A unique case of multiple calvarial hemangiomas with one large symplastic hemangioma

Background Symplastic hemangioma is a benign superficial abnormal buildup of blood vessels, with morphological features which can mimic a pseudo malignancy. A few cases have been reported in the literature. We report here, a unique case of calvarial symplastic hemangioma, which is the first case in the calvarial region. Case presentation A 29-year-old male patient, with a left occipital calvarial mass since childhood, that gradually increased in size with age, was associated with recurrent epileptic fits controlled by Levetiracetam (Keppra), with no history of trauma. He presented to the emergency room with a recent headache, vomiting, frequent epileptic fits and a decrease in the level of consciousness 1 day prior to admission. A CT scan showed three diploic, expansile, variable sized lytic lesions with a sunburst appearance; two that were biparietal, and one that was left occipital, which were all suggestive of calvarial hemangiomas. However, the large intracranial soft tissue content, within the hemorrhage of the occipital lesion was concerning. The patient had refused surgery over the years; however, after the last severe presentation, he finally agreed to treatment. The two adjacent, left parietal and occipital lesions were treated satisfactorily using preoperative embolization, surgical resection, and cranioplasty. Histopathology revealed cavernous hemangiomas, in addition to symplastic hemangioma (pseudo malignancy features) on top at the occipital lesion. The right parietal lesion was not within the surgical field; therefore, it was left untouched for follow-up. Conclusions Histopathology and radiology examinations confirmed the diagnosis as symplastic hemangioma, on top of a pre-existing cavernous hemangioma. To the best of our knowledge, this is the first case of a calvarial symplastic hemangioma, which we report here.

The “Strange Self-power in the Imagination”

This paper will focus on Coleridge’s writing of epileptic signs in the light of contemporary debates on the physiology and psychology of the brain. By examining the medical narratives of epilepsy, widely debated at a time where both evangelical movements and consumer behaviors were threatening the nerves and brains of English society, I intend to explore the cultural components and meanings attached to epileptic fits in order to understand Coleridge’s dreadful fear of epilepsy and its relation to fanciful imagination. I will argue that his fear of epileptic seizures may have laid the ground for his theory of fancy: body and brain could create against the will of the poet thus acting as moral alibis for his more radical poems.

Clinico-etiological profile of neonatal seizures in term neonates

Background: Neonatal seizures or neonatal convulsions are epileptic fits occurring from birth to the end of the neonatal period. Neonatal seizures are a common neurological problem with a frequency of 1.5-14/1000 neonates. Neonatal seizure is common in this part of the Telangana and there was paucity of data from this area. Identification of etiology will help in management there by reducing morbidity and mortality.Methods: This prospective study was done in NICU of S.V.S. Medical College and Hospital, Mahabubnagar, from Jan 2016 to Jan 2017. Term neonates with clinically identifiable seizure were included in the present study. This study was approved by institutional ethical committee and written consent was obtained from parents of the studied neonates.Results: Of 84 studied neonates, 46 were males and 38 were females. 29 neonates had seizures within first 24 hours and 22 neonates had seizures on day 2. Perinatal asphyxia was seen in 28 neonates and septicemia was seen in 21 neonates.Conclusions: Perinatal asphyxia was the most common cause for neonatal seizures in term neonates, followed by septicaemia and metabolic disturbances.