Reidman College

BackgroundIntraventricular simple cysts, often termed intraventricular arachnoid cysts, are rare benign intracranial lesions in children and are usually asymptomatic. When they become symptomatic, the presentation is typically related to obstructive hydrocephalus or seizures. Clear clinical triggers for abrupt decompensation are not well defined.ObservationsA previously healthy 6.9-year-old boy presented in stupor with acute obstructive hydrocephalus. The only notable antecedent event was repetitive, forceful balloon inflation the night before, followed by early-morning headache and vomiting. Examination showed papilledema, nuchal rigidity, and positive Kernig and Brudzinski signs without focal deficits. CT revealed triventricular hydrocephalus with a normal fourth ventricle. Cerebrospinal fluid (CSF) and blood studies were unrevealing for infection. Worsening hydrocephalus prompted emergent frontal ventriculostomy. MRI confirmed supratentorial obstructive hydrocephalus with trans-ependymal CSF seepage. Endoscopic third ventriculostomy through the ventriculostomy tract exposed a thin, transparent, vascularized cyst bridging the right lateral ventricle and third ventricle near the foramen of Monro. Endoscopic cauterization and fenestration of the cyst wall restored CSF flow, and the child recovered fully without deficit.LessonsThis case suggests that repetitive, forceful Valsalva-like maneuvers during excessive balloon inflation can acutely raise intracranial pressure and precipitate decompensation in children harboring an unrecognized intraventricular arachnoid cyst, resulting in acute obstructive hydrocephalus.

BackgroundA rise in loneliness among older adults since the COVID-19 outbreak, even after vaccination, has been highlighted. Loneliness has deleterious consequences, with specific effects on perceptions of the ageing process during the COVID-19 pandemic. Coping with stressful life events and the challenges of ageing may result in a perception of acceleration of this process.AimStudies have shown a buffering effect of an internal locus of control in the relationship between COVID-19 stress and mental distress. The current study examined whether loneliness predicts subjective accelerated ageing and whether internal locus of control moderates this relationship.MethodTwo waves of community-dwelling older adults (M = 70.44, s.d. = 5.95; age range 61–88 years), vaccinated three times, were sampled by a web-survey company. Participants completed the questionnaire after the beginning of the third vaccination campaign and reported again 4 months later on loneliness, internal locus of control and subjective accelerated ageing level in the second wave.ResultsParticipants with higher levels of loneliness presented 4 months later with higher subjective accelerated ageing. Participants with a low level of internal locus of control presented 4 months later with high subjective accelerated ageing, regardless of their loneliness level. Participants with a high level of internal locus of control and a low level of loneliness presented with the lowest subjective accelerated ageing 4 months later.ConclusionsThe findings emphasise the deleterious effects of loneliness and low internal locus of control on older adults’ perception of their ageing process. Practitioners should focus their interventions not only on loneliness but also on improving the sense of internal locus of control to improve subjective accelerated ageing.

The many branches of body psychotherapy have for many years suffered from the biblical syndrome of ‘The fathers ate the sour grapes, but the children's teeth are set on edge’. Wilhelm Reich's probl...