Bilateral Location Research Articles

092. Overview of the Prevalence of Chronic Kidney Disease (CKD) in Kidney and Ureter Stones at Zainoel Abidin Hospital Banda Aceh, 2021

Background: Kidney stones are a predictor and risk factor for CKD and the prevalence rate is 5-10% with comorbid factors which can increase the risk of CKD events. Chronic Kidney Disease (CKD) is a serious complication of urinary tract stones. Chronic kidney disease can occur as a result of urological procedures, obstruction or due to causes inherent in stone formation. Methods: This type of research is descriptive research using secondary data in the form of medical record data. The design of this research is cross sectional with data collection carried out retrospectively. The samples in this study were patients diagnosed with CKD in patients with ureteral stones or kidney stones at Zainoel Abidin Hospital, Banda Aceh. Samples were taken using the total sampling method. Results: In this study, 70 samples were taken and the results of this study based on gender are majority were found to be men 48 samples (68.6%), the most common age category was 41 - 50 years with 28 samples (40.0% ), the most common comorbid factor causing CKD was hypertension in 30 samples (42.5%), the type of urinary tract stones most often found was ureter stones, namely 34 samples (49.0%), and the most common location or urinary tract was ureter stones. bilateral, namely 22 samples (31.4%). Conclusion: The male gender most often experiences CKD due to complications from urinary tract stones, where the age range of 41 - 50 years is the age that experiences the most complications. The most common type of urinary tract stone is ureteral stone with a bilateral location.

Evaluation of Selected MRI Parameters in the Differentiation of Mucinous Ovarian Carcinomas and Metastatic Ovarian Tumors.

Introduction: Analysis of selected MRI parameters in initial MRI for the characterization of ovarian masses enables differentiation between mucinous ovarian carcinoma and metastatic ovarian tumors. Material and Methods: A prospective analysis of contrast-enhanced MRI of patients with suspected ovarian masses diagnosed in ultrasound and CT examination. Morphological criteria, such as the size of lesion, bilateral location, presence of "mille-feuille sign", so-called Seidman criteria, as well as the diffusion weighted imaging and dynamic contrast enhancement of each lesion, were evaluated. Patients were allocated into two groups; the first group contained patients with mucinous ovarian cancer, and the second group contained patients with metastatic ovarian tumors. Results: A total of 35 patients were enrolled into the study. Median age was 49 in the first group and 59 in the second group of patients (p = 0.04). In the first group, all patients (100%) had unilateral lesions, and in the second group, 94% had bilateral tumors (p < 0.000001). In the first group, a tumor size equal or greater than 10 cm was present in 80% of patients, and the same was true for 21% of patients in the second group. The mille-feuille sign was present in 30% of patients from the first group and in 64% of patients from the second group. In the first group of patients, TTP was 410 and Perf.Max Enhancement was 141; in the second group, they were, respectively, 154 and 167 (p = 0.0001 and p = 0.5). Median ADC values in the first group were significantly higher in the first group than in the second group (p < 0.01). Conclusions: Significant differences in TTP and ADC values as well as in Seidman criteria enable reliable differentiation between the analyzed groups of tumors.

VLR-BPP: An intelligent virtual location replacement based bilateral privacy-preserving architecture for edge cloud systems

Mobile Crowdsourcing (MCS) has emerged as a significant edge-cloud computing paradigm in which workers perceive data at the network edge and report it to cloud-based computing services for processing, enabling the construction of various applications. Consequently, it is imperative to achieve Bilateral Location Privacy-Preserving (BLPP) to protect the privacy of both Data Requester (DR) and workers, as disclosing location information entails many sensitive details that can result in losses for DR and workers alike. The Local Differential Privacy (LDP) approach is widely employed in Privacy-Preserving (PP) techniques due to its inherent advantages, wherein owners release data with added noise, allowing for proactive customization of privacy strength without relying on any third party. However, the current state of LDP methods presents a dilemma: when privacy protection is strong, introducing excessive location noise can lead to a decrease in the accuracy of task-worker matching, while a high rate of task-worker matching necessitates the compromise of privacy strength. In this paper, an intelligent Virtual Location Replacement based enhanced Bilateral Privacy-Preserving (VLR-BPP) architecture is proposed to improve privacy protection strength and matching accuracy in MCS simultaneously. Within the VLR-BPP architecture, a Bipartite-Graph-based Matrix Completion (BGMC) model is employed to establish the spatiotemporal correlations among data. Then, a Virtual Location Replacement (VLR) strategy is proposed to obfuscate the locations of tasks or workers to their highly correlated virtual location before publishing. Based on VLR, three preemptive location virtualization approaches are introduced: Only Task Location Virtual (OTLV), Only Workers Location Virtual (OWLV), and Both Task and Workers Location Virtual (BTWLV). For workers and DR, Randomized Response (RR) techniques and Random Matrix Multiplication Mechanism (RMM) are used to implement LDP independently. A greedy algorithm is adopted to recruit workers for tasks. In response to the data submitted by workers, BGMC imputation mechanism is utilized to enhance data quality. Finally, simulations based on real-world datasets demonstrate that the performance of our architecture surpasses existing state-of-the-art methods in privacy protection and data collection quality by 18.92∼38.17% and 15.49∼50.77%, respectively.

DNF-BLPP: An Effective Deep Neuro-Fuzzy based Bilateral Location Privacy-Preserving Scheme for Service in Spatiotemporal Crowdsourcing

DNF-BLPP: An Effective Deep Neuro-Fuzzy based Bilateral Location Privacy-Preserving Scheme for Service in Spatiotemporal Crowdsourcing

Q-BLPP: A Quality-Enabled Bilateral Location Privacy-Preserving Service Construction Scheme in Mobile Crowd Sensing

Q-BLPP: A Quality-Enabled Bilateral Location Privacy-Preserving Service Construction Scheme in Mobile Crowd Sensing

Resting state functional magnetic resonance imaging: an analysis of the connectivity of brain large-scale networks

Objective: To assess the possibilities of various methods for analyzing the functional integration of large-scale brain neural networks in healthy subjects according to functional MRI resting state.Material and methods. Functional MRI at rest was performed on 28 healthy male subjects aged 27.4 ± 5.1 years, without bad habits and craniocerebral injuries. A functional evaluation of large-scale neural networks included in the triple network model was carried out: default mode network, salience network, executive control network.Results. The analysis of independent components made it possible to fully identify the default mode network and the salience network, however, the executive control network were partially identified, and this mainly concerned structures with a bilateral location. Graph analysis has identified structures of greatest value for neurofunctional research. Almost all structures that have the highest graph indicators are related to the executive control network. The results of the Roi-analysis showed the interaction between all large-scale networks, which indicates their joint work in providing important brain functions. It was also determined that in healthy people, all structures within large-scale networks are functionally interconnected.Conclusion. Different methods of resting functional MRI data analysis reveal different aspects of connectivity in the brain, completely different principles are involved in the processing of each method, and the final quantification parameters also vary depending on the preferred method. Currently, there is no single method that in itself would be considered the standard of analysis. Applying multiple methods to the same dataset can produce more informative results.

PREVALENCE, PREDICTORS TRIGGERS AND COPING STRATEGIES OF TENSION HEADACHE AMONG MEDICAL STUDENTS AND IN KSAU-HS RIYADH, SAUDI ARABIA

This study aimed to investigate the prevalence of primary headaches, specifically tension-type headaches (TTH), among medical students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh, Saudi Arabia, and to identify the factors that contribute to the occurrence and relief of headaches. A cross-sectional study was conducted among second to sixth-year medical students at KSAU-HS from October 2022 to February 2023. Participants with chronic headaches who volunteered to participate were included. The International Classification of Headache Disorders, third edition (ICHD-3), was used to classify and differentiate between different types of headaches. Additional questions were included to assess factors that exacerbate or alleviate headaches, headache management strategies, and the impact of headaches on academic performance. Data were collected using electronic self-administered questionnaires and analyzed using SPSS version 21. A total of 303 participants were included in the study, with a mean age of 22 ± 1.7 years. The majority of participants were male (59.4%), and most were in clinical years (61.1%) with a GPA of 4.5 to 5 (57.1%). Nearly all participants reported experiencing at least one episode of headache in the past year, and 60.7% met the criteria for TTH. The most commonly reported headache characteristics were bilateral location (71.3%), frequent occurrence (53.8%), duration of more than one hour (84.5%), and frontal site (61.7%). Lack of sleep (62.4%) was identified as the most common trigger, while taking simple analgesics like Paracetamol (72.3%) and sleep (50.5%) were the most commonly used therapies to manage headaches. The majority of participants (75.9%) reported that their headaches did not significantly affect their academic performance. A significant association was found between gender and tension-type headaches, with male students being at a higher risk (p-value &lt; 0.001). In conclusion, primary headaches, particularly tension-type headaches, are prevalent among medical students at KSAU-HS, potentially impacting their academic performance. Further research is warranted to raise awareness among students regarding effective headache management strategies.

Telerehabilitation for the treatment in chronic low back pain: A randomized controlled trial.

Although there is growth in the approach to telerehabilitation (TLRH) in different pathologies, research on TLRH for the management of low back pain is scarce and controversial. Thus, the purpose of this study was to analyze whether a TLRH program is as effective as a clinical exercise program in improving pain and different functional variables in patients with nonspecific low back pain (NLBP). A single-blind, two-armed randomized controlled trial was carried out with 68 individuals with chronic NLBP. Participants were randomly allocated to either the TLRH group (TG) (n = 34) or the clinic group (CG) (n = 34). The TG received an exercise-based TLRH video and an educational program on the neurophysiology of pain. The CG received the same pain education and exercise program at the clinic facility supervised by a clinician. Both groups performed 2 weekly sessions for 8 weeks. Active movements of the lumbar spine, pain and range of motion, and kinesiophobia were assessed at baseline, at the end of 8 weeks of treatment, and at 3 months. Statistically significant differences for time-by-group interaction were identified in range of motion of right (F = 11.668; p = 0.001) and left (F = 4.219; p = 0.042) legs when knee extended test is performed; as well as in pain intensity when the same test (F = 5.176; p = 0.043). Moreover, higher pain level during flexion (F = 5.133; p = 0.009) and extension movements (F = 6.335; p = 0.003) in patients with bilateral pain location than those with unilateral or central pain location has been appreciated. A TLRH rehabilitation program via mobile app is as effective as the same exercise program supervised in a clinic.

Evaluation of the role of prophylactic bilateral central neck lymph node dissection in patients with papillary thyroid carcinoma: a case controlled study.

Thyroid cancer is the most common malignancy in the endocrine system. Papillary thyroid carcinoma (PTC) is the most common differentiated thyroid cancer. There are considerable discrepancies regarding the role and extent of prophylactic central lymph node dissection (PCLND) for patients with PTC. Our primary goal was the evaluation of CLN involvement based on the tumor features and staging on the eight version of the American Joint Committee on Cancer and also the TNM method. Our secondary aim was to evaluate the features of the CLNs with tumoral features and also features associated with the development of transient hypoparathyroidism. This prospective case-controlled study was performed among PTC patients. Total thyroidectomy and bilateral dissection of the CLNs of the central compartment of the neck was performed, and samples were sent for pathological evaluation. CLN involvement, tumoral features and transient hypoparathyroidism were cross-evaluated and analyzed with SPSS version 26.0. In this study, out of 61 patients, 11 (18%) were male, the average age was 37.3 ± 13.7years, based on AJCC staging, 53 (86.9%) were stage I and 8 (13.1%) were stage II, and based on TNM staging, 39 patients (66.1%) were T1, including 13 (22.0%) T1a and 26 (44.1%) T1b, 15 patients (25.4%) were T2, and five patients (8.5%) were T3. Based on permanent pathology evaluation, the majority of patients (n = 48; 78.7%) had CLN involvement. None of the preoperative and tumor features had a significant association with CLN involvement. 75% of stage I and 100% of stage two cases, while 76.9% of T1, 86.7% of T2, and 80.0% of T3 cases had CLN involvement. There was no significant association between the involvement of CLN and the AJCC staging (P = 0.184) or TNM staging (P = 0.875). The involved to dissected CLN ratio was significantly higher in stage II patients compared to stage I (72.5 vs. 34.8%; P = 0.006), and also with higher T staging (0.009). There was a statistically significant association between the larger CLN size and older patients' age, higher postoperative thyroglobulin levels, and smaller tumor size. Higher postoperative thyroglobulin level was significantly associated with larger tumors size and thyroid capsule invasion. Also, 26 (44.8%) of patients developed transient hypoparathyroidism, which was significantly associated with vascular invasion (P = 0.048), bilateral location of tumor (P = 0.048) or on the right side (0.005), and larger size of the tumor (P = 0.016). Tumor features and staging were not associated with CLN involvement features. Therefore, full extent PCLND should be carried out to avoid reoperation or metastasis in PTC patients.

Effectiveness and safety of ear acupuncture for tension-type headache: A protocol for a systematic review and meta-analysis

Tension-type headache (TTH) refers to a type of functionalism disease, which is commonly characterized by recurrent headaches of mild to moderate intensity, bilateral location, pressing or tightening quality, and no aggravation by routine physical activity. Has significantly impacts on people's work and life. Ear acupuncture as a traditional Chinese therapy, showing several advantages (e.g., safety, economy, and less side effects), has been extensively used to treat TTH. However, its curative effect is supported by limited evidence. Accordingly, the present study aims to comprehensively assess the reliability of ear acupuncture in TTH. The study will conduct a systematic review and meta-analysis. Seven databases, including the Embase, Cochrane Library, Pubmed, SinoMed, CNKI, VIP, and Wanfang Data, will be searched using predefined search terms to identify relevant studies. The primary outcomes will be the pain intensity, the pain frequency and the impact of headache. The methodological quality of the included studies will be assessed with a previously established checklist. The Cochrane Collaboration's bias risk tool will be used for assessing the bias of included RCTs. Stata 17.0 software is used for meta-analysis.

Evaluation of Supratrochlear, Supraorbital and Angular Artery Course Variations and Depth by Doppler Ultrasound.

Supratrochlear (STA), supraorbital (SOA), and dorsal nasal artery (DNA) branches from the ophthalmic artery and angular artery (AA) from the facial artery are the primary suppliers of blood to the upper face. Filler injection without precise knowledge of its vascular topography poses a risk of severe complications. Seventy-four hemifaces from 37 subjects with a median age of 25.0 (21.0, 35.0) years and a median body mass index of 21.2 (20.0, 25.4) kg/m2 underwent high-frequency ultrasound tests between March 2022 and April 2022. The bilateral location, depth, peak systolic velocity (PSV), and inner diameter (ID) of the four periorbital arteries (STA, SOA, DNA, AA) were measured. The average ID ranges from 0.6~1.0 mm, and the average PSV ranges from 9.2~24.9 cm/s. All arteries detected passed through the superficial subcutaneous fascia. Most subjects' STAs traveled within 1.0 to 2.0 cm from the midline (left 96.8%, right 93.8%), while SOAs were mainly concentrated within 2.0 to 4.0 cm (left 83.9%, right 81.3%). STAs were more superficial and had a larger internal ID and PSV than SOAs (p<0.001). Except for the ID of the right SOA2 being significantly larger than that of the left SOA2 (p<0.05), no dominant side was found. The depth of STAs and SOAs was moderately correlated with BMI (p<0.05), except for STA1 on the left side. The course of AAs presented a high variability. These findings emphasize that the periorbital arteries carry with it a likelihood of ocular complication risks during injection. Targeting the supraperiosteal layer in the STA area and the supramuscular layer in the SOA area of the inferior forehead during injection seems reasonable, and an area within 1.0~2.0 cm from the midline should be avoided. Additionally, the high variability of AAs will enhance the understanding of the anatomy of the facial artery terminals. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

How does a CIED presence influence chances and safety of haemodialysis access? Conclusions from over 3000 thoracic venografies.

The authors analysed preoperative venogrphies of 3100 patients referred for transvenous lead extraction for a possible chance of safe haemodialysis catheter (HC) implantation or proper AVF function. A chance of safe catheter implantation parallel to existing leads reaches 68.8% ipsilaterally to CIED. Contraindications for implantation have been found in less than 2% of cases contralaterally. Ipsilaterally proper AVF function chance has been found in 50.3% of the cases and almost 98% contralaterally. A bilateral chest electrodes location require the special attention. Abandoned lead, lead burden, bilateral leads, additional lead implantation or abandonment, and implant duration may have a significant influence on HC insertion or proper function of arteriovenous fistula. (1) Obstruction of prominent thoracic veins is a frequent finding in CIED carriers and may impede or disable implantation haemodialysis accesses. (2) Implantation of temporary or permanent HC may be questionable ipsilaterally to the CIED in 31.2% and contralaterally in 2.0% of patients. Proper function of AVF is uncertain in 49.7% ipsilaterally and 2.1% contralaterally to CIED. (3) Pacing history and leads dwell time influence chances of success haemodialysis access even on the free-from CIED chest side. (4) Proper venous flow evaluation seems to be valuable in CIED carriers before an attempt of haemodialysis access formation, even contralaterally.

Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors.

Background:Thyroid gland malignancies are rare in pediatric patients (0.7% of tumors); only 1.8% are observed in patients aged <20 years, with a higher prevalence recorded in women and adolescents. Risk factors include genetic syndromes, MEN disorders, autoimmune diseases, and exposure to ionizing radiation. Radiotherapy is also associated with an increased risk of secondary thyroid cancer. This study describes the clinical features and surgical outcomes of primary and secondary thyroid tumors in pediatric patients.MethodsInstitutional data were collected from eight international surgical oncology centers for pediatric patients with thyroid cancer between 2000 and 2020. Statistical analyses were performed using the GraphPad Prism software.ResultsAmong 255 total cases of thyroid cancer, only 13 (5.1%) were secondary tumors. Primary thyroid malignancies were more likely to be multifocal in origin (odds ratio [OR] 1.993, 95% confidence interval [CI].7466–5.132, p = 0.2323), have bilateral glandular location (OR 2.847, 95% CI.6835–12.68, p = 0.2648), and be metastatic at first diagnosis (OR 1.259, 95% CI.3267–5.696, p > 0.999). Secondary tumors showed a higher incidence of disease relapse (OR 1.556, 95% CI.4579-5.57, p = 0.4525) and surgical complications (OR 2.042, 95% CI 0.7917–5.221, p = 0.1614), including hypoparathyroidism and recurrent laryngeal nerve injury. The overall survival (OS) was 99% at 1 year and 97% after 10 years. No EFS differences were evident between the primary and secondary tumors (chi-square 0.7307, p = 0.39026).ConclusionsThis multicenter study demonstrated excellent survival in pediatric thyroid malignancies. Secondary tumors exhibited greater disease relapse (15.8 vs. 10.5%) and a higher incidence of surgical complications (36.8 vs. 22.2%).

Endovascular Management of Intracranial Pial Arteriovenous Fistula with Giant Venous Varix: Case Report and Review of Literature.

Abstract: Background: Intracranial pial arteriovenous fistulas (AVFs) are rare intracranial vascular malformation and their treatment is challenging because of high-flow pial supply of the lesion. We report a case of intracranial pial AVF with associated giant venous varices managed successfully by embolization. Case Description: A 25-year-old male presented with sudden onset headache and altered sensorium. Computed tomographic scan was suggestive of frontal lobar hematoma that had dissected into the third ventricle with associated intraventricular hemorrhage. Magnetic resonance imaging revealed presence of large vascular channels with the presence of multiple flow voids in bilateral frontal location. Digital subtraction angiography revealed pial fistula with arterial supply from hypertrophied left anterior cerebral artery. Treatment was done using combined coil and onyx embolization after careful analysis of angioarchitecture of the lesion using three-dimensional rotational angiogram cross-sectional reconstructions. Postprocedure angiogram revealed closure of fistula and giant varices. Conclusion: Pial AVFs with giant venous varix in adults are rare vascular malformation and understanding the angioarchitecture with exact identification of fistulous point is important to plan for surgical/endovascular management strategies. Combined strategy of embolization using coils and onyx is a safe option in such cases with giant varices.

Bilateral Privacy-Preserving Truthful Incentive for Mobile Crowdsensing

Reverse auction-based incentive mechanisms have been widely adopted to stimulate mobile workers to participate in mobile crowdsensing (MCS), where workers need to provide location information for winner selection. However, most existing mechanisms rely on trusted platforms. The worker’s location data uploaded to platforms thus can be easily exposed. Recent works start to incorporate location privacy in designing incentive mechanisms, but they have not considered the task’s location privacy and the worker’s location privacy simultaneously. Therefore, we propose a bilateral location privacy-preserving mechanism for MCS on untrusted platforms. In our model, each worker adopts differential privacy to obfuscate his location locally and then submits the obfuscated location together with the bid information. Besides, instead of the exact location, the task requester is only required to upload the task profile and the task’s obfuscated location. Then, we propose the lowest-cost winner selection mechanism which aims to minimize the social cost of winner selection under the location constraint while ensuring task quality requirements, and adopt the critical payment determination mechanism to determine the payments for the winners, which satisfies truthfulness, individual rationality, and computational efficiency. Theoretical analysis and extensive experiments on real-world datasets show the effectiveness of the proposed mechanisms.

Diagnostic utility of T2*-weighted GRE in migraine with aura attack. The cortical veins sign.

To evaluate the frequency, distribution, and clinical associations of the dilated appearance of cerebral cortical veins, termed cortical veins sign on T2*-weighted gradient recalled-echo (T2*-GRE) in the acute setting of migraine with aura attack in adult patients. We conducted a retrospective analysis of 60 consecutive patients admitted for acute neurological symptoms with a final diagnosis of migraine with aura (42%) or probable migraine with aura (58%) who underwent emergency brain magnetic resonance imaging and 60 non-migrainous control adults. The cortical veins sign was defined as a marked hypo-intensity and/or an apparent increased diameter of at least one cortical vein. We examined the prevalence, the spatial distribution, and the associations of cortical veins sign with clinical characteristics of migraine with aura. We detected the cortical veins sign in 25 patients (42%) with migraine with aura, compared to none in the control group (p < 0.0001). The spatial distribution of cortical veins sign was characterised by the predominantly bilateral and posterior location. Presence of cortical veins sign was associated with increased severity of aura (p = 0.05), and shorter delay to MRI (p = 0.02). In the setting of acute neurological symptoms, the presence of cortical veins sign is frequent in patients with migraine with aura and can be detected with good reliability. This imaging marker may help clinicians identify underlying migraine with aura.

Carotid body tumors: case series of extremely rare head and neck paragangliomas

Carotid body tumors, also commonly known as nonchromaffin paragangliomas and chemodectomas, is a slowly growing neoplasm originating from carotid body chemoreceptors. Herein we have presented a case series of surgical treatment of patients with carotid body tumors in National Scientific Center of Surgery named after AN Syzganov (2009-2020). Total number of patients was 10 with 11 neck mass, of which 7 (70%) were women, the average age was 47 (31-73) years, one case we faced with a bilateral location. The main complaint was slow-growing neck mass. On computed tomography angiography most of cases (70%) were of the 3th type according to the Shamblin grade with average size of 5.9 (4-8) cm. The main treatment was surgical excision in all cases. Mean duration of surgery 111.5 (75-190) min and hospital stay days 12.1(8-20) were registered. Total number of complications were 2 (20%), where in 1 case surgery complicated by bleeding more than 500 ml, and 1 patient presented dysphonia after the surgery, which resolved by time. Duration of surgery and hospital stay days were directly associated with size of mass and distance to base of skull. Pathology results showed that two patients (20%) had malignant cells, one of them with metastases to the nearest lymph nodes. Surgical resection is the treatment of choice for carotid body tumors. The large size of the masses and involvement of the carotid arteries and cranial nerves in the process directly affect the surgical approach and increase the risk of complications.

Multidetector Computed Tomography Venography versus Magnetic Resonance Venography in Cerebral Venous Thrombosis: A Cross-sectional Study

Introduction: Cerebral Venous Thrombosis (CVT) is a relatively uncommon condition whose presentation is varied. The diagnostic imaging features can be subtle. The correct diagnosis of CVT relies on neuroimaging Non Contrast Computed Tomography (NCCT), CT Venography (CTV), Magnetic Resonance Imaging (MRI), MR Venography (MRV). Aim: To compare 128 slice Multidetector Computed Tomography (MDCT) venography and MRV in CVT, taking MRV as gold standard. Materials and Methods: This cross-sectional study was conducted in the Department of Radiodiagnosis, Gandhi Medical College, Secunderabad, Telangana, India, from October 2017 to September 2019. The study constituted of 56 patients, with clinical signs and symptoms of CVT who underwent MDCT venography and MRV. NCCT with MDCT venography was carried out on HITACHI 128 slice CT machine and MR imaging was performed in 1.5 tesla SIEMENS AVANTO systems. Imaging findings analysed on NCCT were hyperdense cord sign, delta sign, and multiple parenchymal hypodense lesions in bilateral parasagittal location, bilateral thalamic hypodensities, and isolated temporal bleed and on CTV signs like empty delta / empty triangle sign. Plain MRI was assessed for involved sinuses with thrombus showing loss of expected flow void with hyperintensity on T1-Weighted (T1W) and blooming on Gradient Recalled Echo (GRE). Parenchymal changes were assessed for presence of cytotoxic oedema, vasogenic oedema and haemorrhagic infarct. MRV was assessed for nonvisualisation of involved sinus or lack of normal flow related enhancement. Results: Among the total 56 study subjects evaluated, 48 were diagnosed to have CVT on both CTV and MRV. On CTV, 147 sinuses were found to be involved, while MRV showed involvement of 142 sinuses. One case was found to be negative for thrombus on CTV but positive on TOF (Time of Flight) MRV. Both CTV and MRV were negative for CVT in seven patients. The sensitivity and specificity of NCCT in diagnosing CVT was found to be 60% and 87% respectively. Conclusion: The parenchymal changes in CVT were better evaluated on MRI. Venous abnormalities were better depicted in MRI as loss of flow voids in T1, T2 and with dark signal on GRE. Haemorrhagic bleeds were easily evaluated on MRI with 100% sensitivity of GRE sequence. CTV was easier to interpret, showed better and faster depiction of sinuses, with thin section reformatted images and showed higher spatial resolution compared to MRV.

ANATOMICAL VARIATIONS OF THE PARIETAL FORAMEN AND ITS RELATIONS TO THE CALVARIAL LANDMARKS: A CROSS-SECTIONAL CADAVERIC STUDY.

The aim: Estimate the prevalence of the parietal foramen in the adult human skulls of Ukrainian origin, and study its morphology and relationships to main anatomical landmarks of the skull. Materials and methods: A cross-sectional observational study of PF was conducted with 42 random cadaveric adult human skull roofs (calvaria) collected from the laboratory and museum of Human Anatomy Department, Kharkiv National Medical University, Ukraine. The patency and the length of the PF canal were determined, and PF external/internal diameters and the distance to the calvarial landmarks from PF were measured using the caliper. Mean and standard deviation were calculated to compare with the existing data. Results: In the present study 85.7% (n = 36) of the calvaria had the PF, 54.8% (n = 23) had bilateral location of PF, 30.9% (n = 13) had unilateral presence of PF (right side: 23.8%, n=10 and left side: 7.1%, n=3), and 14.3 % (n = 6) demonstrated bilateral absence of PF. Conclusions: An anatomical variation in parietal foramen is not uncommon, and the differences can be based on multiple factors like geography and race. It is important to have detailed information on anatomical variations in different population groups to facilitate surgical and radiological interventions.

Headache Attributed to Vaccination Against COVID-19 (Coronavirus SARS-CoV-2) with the ChAdOx1 nCoV-19 (AZD1222) Vaccine: A Multicenter Observational Cohort Study.

IntroductionThe most frequently reported neurological adverse event of ChAdOx1 nCoV-19 (AZD1222) vaccine is headache in 57.5%. Several cases of cerebral venous thrombosis (CVT) have developed after vaccination. Headache is the leading symptom of CVT. For the differential diagnosis of headaches attributed to this vaccine and headaches attributed to CVT, it is of central clinical importance whether and, if so, how the phenotypes and course of these headaches can be differentiated. The study aims to examine in detail the phenotype of headache attributed to this vaccine.MethodsData on the clinical features and corresponding variables were recorded using a standardized online questionnaire in this multicenter observational cohort study. The primary outcomes of this study are the clinical features of headaches after vaccination.FindingsA total of 2464 participants reported headaches after vaccination with the ChAdOx1 nCoV-19 (AZD1222) vaccine. On average, headaches occurred 14.5 ± 21.6 h after vaccination and lasted 16.3 ± 30.4 h. A bilateral location was described by 75.8% of participants. This is most often found on the forehead (40.0%) and temples (31.4%); 50.4% reported a pressing and 37.7% a dull pain character. Headache intensity was most often severe (38.7%), moderate (35.2%), or very severe (15.5%). Accompanying symptoms were most commonly fatigue (44.8%), chills (36.1%), exhaustion (34.9%), and fever (30.4%).ConclusionHeadaches attributed to COVID-19 vaccination with the ChAdOx1 nCoV-19 (AZD1222) vaccine demonstrate an extensive and characteristic complex of symptoms. The findings have several important clinical implications for the differentiation of post-vaccinal headache and other primary as well as secondary headaches.