Interpeduncular fossa lipoma: a novel cause of oculomotor nerve palsy in childhood

Evaluation of Glucocorticoid Therapy in Asthma Children with Small Airway Obstruction Based on CT Features of Deep Learning

This study was aimed at exploring the treatment of asthma children with small airway obstruction in CT imaging features of deep learning and glucocorticoid. A total of 145 patients meeting the requirements in hospital were included in this study, and they were randomly assigned to receive aerosolized glucocorticoid (n = 45), aerosolized glucocorticoid combined with bronchodilator (n = 50), or oral steroids (n = 50) for 4 weeks after discharge. The lung function and fractional exhaled nitric oxide (FENO) indexes of the three groups were measured, respectively, and then the effective rates were compared to evaluate the clinical efficacy of glucocorticoids with different administration methods and combined medications in the short-term maintenance treatment after acute exacerbation of asthma. Deep learning algorithm was used for CT image segmentation. The CT image is sent to the workbench for processing on the workbench, and then the convolution operation is performed on each input pixel point during the image processing. After 4 weeks of maintenance treatment, FEF50 %, FEF75 %, and MMEF75/25 increased significantly, and FENO decreased significantly (P < 0.01). The improvement results of FEF50 %, FEF75 %, MMEF75/25, and FENO after maintenance treatment were as follows: the oral hormone group was the most effective, followed by the combined atomization inhalation group, and the hormone atomization inhalation group was the least effective. The differences among them were statistically significant (P < 0.05). The accuracy of artificial intelligence segmentation algorithm was 81%. All the hormones were more effective than local medication in the treatment of small airway function and airway inflammation. In the treatment of aerosol inhalation, the hormone combined with bronchiectasis drug was the most effective in improving small airway obstruction and reducing airway inflammation compared with single drug inhalation. Deep learning CT images are simple, noninvasive, and intuitively observe lung changes in asthma with small airway functional obstruction. Asthma with small airway functional obstruction has high clinical diagnosis and evaluation value.

Complete third nerve palsy as a presenting feature of an interpeduncular lipoma

BACKGROUND

Intracranial lipomas are rare, benign lesions, of congenital origin commonly found incidentally on imaging studies.

METHODS

We describe a case of interpeduncular lipoma in an 18 year-old female presenting with a painful left complete oculomotor (IIIrd) nerve palsy and associated headache, which to the best of our knowledge has not been reported in an adult patient.

RESULTS

Following eye patching and steroid treatment, at 6-week follow-up the patient's pain had significantly improved however the complete IIIrd nerve palsy remained.

CONCLUSIONS

Evidence suggests improvement will occur regardless with conservative management independent of radiological changes to the lipoma.

Ophthalmoplegic migraine: Migraine or oculomotor neuropathy?

Background

Ophthalmoplegic migraine (OM) is a rare condition characterized by the association of headaches and an oculomotor nerve palsy. The third cranial nerve is commonly involved in recurrent attacks, whereas involvement of the sixth and fourth nerves is uncommon. It is still debated whether an uncontrolled migraine or an oculomotor neuropathy may be the primary cause of ophthalmoplegic migraine.

Cases

We report two patients affected by OM with normal magnetic resonance imaging findings and a history of uncontrolled migraine before an attack of OM.

Conclusion

The cases reported allow us to hypothesize that OM may be considered a form of migraine rather than a cranial neuralgia. It is possible that different factors such as inflammatory or structural factors, may represent a vulnerability of the nerve during a severe migraine attack causing ophthalmoplegia.