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BackgroundPediatric intracranial aneurysms are rare. SAH due to a ruptured intracranial aneurysm is potentially catastrophic; therefore, early identification and treatment are essential. Subarachnoid hemorrhage (SAH) is characterized on brain CT by the presence of blood in the subarachnoid cisterns and sulci.Case presentationAn eight-year-old female presented to the emergency room (ER) unconscious after a generalized tonic-clonic seizure. There was no history of fever or head trauma, or a personal or family history of epilepsy. At the ER, she was unresponsive, with dilated and unreactive pupils, absent brainstem reflexes, and a Glasgow Coma Scale (GCS) of three. Therefore, she was subsequently intubated. An emergency brain CT scan revealed a hyperdense, lens-shaped right parietal collection with surrounding brain edema and midline shift. The diagnosis of non-traumatic EDH was made. The patient underwent decompressive craniotomy and evacuation. Intraoperatively, the surgeons discovered that the hematoma was due to localized subarachnoid hemorrhage (SAH) secondary to a ruptured distal middle cerebral artery aneurysm. Histopathologic examination of the resected tissue excluded an infectious bacterial or mycotic etiology. After a stable in-hospital course, the patient was discharged. A year later, she remains seizure-free.ConclusionsA well-circumscribed aneurysmal SAH could rarely present as a lens-shaped hematoma, leading to the radiological diagnosis of an epidural hematoma. Good outcome remains likely in pediatric patients with aneurysmal SAH.

"Introduction: Ovarian cancer (OC) is often diagnosed at advanced stages. This study aimed to assess the Palestinian women’s knowledge about OC symptoms and determine the factors associated with having good knowledge. Methods: A cross-sectional study was conducted from July 2019 to March 2020 in the two main areas of Palestine: the West Bank and Jerusalem as well as the Gaza Strip. A translated-into-Arabic version of the validated OC awareness measure (OCAM) was utilized for data collection. Stratified convenience sampling was used to recruit adult women attending hospitals, primary healthcare centers, and public spaces at 11 governorates. The knowledge level was categorized into three categories based on the number of symptoms recognized: poor (0 to 4), fair (5 to 8), and good (9 to 11). Results: Of 6095 approached, 5618 participants completed the Arabic OCAM (response rate = 92.1%).A total of 5411 questionnaires were included in the analysis: 2278 from the Gaza Strip and 3133 from the West Bank and Jerusalem. Participants living in the West Bank and Jerusalem were older, of higher monthly income, and with more chronic diseases than those living in the Gaza Strip. The most frequently identified symptoms were ‘extreme generalized fatigue’ (n = 3821, 70.6%), ‘unexplained weight loss’ (n = 3607, 66.7%), and ‘increased abdominal size on most days’ (n = 3252, 60.1%). On the other hand, the least recognized symptoms were ‘feeling full persistently’ (n = 1553, 28.7%) and ‘difficulty eating on most days’ (n = 1971, 36.4%). Only 943 participants (17.4%) displayed good knowledge of OC symptoms. Participants from the Gaza Strip had a higher likelihood than participants from the West Bank and Jerusalem to have a good level of knowledge (21.0% vs. 14.8%). Being married, knowing someone with cancer, and visiting hospitals were all associated with a higher likelihood of having good knowledge level. However, living in the West Bank and Jerusalem was associated with a lower likelihood of having good knowledge. Conclusion: The overall knowledge of OC symptoms in this study was low. Educational interventions are needed to improve Palestinian women’s knowledge about OC symptoms." "مقدمة: غالبًا ما يتم تشخيص سرطان المبيض في مراحل متقدمة. هدفت هذه الدراسة إلى تقييم معرفة المرأة الفلسطينية بأعراض سرطان المبيض وتحديد العوامل المرتبطة بالحصول بالمعرفة . المنهجية: أجريت دراسة مقطعية في الفترة من تموز (يوليو) 2019 إلى آذار (مارس) 2020 في المنطقتين الرئيسيتين في فلسطين: الضفة الغربية والقدس وقطاع غزة. تم استخدام نسخة مترجمة إلى العربية من مقياس الوعي ذو المصداقة (OCAM) لجمع البيانات. تم جمع البيانات من عينات من النساء البالغات المتواجدات في المستشفيات ومراكز الرعاية الصحية الأولية والأماكن العامة في 11 محافظة. تم تصنيف مستوى المعرفة إلى ثلاث فئات بناءً على عدد الأعراض المعترف بها: ضعيف (0 إلى 4) ، متوسط (5 إلى 8) ، وجيد (9 إلى 11). النتائج: أكمل 5618 مشاركًا اختبار OCAM باللغة العربية (معدل الاستجابة = 92.1٪) ، وشمل التحليل 5411 استبيانًا: 2278 من قطاع غزة و 3133 من الضفة الغربية والقدس. كان المشاركون الذين يعيشون في الضفة الغربية والقدس أكبر سناً ، وذوي دخل شهري أعلى ، ومصابين بأمراض مزمنة أكثر من أولئك الذين يعيشون في قطاع غزة. كانت الأعراض الأكثر تحديدًا هي ""التعب الشديد العام"" (العدد = 3821 ، 70.6٪) ، ""فقدان الوزن غير المبرر"" (العدد = 3607 ، 66.7٪) ، ""زيادة حجم البطن في معظم الأيام"" (العدد = 3252 ، 60.1٪ ). من ناحية أخرى ،كانت أقل الأعراض التي تم التعرف عليها ""الشعور بالشبع باستمرار"" (العدد = 1553 ، 28.7٪) و ""صعوبة الأكل في معظم الأيام"" (العدد = 1971 ، 36.4٪). أظهر 943 مشاركًا فقط (17.4٪) معرفة جيدة بأعراض سرطان المبيض. كان لدى المشاركين من قطاع غزة احتمالية أعلى من المشاركين من الضفة الغربية والقدس في الحصول على مستوى جيد من المعرفة (21.0٪ مقابل 14.8٪). ارتبط الزواج ومعرفة شخص مصاب بالسرطان وزيارة المستشفيات بارتفاع احتمالية امتلاك مستوى معرفة جيد. ومع ذلك ، ارتبط العيش في الضفة الغربية والقدس بانخفاض احتمالية امتلاك المعرفة الجيدة. الخلاصة: كانت المعرفة العامة لأعراض سرطان المبيض في هذه الدراسة منخفضة. هناك حاجة إلى التدخلات التعليمية لتحسين معرفة المرأة الفلسطينية بأعراض سرطان المبيض."

IntroductionHaving a good awareness of ovarian cancer (OC) risk and protective factors could facilitate early diagnosis. This study aimed to assess Palestinian women’s awareness about OC risk and protective factors and to identify the factors associated with having good awareness.MethodsA cross-sectional study was conducted from July 2019 to March 2020 in the two main areas of Palestine: the West Bank and Jerusalem (WBJ) and the Gaza Strip. A translated-into-Arabic version of the validated OC awareness measure was utilized. Adult women attending hospitals, primary healthcare centers, and public spaces at 11 governorates were invited to participate. The awareness level was categorized based on the number of factors recognized: poor (0 to 5), fair (6 to 10) and good (11 to 15).ResultsOf the 6095 women approached, 5618 agreed and completed the questionnaire (response rate = 92.1%). The final analysis included 5411 questionnaires. The most identified modifiable OC risk factor was ‘being a smoker’ (n = 4024, 74.4%), whereas the least identified was ‘having in vitro fertilization treatment’ (n = 1652, 30.5%). The most identified non-modifiable OC risk factor was ‘having ovarian cysts’ (n = 3136, 58.0%), whereas the least identified was ‘having endometriosis’ (n = 1880, 34.7%). The most identified OC protective factor was ‘breastfeeding’ (n = 4770, 88.2%), whereas the least identified was ‘using the pill for a long time’ (n = 930, 17.2%). Only 820 women (15.2%) displayed good awareness of OC risk and protective factors. Women from the Gaza Strip were slightly more likely than women from the WBJ to have good awareness (16.4% vs. 14.2%). In contrast, post-secondary education, higher monthly income, being married, and knowing someone with cancer were associated with an increase in the likelihood of displaying good awareness.ConclusionThe overall awareness of OC risk and protective factors in this study was low. Educational interventions are needed to improve Palestinian women’s awareness.