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Fulltext Scalp arteriovenous malformation : a case report

Mohamed WN, Abdullah NN, Muda AS

Malays J Med Sci, 2008 Jul;15(3):55-7.
PMID: 22570590 MyJurnal

We report a rare case of Arteriovenous malformation (AVM) of the scalp in a 30 year-old Malay gentleman who presented with painless forehead swelling since birth. Magnetic Resonance Imaging (MRI) and cerebral angiogram performed and the findings are discussed.

Matched MeSH terms: Forehead
Cutaneous Warm and Cool Sensation Thresholds and the Inter-threshold Zone in Malaysian and Japanese Males

Lee JY, Saat M, Chou C, Hashiguchi N, Wijayanto T, Wakabayashi H, et al.

J Therm Biol, 2010 Feb;35(2):70-76.
PMID: 28799915 DOI: 10.1016/j.jtherbio.2009.11.002

The purpose of this study was to investigate ethnic differences in cutaneous thermal sensation thresholds and the inter-threshold sensory zone between tropical (Malaysians) and temperate natives (Japanese). The results showed that (1) Malaysian males perceived warmth on the forehead at a higher skin temperature (Tsk) than Japanese males (p<0.05), whereas cool sensations on the hand and foot were perceived at a lower Tsk in Malaysians (p<0.05); (2) Overall, the sensitivity to detect warmth was greater in Japanese than in Malaysian males; (3) The most thermally sensitive body region of Japanese was the forehead for both warming and cooling, while the regional thermal sensitivity of Malaysians had a smaller differential than that of Japanese; (4) The ethnic difference in the inter-threshold sensory zone was particularly noticeable on the forehead (1.9±1.2C for Japanese, 3.2±1.6°C for Malaysians, p<0.05). In conclusion, tropical natives had a tendency to perceive warmth at a higher Tsk and slower at an identical speed of warming, and had a wider range of the inter-threshold sensory zone than temperate natives.

Matched MeSH terms: Forehead
A New Human-Biting Black Fly Species of Simulium (Simulium) (Diptera: Simuliidae) From Thailand

Takaoka H, Srisuka W, Saeung A

J Med Entomol, 2017 Jul 01;54(4):945-948.
PMID: 28399286 DOI: 10.1093/jme/tjx064

Simulium (Simulium) umphangense, a new human-biting species of black fly, is described based on females captured while attacking humans in western and central Thailand. The female of this new species is similar to those of S. (S.) indicum Becher, S. (S.) nigrogilvum Summers, and S. (S.) vanellum Huang et al. in the Simulium griseifrons species-group of the subgenus Simulium Latreille in having the frons densely covered with golden-yellow short hairs, a character rarely found in the subgenus Simulium. This new species is readily distinguished from the three related species by having a darkened fore tibia, a bare subcosta (or rarely with a few hairs), and an ovipositor valve not protruded posteriorly. Additional diagnostic characters of this new species are noted. This is the seventh human-biting species of black fly in Thailand.

Matched MeSH terms: Forehead
Facial Overfilled Syndrome

Lim T

Dermatol Clin, 2024 Jan;42(1):121-128.
PMID: 37977678 DOI: 10.1016/j.det.2023.06.007

Facial overfilled syndrome is an underdiagnosed aesthetic complication due to multiple incorrect placements of fillers. Facial distortion due to the overfilled syndrome can be exaggerated by facial expressions and movements and worsens with tissue ptosis due to aging. Commonly "produced" by practitioners depending solely on fillers as a single modality for treatment, the overfilled syndrome can be seen among those who had volume overload in the midface, forehead, chin, and nose. Incorrectly placed dermal fillers, poor selection of filler products, overzealous attempts by the injectors, and overly enthusiastic clients who "chase the lines" are the common causes of this phenomenon.

Matched MeSH terms: Forehead
Fulltext Langerhans cell histiocytosis in an adult - a rare, life-threatening and not to be missed

Lai JY, Tang MM, Priya G, Rajasuriar JS, Suganthi T

Med J Malaysia, 2014 Apr;69(2):95-7.
PMID: 25241821

Langerhans Cell Histiocytosis (LCH) is an uncommon neoplastic disorder characterized by accumulation of histiocytes in various tissues. The clinical manifestation is highly variable, ranging from an isolated skin rash or a single bony lesion, to fatal multi-organ failure. Due to its rarity and systemic involvement, the epidemiology of LCH is still not fully understood and most studies focus on the paediatric population. The extent of clinical involvement has important prognostic implications. Treatment options may be local or systemic depending on disease extent. Here we describe a rare case of adult onset LCH who presented with recurrent pneumothoraces, diabetes insipidus and papules and plaques over the scalp and forehead.

Matched MeSH terms: Forehead
Fulltext The use of paramedian forehead flap reconstruction after wide excision of basal cell carcinoma of the nose

Chew YK, Noorizan Y, Khir A, Brito-Mutunayagam S, Prepagaran N

Med J Malaysia, 2008 Oct;63(4):339-40.
PMID: 19385500 MyJurnal

Basal cell carcinoma (BCC) is an indolent, slow-growing malignant skin tumour. Approximately 70% of the tumours occur in the head and neck region. The nose is a common site for malignant skin tumours, such as basal cell carcinoma and squamous cell carcinoma because it is exposed to the sun. Excision of the BCC will leave the nose with a soft tissue defect which requires reconstruction. This report illustrates a case of BCC of nose whereby a wide excision and reconstruction was performed with a paramedian forehead flap.

Matched MeSH terms: Forehead
Dural arteriovenous fistula mimicking temporal arteritis

Naserrudin NS, Mohammad Raffiq MA

Clin Neurol Neurosurg, 2019 01;176:44-46.
PMID: 30504098 DOI: 10.1016/j.clineuro.2018.11.021

INTRODUCTION: Dural arteriovenous fistula (dAVF) is a very rare disease characterized by an abnormal vascular communication between arteries and veins in dural mater. It frequently presents with intracranial haemorrhage. Common presenting symptoms are headache and seizures.
CASE REPORT: Here we report a case of dAVF in which the patient's symptoms mimic a temporal arteritis in a 23-year-old woman. She presented with painful mass at forehead for 9 months with frontotemporal headache. Magnetic resonance imaging demonstrated dural arteriovenous fistula.
CONCLUSION: Since both diseases have different prognosis but similar presentation, it is important to ensure that there is no dural arteriovenous fistula in patient with suspected temporal arteritis.

Matched MeSH terms: Forehead
A New Simplified Visual Assessment Tool Describing Facial Morphotypes Observed and Desired in Asian Populations

Corduff N, Chao YY, Lam SC, Lim J, Lim TS, Lohia K, et al.

J Clin Aesthet Dermatol, 2020 Apr;13(4):23-34.
PMID: 33144908

OBJECTIVE: A group of established aesthetic physicians sought to develop treatment guidelines for assessing Asian face morphologies that reflect accurate and current beauty standards across Asia. DESIGN: Physicians completed surveys, debated, and voted on their clinical strategies and developed an alternative simplified visual tool of assessment (SVAT) that discerns between country variations in genetic and ideal morphotypes. SETTING: Electronic and paper surveys were followed by consensus debates and voting. PARTICIPANTS: Established aesthetic physicians practicing regularly on Asian patients. MEAUSUREMENTS: A clinically applicable SVAT was developed, which considered facial index, mid-face projection, upper and lower face shape, submalar contour, nose length and dorsal height, eye shape and brow shape, proportion of lips-to-lower face and ratio of upper-to-lower lip, and chin shape. RESULTS: For facial shape change, physicians always assessed the horizontal thirds, facial symmetry, and lip-chin complex profile, and also analyzed overall face shapes and Ogee curves. Criteria for creating oval-shaped faces was also defined and included treating indications, such as loss of angularity and bilateral masseter muscle hypertrophy, narrow jawlines, and longer and wider foreheads. Critical differences and similarities in country-specific aesthetic preferences, treatment requests, and considerations or strategies were uncovered, including the inadequacy of assessing overall peripheral facial shapes. CONCLUSION: This consensus establishes the assessment and treatment criteria for achieving ideal shapes for Asian patients. Specific descriptors are affected by variations; therefore, we present the visual criteria for Asian facial morphotypes. We hope that physicians new to treating Asian patients can use this clinical information to improve their practice.

Matched MeSH terms: Forehead
Single Port Endoscope-Assisted Excision of Forehead Lesions: An Innovative Way of Improving the Optical Cavity

Narayanan V, Jayapalan RR, Singh Sidhu A, Koh KMR

J Craniofac Surg, 2019 2 27;30(3):841-842.
PMID: 30807473 DOI: 10.1097/SCS.0000000000005185

Exophytic lesions involving the face present with an undesirable esthetic deformity and usually necessitate surgical excision. Conventional open excision techniques may lead to scar formation or pigmentation issues postoperatively. Minimally invasive endoscope-assisted surgery will be able to overcome these problems. However, this technique is not widely used because of the limited optical cavity working space, which hinders good visualization. We describe a technique to improve the optical cavity workspace to enable adequate endoscope-assisted surgical excision of forehead lesions in 2 cases. Foley's catheter and ribbon gauze were used in both cases to gain optical cavity workspace. The surgical technique is described in detail. One case had a frontal osteoma, whereas other was a nodular fasciitis of the forehead, confirmed by histology. Postoperative follow-up showed good outcomes at 1 year with no recurrences. Both patients were satisfied with the surgical and cosmetic outcomes. Endoscopic excision of a forehead lesion using the described technique is both safe and reliable. It is an excellent method for excising benign growths over the forehead while being cosmetically acceptable.

Matched MeSH terms: Forehead
Fulltext What eyes behold if missed can be a life taking event: a case of orbital cellulitis

Reza, M.Q., Johar, M.J., Ismail, M.S.

Medicine & Health, 2013;8(2):89-93.
MyJurnal

Orbital cellulits is one of the life threatening event that should not be missed out and must be distinguished from preseptal cellulitis. It is an infective process involving ocular adnexal structures posterior to the orbital septum. High index of suspicion is the key to its diagnosis as even experienced physician can miss. Here, we present a case of a 15-year-old female who presented with progressive swelling over right forehead associated with high grade fever, headache and purulent discharge of the swelling. She was diagnosed with sepsis due to right forehead abscess and was treated with intravenous antibiotics followed with admission. However, she suddenly deteriorated in the ward which required intubation and thereby Intensive Care Unit (ICU) admission. Investigations revealed fluid collection at right retrobulbar space suggestive of an abscess where emergency drainage was carried out. Unfortunately, her condition worsened and patient succumbed at day-10 of admission, despite all efforts.

Matched MeSH terms: Forehead
Fulltext Sensitivity and specificity of vestibular evoked myogenic potential elicited by different tone bursts to diagnose peripheral vestibular disordered

Zuraida Zainun, Mohd Normani Zakaria, Din Suhaimi Sidek, Zalina Ismail

Malaysian Journal of Medicine and Health Sciences, 2014;10(2):9-17.
MyJurnal

Peripheral vestibular disorder (PVD) is serious and common. Clinically, giving an accurate diagnosis of PVD can be challenging. Vestibular evoked myogenic potential (VEMP) is an objective test to evaluate the integrity of vestibular organs, particularly saccule and/or inferior vestibular nerve. This study was performed to determine the sensitivity and specificity of VEMP using different stimuli. Fourty normal and 65 PVD subjects who fulfilled the inclusion criteria were recruited. While sitting comfortably, VEMP waveforms were recorded with active electrode on sternocleidomastoid muscle and negative electrode on upper forehead. Tone bursts (500, 750 and 1000 Hz) were delivered via headphones at 90 dBnHL and 5/s presentation rate. VEMP parameters for each stimulus (amplitude and latency of P1 and N1 peak) were analyzed accordingly. Receiver operating characteristic (ROC) was performed to determine the sensitivity and specificity of VEMP at different test frequencies. N1 amplitude of 750 Hz stimulus produced the most ideal sensitivity (65% on right and 63% on left) and specificity (83% on right and 78% on left). The importance of using a few tone bursts in VEMP test in order to minimize the false negative in cases might be encountered in clinics as the certain tone burst had inadequate sensitivity in detecting PVD cases. The 750 Hz stimulus produced the most ideal VEMP with adequate values of sensitivity and specificity, at least in this study.

Matched MeSH terms: Forehead
Fulltext Tuberculosis of the skull mimicking a bony tumor

Rosli FJ, Haron R

Asian J Neurosurg, 2016 2 19;11(1):68.
PMID: 26889285 DOI: 10.4103/1793-5482.172594

We present a rare case of calvarial tuberculosis mimicking a solitary bone tumor, which was surgically removed. A 52-year-old female presented with a right forehead swelling, which gradually enlarged over the course of 2 years, with no symptoms or raised intracranial pressure or neurological deficits. Plain and contrast-enhanced brain computed tomography scans were done, revealing a punched-out lesion of the right frontal bone, with a nonenhancing lytic mass. With an initial diagnosis of an intraosseous meningioma, and later on intraoperatively thought to be a metastatic tumor, the mass was excised along with a rim of bone. Histopathological examination results came back as caseous necrosis, highly suggestive of tuberculosis. The patient was then treated with a 1 year regimen of anti-tuberculous medications. Tuberculosis of the cranium is a rare entity, and can mimic tumors or multiple myeloma. A high index of suspicion and knowledge is required for an early diagnosis. A combined surgical and medical therapy is curative.

Matched MeSH terms: Forehead
Fulltext Gunshot-like wound caused by sling shot injury - a case report

Vinuthinee N, Azreen-Redzal A, Juanarita J, Zunaina E

Int Med Case Rep J, 2015;8:47-50.
PMID: 25709507 DOI: 10.2147/IMCRJ.S75198

We report a rare case of sling shot injury that presented with a gunshot-like wound with preseptal cellulitis, in a toddler. An 11-month-old Malay child presented with a gunshot-like wound over the forehead following sling shot injury. On examination, he had a deep circular laceration wound over the forehead, measuring 2.0 cm in diameter, with minimal bleeding. There was no obvious foreign body seen inside the wound and no palpable foreign body surrounding the wound. The gunshot-like wound was associated with left preseptal cellulitis. A skull X-ray showed a white opaque foreign body in the left frontal bone. Computed tomography (CT) scan of orbit and brain revealed a left comminuted fracture of the left orbital roof, and left frontal brain contusion with prelesional edema. Wound exploration was performed and revealed a 0.5 cm unshattered marble embedded in the left frontal bone. The marble and bone fragments were removed. The left preseptal cellulitis responded well to intravenous antibiotic and topical antibiotic.

Matched MeSH terms: Forehead
Fulltext Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia

Hanapi MS, Ghani SI, Sonny Teo KS, Wan-Embong WZ, Ariffin N, Wan Hitam WH

Cureus, 2018 Nov 03;10(11):e3539.
PMID: 30648072 DOI: 10.7759/cureus.3539

Acute lymphoblastic leukemia (ALL) manifestations in a child are varied. We report a unique and rare presentation of acute lymphoblastic leukemia in a child who presented with frontal swelling involving bilateral upper lids. A previously healthy one-year-old girl presented with progressively increasing frontal swelling of seven months duration. An examination revealed erythematous, firm, nontender forehead swelling that extended up to the medial part of bilateral upper eye lids. The extraocular muscle movement was normal. The anterior segment and fundus examination were also normal in both eyes. Other systemic examination revealed multiple leukemic cutis on the scalp. The cervical lymph nodes were also palpable with hepatosplenomegaly. A full blood picture (FBP) showed the presence of leucoerythroblastic blood film with 62% blast cells. Flow cytometry and bone marrow aspiration confirmed the diagnosis. Computed tomographic (CT) scan images revealed multiple well-defined hyperdense lesions at the subcutaneous skull with the largest lesion at the anterior glabella. Upon diagnosis, the patient was started on chemotherapy and the swelling resolved after one month post treatment. Extensive forehead swelling is a rare manifestation of acute lymphoblastic leukemia. A high index of suspicion aided with diagnostic investigations could help the doctors arrive at a correct diagnosis and treatment.

Matched MeSH terms: Forehead
Fulltext Frontonasal dysplasia in Yangon, Myanmar

Nang, Kham Oo Leik, Rhanye Mac Guad, Yuan, Seng Wu, Shwe, Yi Wai

Borneo Journal of Medical Sciences, 2020;14(3):51-55.
MyJurnal

Frontonasal dysplasia (FND) is an uncommon congenital anomaly affecting the eyes, nose and forehead. In this case report, a baby of a 22-year-old mother was diagnosed with a midline facial cleft, bifid nose and hypertelorism during an ultrasound scan at 29th week of gestation. Besides a history of miscarriage on first pregnancy, no other abnormalities findings were found in laboratory or radiological examination of the newborn. Counselling about abnormality and psychological support were given by both obstetrician and neonatologist during the antenatal period. The patient delivered vaginally at 36th week with spontaneous labour and no complication was observed. Further interventions including corrective treatment have been planned as they often interfere with important functions such as breathing and feeding. Thus, the paediatric surgical team decided to do the operation when the baby reaches one year old as then tissues have been developed to 90% of their eventual form to give optimal treatment results. Further life expectancy depends on the severity of the malformation and whether or not surgical intervention can improve the associated health problems. This case report raises the importance of awareness on the nutritional value of pregnant mothers especially carotene and folic acid intake which may be associated with the organ maldevelopment. Overall, this report outlined the management of this rare condition experienced by the patient, particularly in a resource-limited setting like Yangon in Myanmar and also reviewed the literature about the presentation and classification of this condition.

Matched MeSH terms: Forehead
Fulltext Head Cooling Prior to Exercise in the Heat Does Not Improve Cognitive Performance

Mazalan NS, Landers GJ, Wallman KE, Ecker U

J Sports Sci Med, 2021 03;20(1):69-76.
PMID: 33707989 DOI: 10.52082/jssm.2021.69

This study investigated the effectiveness of head cooling on cognitive performance after 30 min and 60 min of running in the heat. Ten moderately-trained, non-heat-acclimated, male endurance athletes (mean age: 22 ± 6.6 y; height: 1.78 ± 0.10 m; body-mass: 75.7 ± 15.6 kg; VO2peak: 51.6 ± 4.31 mL-1>kg-1>min) volunteered for this study. Participants performed two experimental trials: head cooling versus no-cooling (within-subjects factor with trial order randomized). For each trial, participants wore a head-cooling cap for 15 min with the cap either cooled to 0°C (HC) or not cooled (22°C; CON). Participants then completed 2 × 30 min running efforts on a treadmill at 70% VO2peak in hot conditions (35°C, 70% relative humidity), with a 10 min rest between efforts. Working memory was assessed using an operation span (OSPAN) task immediately prior to the 15 min cooling/no-cooling period (22°C, 35% RH) and again after 30 min and 60 min of running in the heat. Numerous physiological variables, including gastrointestinal core temperature (Tc) were assessed over the protocol. Scores for OSPAN were similar between trials, with no interaction effect or main effects for time and trial found (p = 0.58, p = 0.67, p = 0.54, respectively). Forehead temperature following precooling was lower in HC (32.4 ± 1.6°C) compared with CON (34.5 ± 1.1°C) (p = 0.01), however, no differences were seen in Tc, skin temperature, heart rate and ratings of perceived exertion between HC and CON trials at any time point assessed (p > 0.05). In conclusion, despite HC reducing forehead temperature prior to exercise, it did not significantly improve cognitive performance during (half-time break) or after subsequent exercise in hot environmental conditions, compared to a no cooling control.

Matched MeSH terms: Forehead

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