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PubMedDate not supplied

Aggressive CD34-positive fibrous scalp lesion of childhood: extrapulmonary solitary fibrous tumor.

Although solitary fibrous tumor (SFT) was originally described as a pleural tumor, an increasing number of extrapleural sites of SFTs have been documented. This has been attributed not only to the heightened awareness of the spectrum of histopathological features that characterizes SFTs but also to the recognition of the role of CD34 immunostaining in soft tissue tumors in general, and in SFTs in particular. Despite the large number of documented extrapleural SFTs in adults, cranial SFTs are rare, having been documented in the meninges, scalp, and infratemporal fossa. Extrapleural SFTs are, to date, an unrecognized entity in children. We document an aggressive fibrous scalp lesion in a 30-month-old female child that demonstrated features common to benign cranial fasciitis and SFT. However, based on bright, diffuse CD34 antigen immunopositivity, a diagnosis of SFT was made. The need to include the CD34 antigen stain in a panel of immunohistochemical markers used to assess spindle cell lesions of childhood is emphasized.

Antigens, CD34↗

PubMed1977

Neonatal scalp abscess and fetal monitoring: factors associated with infection.

Forty-two of 929 (4.5 per cent) newborn infants prospectively studied following continuous, direct fetal heart rate monitoring during labor developed a scalp abscess at the site of electrode application during the neonatal period. Factors associated with infection with the use of a multivariate analysis were duration of monitoring (p less than 0.01) and high-risk indications for monitoring (p less than 0.01). Of the 42 infected neonates, 33 had complete bacteriologic studies. Microorganisms were isolated from all the infection tended to be polymicrobial, most commonly containing both aerobes and anaerobes. Staphylococcus epidermidis, Streptococcus, Peptostreptococcus, and Peptococcus were the predominant isolates. These data indicate that scalp abscess complicating intrapartum fetal monitoring may be nosocomial importance, and infants monitored should be closely observed in order to prevent more serious infectious complications.

Abscess↗

PubMed1983

Scalp abscess: a benign and infrequent complication of fetal monitoring.

Scalp abscess is an infrequent and usually benign complication of the implantation of fetal heart rate electrodes that becomes noticeable from 2 to 10 days after birth. The lesions are usually single and localized. Most exudates will produce aerobic and/or anaerobic bacteria similar to the cervical flora of the late trimester of pregnancy. Scalp abscesses are more likely to occur subsequent to prolonged rupture of the membranes and an extended period of fetal heart rate monitoring. Local treatment may be adequate in most cases, but parenteral antibiotic therapy may be needed in others. Since herpes simplex virus infection has been reported to start as vesicles around the site of electrode implantation, careful attention to the maternal history must be given. The parents of infants who undergo internal fetal heart rate monitoring should be given careful and concise follow-up instructions when the infant is discharged from the hospital. It is apparent after a decade of experience that the benefits of electronic fetal heart rate monitoring, even when invasive, far outweigh the risks of this still infrequent complication.

Abscess↗

PubMed1979

Successful replantation of a totally avulsed scalp.

A case of a totally avulsed scalp was replanted successfully by microvascular anastomosis. Though the avulsed part was heavily crushed, which resulted in a central wound, the appearance of a "necrotic" area, haematomas and persistent serous exudation after the restoration of circulation, the whole scalp survived.

Adolescent↗

PubMed1983

Avulsion of the scalp treated by microvascular repair: the use of leeches for post-operative decongestion.

A 28-year-old fitter and turner was scalped at work. The scalp was avulsed from the nuchal area to the eyebrows in one piece. It was successfully replanted by microvascular surgery. Leeches were used to decongest the flap when venous drainage appeared inadequate during the first week. Only a small part of the flap eventually failed to survive and normal hair growth returned in all other areas.

Accidents, Occupational↗

PubMed1989

Accidental reinnervation as a complication of latissimus dorsi free flap to the face and scalp.

Although direct nerve neurotization is well known, accidental full reinnervation of a major muscle following microvascular transfer has not previously been reported. Our patient, who presented with total scalp loss, was initially treated with simple skin grafts. Repeated breakdowns over the years necessitated the use of more durable cover. A free latissimus dorsi muscle flap achieved this objective. Two years post-transfer it became evident that the whole of the latissimus dorsi had become innervated, producing facial and scalp distortion when the patient smiled. Formal exploration and section of both neural trunks to the latissimus dorsi was necessary to abolish this bizarre grimace.

Adolescent↗

PubMedDate not supplied

A simple method of securing a dressing on scalp wounds.

A method of securing a dressing on scalp wounds, using silastic foam, is described. This method has the advantage of leaving the rest of the scalp uncovered and is particularly effective in the unco-operative patient.

Bandages↗

PubMed1994

Scalp tourniquet.

A pneumatic tourniquet with special features for the scalp region has been devised. A safe and well controlled surgical ablation can be performed with shortened operative time. The new tourniquet permits a larger access to the scalp and easier applicability to different cranial sizes. The tourniquet development, clinical indications, and illustrative cases are demonstrated.

Adult↗

PubMed1995

Heterotopic brain tissue in the scalp.

A posterior midline cutaneous lesion in the scalp of a 15-month-old child was excised. Clinical examination, extensive investigations and finally surgery revealed no intracranial connection. Histologically, the lesion was composed of well differentiated meningeal, glial and cerebral tissues, establishing it to be heterotopic brain tissue. Even when all preoperative procedures exclude the diagnosis of cephaloceles, surgeons should keep in mind the possibility of an intracranial connection of any midline scalp lesion in a child and the subsequent risk of meningitis.

Brain↗

PubMed1975

An on-line transformation of EEG scalp potentials into orthogonal source derivations.

A new type of EEG derivation has been investigated. This derivation, constituting a practical implementation of the Laplace operator, detects source activity as it appears at the surface level of the scalp. It is realized in the 10-20 system of electrode placement basically as an analogue superposition of four bipolar derivations, forming a star-like configuration around each electrode. Visual estimation of the topographical origins of a pattern, is thus replaced by a more efficient on-line process, which derives the source activity at the position of each individual electrode. Practical correlation tests have shown that the separation of adjacent derivations is improved by a factor of between two and four, compared to the corresponding bipolar and common reference derivations. Any feature of local origin will therefore have a correspondingly increased signal-to-noise ratio prior to the stage of visual or automatic interpretation. As a consequence of the partition of the scalp field into 19 source zreas, instead of utilizing an arbitrary number of potential differences, one fixed montage with 19 recorder channels is sufficient to present the total surface activity, within the limits of resolution of the electrode system.

Data Display↗

PubMed1977

The scalp topography of human somatosensory and auditory evoked potentials.

The waveform and topography of components of the scalp recorded somatosensory evoked poal (AEP) to click stimulation of the right ear, were determined for scalp electrode locations of the 10-20 system and for locations at the eye, mastoids, and posterior neck. Twenty-one SEP and twenty-two AEP components were analyzed. Differentiation of neurogenic and myogenic components was attempted on the basis of localization and variability. Some components of extracranial origin, apparently originating in frontal musculature, were small in most experienced subjects and large in most experimentally naive subjects. These and other presumptive myogenic potentials can distort adjacent neurogenic components. These data should aid in predicting SEP and AEP characteristics and in assessing myogenic distortion of neurogenic components.

Adolescent↗

PubMed1980

Topography of scalp recorded potentials evoked by stimulation of the digits.

The amplitude of the primary positive deflection, P24, was measured in each wave form recorded from a 36-channel scalp electrode array placed over sensorimotor cortex. Electrical stimulation of contralateral little, middle, index finger, or thumb produced wave forms possessing common features, but the location of peak P24 amplitude depended upon the digit stimulated. With thumb stimulation peak P24 amplitude was located approximately two-thirds the distance from midline to sylvian fissure, while stimulation of the other digits resulted in more medially located topographic peaks. These shifts correlate with previous descriptions of body-part representation in somatosensory cortex and suggest that at least certain wave form deflections recorded from the scalp provide accurate localization of their underlying neural generators.

Adult↗

PubMed1982

Short latency somatosensory evoked spinal and scalp-recorded potentials following posterior tibial nerve stimulation in man.

Short latency somatosensory evoked potentials (SEPs) following posterior tibial nerve stimulation at the ankle were studied by using surface electrodes placed on the spine and scalp with a non-cephalic reference (unipolar recording) in normal young adults. In order to improve recording technique, ECG was used to trigger the stimulator, and bilateral simultaneous stimulation was employed. A triphasic (positive-negative-positive) or biphasic (negative-positive) potential was recorded at each spinal electrode. Latency of this potential was longer in the more rostral channels. Conduction velocity of the spinal cord from the 12th thoracic to the 2nd cervical spine was 73.4 +/- 7.53 m/sec. At scalp electrodes, 4 components (P25, N27, P28 and N31) were identified preceding the major positive peak (P36). These 4 components showed similar latency and amplitude at all 4 electrodes investigated (Fs, Fz, C3 and C4) and are considered to be generated in the deep structure. Especially, P25 is estimated to be generated in the ascending sensory pathway of the upper cervical cord, but generator sources of other components remain to be determined. P36 appears to be generated in the somatosensory foot area.

Adult↗

PubMed1987

Transverse relationships of the alpha rhythm on the scalp.

Using auto- and cross-spectral analyses on data of 3 normal adult subjects, two components of rhythmic alpha activity were distinguished with respect to their spatial distribution and spatial relationships on the scalp. Derivations from 21 scalp points vs. linked ears were analyzed. The alpha activity with power maxima in the bilateral occipital areas (component A) showed high coherence with activity in the anterior areas and somewhat lower coherence with activity in the central/parietal areas. The other component (B) appeared dominantly in the central areas, showing extremely low values of coherence between the anterior and posterior regions, and an unstable phase relation among recording points. Components A and B appear to correspond to the 'generalized' and 'localized' alpha components described earlier. It is suggested that these two components account for the major properties of the rhythmic alpha activity.

Adult↗

PubMed1987

Scalp topography of photic evoked potentials. Application of wave form decomposition technique.

A new method of wave form decomposition by using an evoked potential model was applied to the study of scalp topography of photic evoked potentials in 3 normal subjects. The parameters of the evoked potential model were composed of gain, natural frequency, damping ratio and time lag, and were determined in the frequency domain to minimize the square sums of the modeling error. By using the optimal model parameters, the wave form was decomposed into basic components. At least 4 components occurring within the initial 200 msec period after the stimulus onset were identified in all subjects and were shown to have different scalp distributions, suggesting different generator sources.

Adult↗

PubMed1989

Spherical splines for scalp potential and current density mapping.

Description of mapping methods using spherical splines, both to interpolate scalp potentials (SPs), and to approximate scalp current densities (SCDs). Compared to a previously published method using thin plate splines, the advantages are a very simple derivation of the SCD approximation, faster computing times, and greater accuracy in areas with few electrodes.

Computer Simulation↗

PubMed1994

Location of electric current sources in the human brain estimated by the dipole tracing method of the scalp-skull-brain (SSB) head model.

Using a realistic, 3-shell head model including the scalp (S), skull (S) and brain (B) with conductivity ratios of 1:1/80:1, respectively, the electrical activity in the human brain recorded by conventional electroencephalography was approximated by 1 or 2 equivalent current dipoles. The dipole locations and vector moments were estimated by minimizing the squared difference between the potentials actually recorded from the scalp and those theoretically calculated from the equivalent dipoles. The validity of this dipole tracing method (the DT of the SSB head model) was tested in patients with focal epileptic seizures undergoing presurgical evaluation with intracranial subdural strip electrodes. Weak currents were passed through 1 or 2 pairs of subdural electrodes to create artificial dipoles. The dipole estimations correctly distinguished between single and double generator sources, but there were certain dislocations of the calculated dipoles. The average error of dislocation was found to be 8.5 mm for the 1-dipole model. That for the 2-dipole model was 6 mm for one of the components and 18 mm for the other. It was concluded that the DT method of the SSB head model can be a valuable clinical tool in 3-dimensional localization of focal epileptic discharges in the human brain.

Brain↗

PubMed1993

Single artery replantation of totally avulsed scalp.

The treatment of choice for the avulsed scalp is microvascular replantation. After replantation there are numerous arterial anastomoses, with venous congestion. Usually an effort to establish inflow through two arterial anastomoses is made. We elected to anastomose one artery and multiple veins in each of our patients. We present three consecutive successful replantations of total scalp avulsion, using only one arterial anastomosis, and multiple veins. Surprisingly, two of the patients regained their ability to elevate their eyebrows actively.

Accidents, Occupational↗