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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.

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.