Tinnitus is a common auditory symptom. Dysfunction in the autonomic nervous system (ANS) is an essential part of the etiopathogenesis of tinnitus. ANS regulates heart rate and heart rhythm and can lead to ventricular repolarization changes, which can cause malignant ventricular arrhythmias. T wave peak-to-end T(p-e) interval and T(p-e)/QT ratio are known ventricular arrhythmia indexes, and the index of cardiac-electrophysiological balance (iCEB) is a novel index that can be used to predict the risk of malignant ventricular arrhythmia. The goal of the study was to investigate these ventricular arrhythmia indexes in patients with tinnitus. The study population consisted of 240 patients with tinnitus and 240 healthy subjects. A standard 12-channel surface electrocardiogram was applied to both groups. T(p-e) interval, QT interval and QRS duration were determined. Corrected QT (QTc) was determined via Bazett’s formula. To predict ventricular arrhythmia, iCEB (QT/QRS), T(p-e)/QT, corrected iCEB (QTc/QRS) and T(p-e)/QTc values were determined and compared between groups. Compared to the control group, QT (376.46 ± 36.54 vs 346.52 ± 24.51 ms), QTc (426.68 ± 24.68 vs 390.42 ± 24.04 ms), T(p-e) (75.86 ± 14.68 vs 62.42 ± 8.64 ms), T(p-e)/QT (0.201 ± 0.06 vs 0.180 ± 0.01) and T(p-e)/QTc (0.177 ± 0.06 vs 0.159 ± 0.02) were significantly higher in patients with tinnitus (p < 0.001 for all). QT/QRS (3.92 ± 0.68 vs 3.56 ± 0.32) and QTc/QRS (4.44 ± 1.03 vs 4.01 ± 0.64) were also significantly higher in patients with tinnitus (p = 0.018 and p = 0.008, respectively). In addition, significant positive correlations were found between T(p-e), T(p-e)/QTc ratio and disease duration (r = 0.792, p < 0.001; r = 0.500, p < 0.001, respectively). As a result, patients with tinnitus may have an increased risk of malignant ventricular arrhythmia.

Influence of COVID-19 disease on subarachnoid hemorrhage and intracerebral hemorrhage

Objective: The objective of the study was to outline the demographic, clinical, and radiologic features of traumatic pneumocephalus (TP) and to establish the parameters that may be associated with morbidity and mortality. Methods: A total of 73 TP patients (16 females, 57 male) with an average age of 32 years (range, 2 to 80 y) treated conservatively in the neurosurgery department of a tertiary care center were included in the study. Demographics, etiology, and location of TP, site of cranial fractures, occurrences of rhinorrhea, otorrhea, and meningitis, Glasgow Coma Scale, duration of hospitalization, and other parameters related to morbidity and mortality were investigated. Results: The most common cause of TP was traffic accidents (38.4%), and frontal (47.9%) and temporal (35.7%) lobes were affected most frequently. Incidences of meningitis and convulsion after TP were 8.4% and 12.3%, respectively. Otorrhea/rhinorrhea accompanied 80% of TP cases with meningitis, and patients with meningitis seemed to be hospitalized for a longer period. The mortality rate was 20% in TP patients with meningitis. In two thirds of cases, pneumocephalus was detected in epidural-subdural-subarachnoid or subarachnoid-intraparenchymal locations. Subdural hemorrhage and contusion accompanied TP in 22% of our patients. Conclusions: Our results indicate that TP can be treated medically in a vast majority of patients. Precautions and effective treatment against meningitis is crucial for minimizing morbidity and mortality in TP. Regression of pneumocephalus and recovery in terms of the neurological state can be followed closely with the Glasgow Coma Scale.