treating depression is related with its regulation on cortex-limbic circuitry dysfunction and increase the glucose metabolism in various brain regions.

Adult ; Aged ; Brain ; metabolism ; Depressive Disorder ; diagnostic imaging ; metabolism ; therapy ; Electroacupuncture ; methods ; Female ; Glucose ; metabolism ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography ; Scalp

OBJECTIVETo observe the short-term effect of patients with poly-infarctional vascular dementia (PIVD) treated by CT positioning scalp circum-needling (SCN) combined with Chinese herbal medicine.

METHODSEighty-nine patients of PIVD were enrolled and divided into the treated group (n = 57) and the control group (n = 32). They were all treated with oral taking of Fuyuan mixture (FYM, consisted of ginseng, medlar, salvia, bitter cardamon, etc). To the treated group, SCN was applied additionally with the unilateral area around the reflecting region (localized by CT) in scalp as main needling points and Ganshu, Shenshu, Zusanli, Hegu as supplementary points. Two courses of SCN were performed. The changes of clinical symptoms, intelligence and hemorrheological characteristics in patients were analysed.

RESULTSAfter two courses of treatment, the total effective rate in the treated group was 96.5%, which was better than that in the control group (75.0%), with significant difference (u = 2.423, P < 0.01); HDS scores increased in both groups after treatment, showing significant difference as compared with that before treatment (P < 0.01), hemorrheologic parameters were also apparently improved.

CONCLUSIONCT positioning SCN combined Chinese herbal medicine treatment has definite therapeutic effect in treating PIVD.

Acupuncture Therapy ; methods ; Aged ; Dementia, Multi-Infarct ; diagnostic imaging ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Electroacupuncture ; methods ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Scalp ; Tomography, X-Ray Computed