The authors investigated whether asymmetric ending of the clonic phase of secondarily generalized tonic clonic seizures (SGTCS) has lateralizing value concerning the hemisphere of seizure onset. They studied 70 patients with mesial temporal lobe epilepsy who underwent epilepsy surgery. Asymmetric ending of the clonic phase occurred in 43% of patients. The last clonic movement appeared on the upper extremity ipsilateral to the hemisphere of seizure onset in 83%.

Background The superior (SGA) and the inferior gluteal artery (IGA) perforator flaps are widely used in pressure‐sore repair and in breast reconstruction. The aim was to exhaustively depict the topographical anatomy of the whole system of perforators in the buttock. Methods Eighty lower‐extremity computed tomographic angiography (CTA) of patients (20 males/20 females, mean age 61‐years old, range 38‐81) were considered. The source artery, location, type, and caliber of gluteal perforators were analyzed. The location of perforators was reproduced using a standardized two‐dimensional grid on the coronal plane, centered onto defined bone landmarks. We defined “radiosome” the cutaneous vascular territory of a source artery inferred through the representation of its whole perforator system at the exit point through the deep fascia. Results A mean number of 25.6 ± 5.7 perforators in the gluteal region was observed, distributed as follows: 11.6 ± 4.8(45.2%) from SGA; 7.9 ± 4.5(30.8%) from IGA; 1.5 ± 0.8(5.8%) from fifth lumbar artery; 1.2 ± 0.8(4.7%) from internal pudendal artery; 1.2 ± 1(4.8%) from lateral circumflex femoral artery; 0.3 ± 0.7(1.2%) from circumflex iliac superficial artery. At least one large (internal diameter > 1 mm) SGA septocutaneous perforator was present in 77.5% of patients. Conclusions The gluteal region is vascularized by perforators of multiple source arteries. Septocutaneous perforators of SGA and IGA were planned along a curve drawn from the posterior‐superior border of the iliac crest to the greater trochanter. The lumbar artery perforators are clustered over the apex of the iliac crest; the internal pudendal artery perforators are clustered medially to the ischiatic tuberosity. Contributions can also come from the sacral and superficial circumflex iliac arteries.

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Dermatofibrosarcoma protuberans is an uncommon indolent fibroblastic skin tumor with a tendency for local recurrence. Its etiology is unknown, but there may be a link with vaccination sites, burn scars, and previous skin traumas. This report describes a curious case of dermatofibrosarcoma protuberans occurring secondary to a 16-year-old tattoo.