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Liban Hussein Ahmed,1 Tadese Kebede Nadew,1 Amal Naleye Ali,2 Esmail Husein Mohamud,2,3 Mohamed Abdikarim Nur2 1Department of Neurosurgery, Jazeera Specialist Hospital, Mogadishu, Somalia; 2Faculty of Medicine, Somali National University, Mogadishu, Somalia; 3Department of Internal Medicine, Jazeera Specialist Hospital, Mogadishu, SomaliaCorrespondence: Liban Hussein Ahmed, Department of Neurosurgery, Jazeera Specialist Hospital, Mogadishu, Somalia, Email liban1909@gmail.comAbstract: Traumatic posterior fossa extradural hematoma (PFEDH) is a rare but potentially life-threatening condition. It is characterized by the accumulation of blood between the dura mater and occipital bone, leading to compression of the brainstem. We report the case of a 25-year-old male who presented to the emergency department following a fall, exhibiting confusion and a Glasgow Coma Scale (GCS) score of 14. Imaging revealed a significant acute epidural hematoma with associated mass effect, frontal hemorrhagic contusion, and right transverse sinus rupture. The initial hematoma volume was calculated to be 44.41 cm3 using the ellipsoid formula. Prompt neurosurgical intervention was performed, including craniotomy for hematoma evacuation and suction tube placement. Despite a decline in GCS score postoperatively, subsequent surgical management led to hematoma resolution and neurological improvement. The hematoma volume had decreased to 33.19 cm3 after the second intervention. After 15 days, the patient achieved a GCS score of 15. Our case highlights the importance of early recognition, emergent surgical intervention, and standardized management protocols for the treatment of PFEDH. In addition, it emphasizes the value of quantitative hematoma measurements in guiding treatment decisions. Prompt diagnosis and treatment are crucial to alleviate the potentially fatal consequences of this rare neurological condition.Keywords: posterior fossa hematoma, traumatic epidural hematoma, craniotomy, neurosurgery, traumatic brain injury

Aims/introduction: Limited studies have identified risk factors linked to the progression of diabetic peripheral neuropathy (DPN) in type 2 diabetes. This study examined the association of risk factors with change in neuropathy measures over 2 years., Materials and Methods: Participants with type 2 diabetes (n = 78) and controls (n = 26) underwent assessment of clinical and metabolic parameters and neuropathy using corneal confocal microscopy (CCM), vibration perception threshold (VPT), and the DN4 questionnaire at baseline and 2 year follow-up., Results: Participants with type 2 diabetes had a lower corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) (P ≤ 0.0001) and a higher VPT (P ≤ 0.01) compared with controls. Over 2 years, despite a modest reduction in HbA1c (P ≤ 0.001), body weight (P ≤ 0.05), and LDL (P ≤ 0.05) the prevalence of DPN (P = 0.28) and painful DPN (P = 0.21) did not change, but there was a significant further reduction in CNBD (P ≤ 0.0001) and CNFL (P ≤ 0.05). CNFD, CNBD, and CNFL decreased significantly in physically inactive subjects (P < 0.05-0.0001), whilst there was no change in CNFD (P = 0.07) or CNFL (P = 0.85) in physically active subjects. Furthermore, there was no change in CNFD (P = 0.82), CNBD (P = 0.08), or CNFL (P = 0.66) in patients treated with glucose lowering medication associated with weight loss, whilst CNBD (P = 0.001) decreased in patients on glucose lowering medication associated with weight gain., Conclusions: In participants with type 2 diabetes, despite a modest improvement in HbA1c, body weight, and LDL there was a progressive loss of corneal nerve fibers; except in those who were physically active or on glucose lowering medication associated with weight loss., (© 2022 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)