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At least 379 records · Page 21Linked to original sources
PubMed2006

Cirsoid aneurysms of the scalp.

This study reviewed the surgical management of cirsoid aneurysms of the scalp, which are rarely encountered in the neurosurgical practice, and compares the results with embolization. 21 patients with cirsoid aneurysm underwent surgery. There were 1 female and 20 male patients. Trauma was present in four patients. Selective internal and external carotid artery angiograms and cranial magnetic resonance imaging studies were performed on all patients. All angiograms were staged according to published procedures. There were 15 (71.4%) Stage 1a, 4 (19.1%) Stage 1b, and 2 (9.5%) Stage 3 patients. Total excision of the lesion was achieved in 19 patients (90.5%). We operated on only one patient for a second time, because of a residual lesion, and we resected the lesion totally. Only two patients developed necrosis of the scalp (button hole). Both scalp necroses were on the frontal area. Other patients all had good cosmetic results. Surgical resection of cirsoid aneurysms seems to be the most effective treatment with good results. There may be a tendency for the occurrence of necrosis on the frontal area. Staging of the scalp aneurysms has no effect on surgical outcome.

Adult↗
PubMedDate not supplied

Toxic epidermal necrolysis of the scalp following anticonvulsant use and cranial irradiation.

BACKGROUND: Toxic epidermal necrolysis (TEN) of the scalp is rare but it has been shown to occur in patients who had been given a combination of cranial radiation and anticonvulsant therapies. OBJECTIVE: We present a 62-year-old man who received cranial irradiation following craniotomy for glioblastoma multiforme. After he was prescribed the anticonvulsant phenytoin for postsurgical seizure prophylaxis, the patient developed TEN which began on the scalp before spreading to involve other parts of his body. Our second case was a 55-year-old woman who had been diagnosed with lung carcinoma with metastasis to the brain. She was treated with cranial irradiation and the anticonvulsant carbamazepine. TEN developed first on the scalp and then became generalized. CONCLUSIONS: While the combination of radiation and anticonvulsants leads to an increased risk of developing TEN, cranial irradiation appears to be the localizing factor in the development of TEN of the scalp.

Anticonvulsants↗
PubMed1976

Scalp abscess: a complication of the spiral fetal electrode.

During the period from September, 1974, to January, 1975, we performed 276 deliveries, of which 54% were internally monitored with a spiral type of fetal electrode. Eight of the infants monitored (incidence, 5.4%) developed scalp abscesses. We had had no previous complications associated with the electrodes. An intensive investigation was conducted to detect the causative factor(s) of the fetal scalp infections. Case histories of the mothers and infants were scrutinized, instruments were examined, the environment and techniques were analyzed. A survey of maternal and infant complications during the period from September, 1973, to August, 1974, served as control. The findings indicated that a different type of coil electrode had been substituted for the brand we had used previously. The new coil electrode had a barb at the tip, presumably to prevent its falling out of the scalp. We discontinued the use of the coil which had become suspect and returned to the type we had used previously. We have not had another incidence of fetal scalp infection associated with intrapartum monitoring.

Abscess↗
PubMed1977

Neonatal scalp abscess following intrapartum fetal monitoring: prospective comparison of two spiral electrodes.

During a six-month period, 929 newborn infants had continuous, direct fetal heart rate monitoring during labor. Of these, 481 were monitored with the Berkeley Bio-Electronics spiral electrode and 448 were monitored with the Corometrics spiral electrode. The over-all incidence of scalp abscess complicating fetal monitoring was 4.5 per cent. In the group monitored with the Berkeley electrode, 25 newborn infants (5.2 per cent) developed a scalp abscess; in the group with the Corometrics electrode, 17 newborn infants (3.8 per cent) developed scalp abscess. The incidence of scalp abscess was not significantly different in the two groups.

Abscess↗
PubMed1979

Continuous intrapartum monitoring of fetal scalp pH.

Forty patients were monitored intrapartum with a continuous fetal scalp tissue pH electrode in the mean time of 2.39 hours. The monitoring records were considered "accurate" with good correlation to the intermittent fetal scalp capillary pH values in 76.9 per cent. The correlation coefficient was 0.74. The "accuracy" improved in the latter 23 cases to 87 per cent with a correlation coefficient of 0.82. This improvement was probably due to modification of the application technique, as well as to a new calibration method at 37 degrees. Continuous fetal scalp pH monitoring was clinically useful in 65 per cent, it was partially useful in 20 per cent, but of no value in 15 per cent of the patients studied. There were no apparent maternal complications with the use of this technique and 38 of the infants had no sequelae. Two infants had complications: one developed inflammation of the electrode site. This was treated with antibiotics. One electrode broke during the application and a fragment of the electrode tip remained in the fetal scalp. All the infants were grossly normal and there was a good correlation between the continuous pH readings and the immediate neonatal outcome.

Adult↗
PubMed1983

Fetal scalp catecholamines during labor.

Samples of scalp blood were collected from 129 fetuses during the first stage of labor for analysis of plasma norepinephrine and epinephrine concentrations by high-performance liquid chromatography. The catecholamine levels were related to scalp blood pH and fetal heart rate patterns during the 20-minute period preceding the collection of scalp blood. The median norepinephrine level was 9.2 nmol/L (range, 1.3 to 99.7), and the median epinephrine level was 0.5 nmol/L (range, less than 0.5 to 19.2) (n = 111) during the first stage of labor when the pH was above 7.25. The norepinephrine level was considerably higher than that in the resting adult. Significantly higher concentrations of catecholamines were found when scalp blood pH was below 7.26 (p less than 0.001). Maternal analgesia did not influence the fetal catecholamine levels in uncomplicated labor. Significantly higher concentrations of norepinephrine were found during the appearance of abnormal fetal heart rate patterns.

Analgesics↗
PubMed1980

Central somatosensory conduction in man: neural generators and interpeak latencies of the far-field components recorded from neck and right or left scalp and earlobes.

Early somatosensory evoked potential (SEP) components to median nerve or finger stimulation were recorded with non-cephalic references in normal young adults. Detailed topographic data over scalp and neck were related to anatomical observations on the actual conduction distances in dorsal column, medial lemniscus and thalamo-cortical parts of the somatosensory pathway. The extrapolation of afferent conduction velocity (CV) measured from sensory nerve potentials along the peripheral nerve to the C6-C7 spinal segments identified the spinal entry time with the onset of the neck N11 or scalp P11 (far field 2 or FF2). The first far field (FF1) is generated in the nerve proximal to axilla. The definite latency shift of the spinal negativity along the neck indicates a CV of 58 m/sec. Data about the maximal diameter of lemniscal axons in man were used to calculate a CV of 40.5 m/sec. Consideration of transit times from spinal entry to cortex and of synaptic delays clarified the arrival times of the afferent volley at various relay nuclei, and also suggested a thalamo-cortical CV of about 33 m/sec. Interpeak and onset-to-peak measures on scalp far fields suggest that FF3-FF4 are generated in medial lemniscus rather than above the thalamus. Consistent differences in amplitude, but not in wave form, were recorded at right and left earlobes for FF2 (larger ipsilaterally) and FF3-FF4 (larger contralaterally). The scalp topography of far fields was analysed in detail.

Adult↗
PubMed1987

Peripheral origin of BAEP wave II in a case with unilateral pontine pathology: a comparison of intracranial and scalp records.

In a patient with unilateral hearing impairment due to a predominantly ipsilateral pontine pathology, BAEP peak II in a vertex to ipsilateral mastoid derivation (BAEP-II) was preserved on stimulation of the affected ear. All later activity was lost. Intracranial recording from electrodes intraoperatively placed over both cochlear nuclei on the floor of the IVth ventricle showed potentials with size and wave form comparable to the scalp records. Thus only peripheral sources, distant from the ventricular electrode, seem to contribute to scalp BAEP-II. Upon stimulation of the unaffected ear considerably larger intracranial activity was seen with peak 2-4 wave shapes obviously different from the scalp BAEP II-IV. It is concluded that intracranial electrodes sense a complex field distribution predominantly originating in structures to which they are in close electrical connection. This activity, however, need not necessarily project to the scalp.

Brain Neoplasms↗
PubMed1989

Manganese in scalp hair: problems of exogenous manganese and implications for manganese monitoring in Groote Eylandt Aborigines.

The use of scalp hair to monitor manganese was studied as part of an investigation of manganese intoxication amongst a group of Aborigines living on manganese-rich soil on Groote Eylandt, in the Northern Territory of Australia. High scalp-hair manganese values were due largely to manganese from exogenous sources. Manganese (IV) dioxide in dust, trapped in hair, was reduced by the components of sweat, leading to the diffusion of manganese (II) into the hair shaft. At least 15 micrograms Mn g-1 hair could be incorporated into hair via this exogenous route. To overcome the problems of manganese contamination, the ability of a number of leaching agents to remove exogenous manganese selectively from hair was tested. Measurements of manganese along the length of hair strands were extrapolated back to zero length to estimate the amount of manganese in the hair as it emerged from the scalp. Using this extrapolation technique, Aborigines on Groote Eylandt had a mean scalp-hair manganese of 16 ppm. Aborigines in non-manganese areas had 2 ppm manganese in hair. Caucasians living in the same manganese-rich area had 2.5 ppm manganese in hair, compared to 0.5 ppm manganese in non-manganese areas. Measurements of manganese in hair and blood of Groote Eylandt Aborigines showed that the population had a high exposure to manganese, but did not distinguish between those individuals affected/unaffected by the neurological condition, Groote Eylandt Syndrome.

Australia↗
PubMed1990

Cadmium, copper, lead, and zinc concentrations in human scalp and pubic hair.

Cadmium, Cu, Pb, and Zn concentrations were measured in the first 3 cm of the proximal end of scalp hair and in pubic hair of 41 humans, by atomic absorption spectrometry. Data are presented as geometric means. Scalp hair (SH) metal levels were higher than those in pubic hair (PH), (Cd, 85.1 vs 60.8 ng g-1; Cu, 17.7 vs 11.9 micrograms g-1; Pb, 1.72 vs 1.05 micrograms g-1; Zn, 148.8 vs 133.3 micrograms g-1) with correlation coefficients of: Cd, r = 0.474; Cu, r = 0.549; Pb, r = 0.576; and Zn, r = 0.263. Further correlations were established between Cd and Pb levels (SH, r = 0.691; PH, r = 0.621) as well as between Cd and Zn levels (SH, r = -0.268). In PH the Cd, Cu, and Pb levels of males were higher than those of females, whereas the Zn levels were lower in SH and PH of males. Scalp hair Zn contents were inversely related to age. Cadmium and Pb levels in SH and PH were higher in summer than in winter, whereas the SH Zn contents were higher in winter. An influence of place of residence, smoking habit, hair colour and hair structure on SH and PH metal levels is identified. It is concluded that hair metal analysis in samples close to the scalp is not seriously invalidated by sources of external contamination.

Adolescent↗
PubMed1994

Malignant lymphoma of the scalp at the site of a previous blunt trauma: report of two cases.

We describe two cases with malignant lymphoma presented as scalp tumors. Both patients had slowly growing subcutaneous lymphoma masses in the scalp after head trauma. In the first case, the scalp lymphoma presented as a recurrent disease during complete remission of her systemic lymphoma after chemotherapy. In the second case, the tumor involved the scalp, subjacent skull, and intracranial space without systemic manifestation. These cases represent examples of a possible relationship between head trauma and the development of between head trauma and the development of tumors involving the brain and its coverings.

Aged↗
PubMed1992

Eosinophilic pustulosis of the scalp in childhood.

BACKGROUND: Among sterile pustulosis in childhood, a pruritic relapsing eosinophilic variant beginning in infancy and located mostly in the scalp was first described as eosinophilic pustular folliculitis in infancy by Lucky and colleagues in 1984. OBJECTIVE: Our purpose is to describe such a condition in five boys and one girl and comment on differential diagnosis and relation with Ofuji's disease. METHOD: This is a clinicopathologic study. RESULTS: All patients had scalp pustules beginning in infancy or early childhood that were unresponsive to antibiotic therapy. Lesions also occurred on other areas but the scalp was the major site of involvement. Although secondary infection was demonstrated in one case, the lesions were primarily sterile. Smears of pustules showed a variable proportion of eosinophils. Histopathologic findings suggested a major role for eosinophils in this disorder because dermal eosinophilia was noted in all patients. The inflammatory pattern was not similar to Ofuji's disease. Transient blood eosinophilia was recorded in five patients. Topical steroids relieved inflammatory episodes. Dapsone was tried in one case with apparent benefit. CONCLUSION: Eosinophilic pustulosis of the scalp in childhood is a self-limited disease that can be relieved by topical steroids.

Child, Preschool↗
PubMed1991

Evaluation of a total scalp electron irradiation technique.

A dosimetric evaluation of a total scalp electron-beam irradiation technique that uses six stationary fields was performed. The initial treatment plan specified a) that there be a 3-mm gap between abutted fields and b) that the field junctions be shifted 1 cm after 50% of the prescribed dose had been delivered. Dosimetric measurements were made at the scalp surface, scalp-skull interface, and the skull-brain interface in an anthropomorphic head phantom using both film and thermoluminescent dosimeters (TLD-100). The measurements showed that the initial technique yields areas of increased and decreased dose ranging from -50% to +70% in the region of the field junctions. To reduce regions of nonuniform dose, the treatment protocol was changed by eliminating the gap between the coronal borders of abutted fields and by increasing the field shift from 1 cm to 2 cm for all borders. Subsequent measurements showed that these changes in treatment protocol resulted in a significantly more uniform dose to the scalp and decreased variation of doses near field junctions (-10% to +50%).

Electrons↗
PubMed1993

Dosimetric evaluation of total scalp irradiation using a lateral electron-photon technique.

PURPOSE: To evaluate the radiation dosimetry of a new technique for total scalp irradiation. METHODS AND MATERIALS: A treatment technique described by Akazawa (1989) has been studied. During each fraction, two electron and two photon fields are treated. While most of the lateral scalp is treated with the electron fields, a rind of scalp close to the midsagittal plane is irradiated by parallel-opposed lateral photon fields. A wax bolus is used to build up skin dose and to protect the brain from electron dose. The dose distribution and dose-volume histograms were evaluated for different field arrangements using a 3-dimensional treatment planning system. After modifying the technique, in-vivo thermoluminescent dosimetry were used to evaluate the dose distributions for the first two patients. RESULTS: To compensate for the lack of dose from the opposed photon field at the junction, the technique was modified using overlapped fields instead of abutting fields. A field overlap of 3 to 4 mm between the electron and photon fields was found optimal. When used with the field junction shift of 1 cm midway through the treatment, this scheme resulted in a dose uniformity of -5% to +15% of the prescribed dose in the region of abutment. Results of the 3-dimensional dose calculation were supported by in-vivo thermoluminescent dosimetry on two patients. CONCLUSION: On the basis of computer dose calculations and in-vivo dosimetry. Akazawa's technique for scalp irradiation can be improved by using a 3 to 4 mm overlap of electron and photon fields. This modified technique is practical and produces clinically acceptable dosimetry.

Clinical Protocols↗
PubMedDate not supplied

Scalp lacerations resulting in hemorrhagic shock: case reports and recommended management.

Scalp lacerations may bleed profusely when not adequately controlled. Three cases of isolated scalp lacerations that resulted in hemorrhagic shock are reported. A technique for achieving hemostasis using scalp clips is presented. Rapid assessment and early hemostasis of scalp lacerations are advocated, especially in the patient with multiple injuries.

Accidents, Traffic↗
PubMed2006

Technical considerations in replantation of total scalp avulsions.

Total scalp avulsions are devastating injuries and replantation is the best form of reconstruction. We present our experience of replantation of six totally avulsed scalps done between 1996 and 2004. All were technically successful, but one was lost in the post-operative period due to accidental shearing of the scalp during nursing care. A single team performed the surgery in all cases and the average operating time was 6 h. No vein grafts were used. Hair growth was satisfactory in all cases. None underwent formal nerve repair but there was adequate sensory recovery in all of them by 6-9 months. A small area of skin necrosis in the occipital area (three cases), telecanthus and epiphora (two cases) were the minor complications. The available Literature highlights the need for multiple teams to reduce the long operating time, the use of multiple vein grafts and the complexities involved. Since, they are rare injuries, gaining wide experience is difficult. In this article we offer recommendations in pre-op preparation, vessel identification, technique of anchoring the avulsed scalp prior to vessel anastomosis and post-op care to make this rare procedure quicker, easier and successful.

Accidents, Occupational↗
PubMed2004

Radio-induced malignancies of the scalp about 98 patients with 150 lesions and literature review.

INTRODUCTION: - The induction of malignant diseases is one of the most concerning late effects of ionizing radiation. The topic of this study deals with skin tumors developed in the irradiated areas in children given X-ray therapy for tinea capitis. MATERIAL AND METHODS: - All patients with malignant tumors of the scalp referred to Salah Azaiz Institute between 1970 and 2001 have been questioned in order to determine if there had been a prior X-ray irradiation for tinea capitis, its modality, and its consequences. The first scalp irradiation goes back to 1922 and the last was performed in 1963. RESULTS: - Ninety-eight patients with 150 radio-induced cancers of the scalp following irradiation for tinea capitis are reported (1.5 lesion per patient). The patients were irradiated in various hospitals and dispensaries throughout the country. Eighty-one patients (82%) had only one session of radiation. The average age at irradiation was 12 (+/-6) years, the latent period for radiation-induced skin cancers was 36 (+/-14) years. In 61 patients (62%), the scalp appeared normal and in 38% radiodermatitis was noted. Patient age at diagnosis of malignancy varied from 20 to 83 years with an average of 47 years. Basal cell carcinomas (125 cases) and spinocellular carcinomas (16 cases) were the most common, three other cases of annexial tumors, two malignant non-Hodgkin's lymphomas and four melanoma lesions are also present. Radiotherapy was used for the treatment of 74 patients (alone in 42 and associated with surgery in 32 patients); 14 patients had exclusive surgical excision. CONCLUSIONS: - Basal cell carcinomas are the most frequent tumors arising on chronic radiodermatitis. In spite of the long latency period, patients' young age at irradiation explained the occurrence of these cancers at a relatively young age. Literature review is suggesting recessive mutation of tumor-suppressor genes as the characteristic abnormality in radio-induced cancer.

Adult↗
PubMed2006

Evaluation of essential and toxic metals by ultrasound-assisted acid leaching from scalp hair samples of children with macular degeneration patients.

BACKGROUND: The causes of night blindness in children are multifactorial and particular consideration has been given to childhood nutritional deficiency, which is the most common problem found in underdeveloped countries. Such deficiency can result in physiological and pathological processes that in turn influence hair composition. METHOD: An ultrasonic-assisted acid leaching procedure was developed as a sample pretreatment for the determination of Zn, Cu, Cd, As and Pb in human scalp hair samples of night blindness male children with age between 5 to 15 y and compared with the children without vision anomalies that lived in the same localities. The effects of different factors on acid leaching of metals, such as preintensification time (without ultrasonic stirring) after treatment of acid mixture, exposure time to ultrasound and temperature of the ultrasonic bath have been investigated. The proposed method was validated by certified reference samples of scalp hair CRM 397. The wet acid digestion method was used to obtain the total metal concentration in both scalp hair and CRM samples. Cu and Zn in leachates and digests were measured by flame atomic absorption spectrometry (FAAS) using a conventional air/acetylene flame, while Cd and Pb were determined by electrothermal atomic absorption spectrometry (ETAAS) under optimized conditions. RESULTS: It was observed that at optimal conditions, the recovery for Zn, Cd, Pb, As and Cu were 98%, 98.5%, 96%, 97.2% and 94% respectively. The mean values of Zn and Cu in scalp hair samples of children having night blindness were significantly lower as compared to normal healthy children (p for Zn<0.001 and Cu<0.003), while the level of toxic metals As, Cd and Pb were significantly higher in children having ocular problems as related to normal children (p As<0.0074, Cd<0.001 and lead<0.004). CONCLUSION: These data present guidance to clinicians and other professional investigating deficiency of essential trace metals and excessive level of toxic metals in biological samples.

Acids↗