International Journal of Neurology and Neurosurgery

Of all the case of bacterial osteomyelitis ,Eikenella Corrodens is rare causative agent. We report a case of bacterial skull osteomyelitis by eikenellacorrodens in 66 y old man which has no risk factor or direct trauma apart from diabetes mellitus.

Keywords: Bacterial osteomyelitis,Eikenella CorrodensTrauma, Diabetes mellitus

Background: Silent corticotroph adenoma (SCA) is a rare sub-type of non-functioning pituitary tumour and like other macroadenomas, they usually present with symptoms related to compression of the adjacent structures, but still Diabetes insipidus is rarely seen in SCA’s. Case report: We report a 42 year old female presenting with left visual loss and Diabetes insipidus due to a silent corticotroph adenoma. Conclusion: SCA’s have more aggressive course and increased rate of recurrence compared to other non-functioning tumors. Diabetes insipidus can rarely be associated with macroadenomas and thus such atypical presentation should also be kept in mind. 

Keywords: Corticotroph adenoma; Diabetes insipidus; Silent; Pituitary.

Dandy-Walker syndrome is characterized by a triad of complete or partial agenesis of the cerebellar vermis, cystic dilatation of the forth ventricle and enlarged posterior fossa with upward displacement of the transvers sinus, tentorium and torcular. The most striking abnormality is the presence of a huge dilated forth ventricle which acts as a cyst and is roofed by a neuroglial-vascular membrane lined with epandyma.This cyst herniates caudally and separates the cerebellar anteriorly and choroid plexus are rudimentary the formation of the fourth ventricle are often occluded by membranes or are atretic. A varient form, in which is cystic dilatation of the fourth ventricle and hypoplasia of the cerebellar vermis without enlargement of the posterior fossa is more common than the classic Dandy-Walker malformation and account for onethird of posterior fossa malformations. Hydrocephalus is precent in 90% of patients. Some of the patients have other malformations associated with this syndrome include, Occipital Encephalocel, facial angioma,midline cleft palate, cardiovascular malformations and polycystic kidney. Hydrocephalus is not present at birth. It often appears by 3 months of age. In some instance, hydrocephalus fails to develop and this condition remains Asymptomatic throughout life. Prenatal diagnosis with ultrasonography and Postnatal diagnosis with CT scan and MRI in progressive hydrocephalus Treatment is surgical. Befor birth in 10 embrio, dandy walker syndrome was diagnosed with ultrasound, that after delivery, diagnosed and confirmed in eight cases. The case was male and 2nd product of non consanguinous marriage.This study is a case report of Dandy-Walker syndrome in a newborn. 

Migraine is a chronic neurological disorder characterized by recurrent episodes of moderate to severe headaches often in association with a number of autonomic nervous system symptoms, most often unilateral.Worldwide, migraines affect nearly 15% or approximately one billion people. Migraine is caused by the activation of a mechanism deep in the brain that leads to release of pain-producing inflammatory substances around the nerves and blood vessels of the head. Typically the headache is unilateral (affecting one half of the head) and pulsating in nature, lasting from 2 to 72 hours. The Etiology of migraine are, Calcitonin gene related peptides (CGRPs), Genetic, Triggers, Physiological aspects, Dietary aspects, Environmental aspects.Migraines typically present with self-limited, recurrent severe headache associated with autonomic symptoms. There are four possible phases to a migraine, although not all the phases are necessarily experienced 1) Prodrome phase (Early warning signs), 2) Aura phase, 3) Pain Phase (Attack phase: The headache begins), 4) Postdrome. Prevention & management through medication, includes NSAID’s, Triptans,Ergotamines, Botox Injections, ACE Inhibitors, Angiotensin-Receptor Blockers, Histamine and Beta Blockers.Studies have showed mixed results on the benefits of acupuncture for preventing migraine. Herbs & Supplements treatment includes, Butterbur (Petasites hybridus), Feverfew, Riboflavin (Vitamin B2) and Magnesium, Fish Oil, Ginger etc. Other treatments include spinal manipulation/ Chiropractic manipulation,relaxation techniques combined with applying a cold compress, Cognitive- ehavioral therapy, laughter therapy, Yoga Nasal sprays and powders, Intra-oral appliances Biofeedback, Transcranial magnetic stimulation, Vagus Nerve Stimulation, Occipital nerve stimulation, Arterial surgery, Muscle Surgery: Trigger site release, Septoplasty and Turbinectomy, Decompression of certain nerves around the head and neck and Patent foramen ovale closure.  

Craniopagus twins are conjoined twins who are fused at the cranium.This condition occurs in about 10- 20 babies in every million births. Among this small group, cephalic conjoining, or craniopagus twinning, represents the rarest of congenital abnormalities only accounting for 2-6% of all conjoined twins. Additionally, conjoined twins are genetically identical and always share the same sex. The union in craniopagus twins may occur on any portion of the calvarium, but does not include either the face or the foramen magnum. The union may involve the entire diameter of the head or only a small portion. There are an infinite amount of variations that can occur. Most of these variations are based on the rotation of one twins’ skull to the other. Each of these factors (rotation, spot of union) affect the development of the brain,the vascular system within the brain and overall wellness of life both of the twins have outside the womb.Relatively few craniopagus twins survive the perinatal period- approximately 40% of conjoined twins are stillborn and an additional 33% die within the immediate perinatal period, usually from organ abnormalities and failure. 

Keywords: Conjoined twins; Craniopagus type; Medical and social issues.

 Background: Balance is an integrated function of visual, vestibular and somatosensory systems in the human body which helps the body and its parts to be energy efficient in their static and dynamic postures both at rest and during activity. Purpose: The objective of this review was to provide an overview of evidence for balance dysfunction and balance interventions for people with Diabetic peripheral neuropathy (DPN). Methods: Three studies on assessment and nine intervention studies support the presence of balance dysfunction in DPN and treatments that improved balance respectively. Results and Conclusion: There was thus limited evidence existed for presence of balance impairments such as shifts in center of pressure, reduced unipedal stance time or reduced Berg balance test scores and few treatments such as pain-relieving modalities and exercises had been shown to improve balance among people with DPN. More studies are required in the future to derive evidence-informed recommendations for practice.

Keywords: Balance; Equilibrium; Falls; Metabolic neuropathy; Rehabilitation.