We report the radio-clinical observation of a 21-year-old patient, referred for anterior chest parietal discomfort evolving for 3 months ago, with the notion of trauma.
The chest CT (computed tomography) scan detected a costal cartilage fracture without associated traumatic pulmonary or mediastinal changes.
This case illustrates the usefulness of imaging in the diagnosis and management of costal cartilage fractures, and for screening out differential diagnoses.
The aim of this study is to determine the interest of imaging in the study of fractures of the chrondro-costal cartilage.
Is to determine the CT value in chrondro-costal cartilage fracture.
Here we reported an interesting case of an 84-year-old woman with acute onset of paresis of left arm and paresthesia of left face and arm. The symptoms resolved within two hours. She also had a similar prior episode two weeks ago with only left arm paresthesia. Her MRI revealed different stages of lacunar ischemic lesions. Interestingly, the SWAN sequences showed lateralized rather than global multiple microhemorrhages over the right MCA and PCA territory, and the sulcal hyperintensity on FLAIR was also seen with no associated susceptibility effect and minimal enhancement, indicating probable cerebral amyloid angiopathy (CAA) based on Boston Criteria.
It has been acknowledged that the CAA could manifest with certain localization preference. Cerebral microinfarct and white matter disease in CAA have been more often observed in the posterior circulation territory, however the restricted lateralization reported in our case has not been seen. Since CAA is often diagnosed when the characteristic MRI findings are picked up incidentally, recognizing this as a potential “TIA mimic” will be important for guiding treatment due to its higher risk of bleeding. In summary, this case highlights that the CAA could present as restricted lateralized lesions and occur as transient neurologic deficits, which to our knowledge has not be reported before. Recognition of it as a potential manifestation of CAA will be valuable in the clinical diagnosis process.
Ependymomas, which account for 10% of pediatric central nervous system (CNS) tumors, arise from the ependymal cells that line the cerebral ventricles and the central canal of the spinal cord. Extraneural metastasis to lung is rare for ependymomas primary tumors. Repeated surgeries that disrupt the blood-brain barrier may contribute to haematogenous spread, but the mechanism remains unclear. We present a case of ependymoma with extraneural metastasis to lung in a child and discuss reported cases of extracranial metastatic ependymoma with this presentation.
Sinonasal inverted papilloma (SIP) is a benign tumor which originates from the sinonasal Schneiderian mucosa and accounts for 0.5% to 4% of all nasal and sinus neoplasm [1]. Pathologically, SIP epithelium inverts into submucosal stroma, which is different from other types of nasal papilloma. Unlike other benign tumors, SIP exhibits remarkable aggressive behaviors, including invasiveness, recurrence and malignant transformation [2]. Therefore, SIP can spread into the paranasal sinus, orbit, and cranial base, which can lead to poor prognosis for SIP patients [2]. Secondary squamous cell carcinoma is malignancy formation within the SIP. It is considered primary if there is no additional mucosal condition or secondary if it occurs in conjunction with an additional condition, which is estimated to occur in about 9% of cases [3]. The authors report the case of a 66-year-old woman with SIP and secondary SCC of the right nasal cavity. This study was adherent with the tenets of the Declaration of Helsinki.
Objective: To report our experience of direct carotid puncture and its use in the management of a large and rapidly expanding cavernous aneurysm.
Methods: A patient with a cavernous aneurysm that measured 25mm in maximum diameter underwent treatment with flow diversion. The initial treatment strategy was parent vessel occlusion however she failed the balloon occlusion test at 3 minutes. Due to extremely tortuous vessels stable access via a common femoral artery approach was impossible to achieve. We present our strategy, the post-operative management and long term results.
Results: Using a direct carotid puncture three telescoped Pipeline embolisation devices were successfully deployed across the neck of the cavernous aneurysm without complication. The puncture site formed a stable platelet plug after direct compression with an ultrasound probe for 90 minutes with no post-operative complications either intracranially or at the neck puncture site. At 2 year follow-up the aneurysm is completely excluded from the circulation.
Conclusion: Direct carotid puncture can be used as access for intracranial interventional procedures even if patients are on dual anti-platelet medication.
Introduction: Arachnoid cyst (AC) is a congenital, benign, extra-axial lesion often found incidentally on intracranial imaging and makes up almost 1% of all intracranial masses. It arises from the splitting of arachnoid membranes with components similar to the cerebrospinal fluid. It’s reported that AC can be complicated by chronic subdural haematoma in athletes with repeated head injuries.
Case report: we describe a case of a soccer player with an AC that underwent surgery for a chronic subdural haematoma with full recovery.
Material and method: From a PubMed research, we found 14 relevant studies reporting a total of 15 patients who met the inclusion criteria: playing soccer, subdural hematoma and arachnoid cyst.
Results: Patients underwent different surgical treatment. In the case of hygroma with no midline shift, a conservative treatment was performed. In all cases the reported follow up was a full recovery.
Discussion: Soccer is not usually considered a contact sport related to a high risk of head trauma or shaking head. From our review we can postulate that a soccer player with AC has an augmented risk to have a subdural haemorrhage, more rarely intracerebral haemorrhage.
Conclusion: ACs are common meningeal abnormalities. They may bleed after minor head trauma, although it is rare. Asymptomatic patients with known AC should be monitored by a neurosurgeon and decision to engage this patient in soccer sport participation is still controversial.
The sequelae of deep and extensive burns to the abdomen can lead to serious complications during pregnancy. Studies and publications covering this subject are scarce and outdated. The complications described arise during the 3rd trimester of pregnancy, and surgical treatments to address these complications can initiate premature labor with a risk of fetal demise. We felt it would be of interest to prevent these complications through surgical treatments performed before the pregnancy. The need to reconstruct large regions of abdominal scar tissue prompted us to turn to the Integra® dermal equivalent for preventative surgical treatments.
On January 19, 2020, a 28-year-old male presented to the hospital with a 2-day history of fever, occasional cough and headache. He disclosed that he worked in Wuhan [1], China (the center of novel coronavirus outbreak) and flew to Yinchuan on the day of admission.
Introduction: Diffuse axonal injury (DAI) is a major cause of disability in the pediatric patient. Herein we describe the MRI/DWI findings in a case with DAI. We also discuss the current role of CT and MRI with DWI in the evaluation of DAI.
Aim of the study: To stress the role of diffusion-weighted imaging in diffuse axonal injury.
Methods: A pediatric patient, who was hospitalized in the ICU, was submitted to MRI with DWI for the evaluation of brain lesions. The patient was scanned with T1-weighted images, T2-weighted images, FLAIR, T2*-weighted images and diffusion weighted images.
Result: Brain lesions caused by DAI were more conspicuous on diffusion-weighted images compared to FLAIR images. T2*-weighted images were a helpful adjunct in showing micro-hemorrhages.
Conclusion: T2*-weighted images and FLAIR images alone underestimate the true extent brain lesions in DAI compared to DWI.
Jigar Modi, Ahmed Altamimi, Ashleigh Morrell, Hongyuan Chou, Janet Menzie, Andrew Weiss, Michael L Marshall, Andrew Li, Howard Prentice* and Jang-Yen Wu*
Stroke and neurodegenerative diseases including Alzheimer’s disease (AD) are responsible for a major proportion of mortalities in the elderly. We have previously investigated novel mechanism-based therapies of AEURA in cell culture models against viral infection and in glutamate excitotoxity. In our new studies, we propose that the homeopathic formula AEURA could serve as a potential therapeutic agent for stroke & for AD. In examining AEURA treatment of PC12 cells exposed to glutamate excitotoxicity, hypoxia /re-oxygenation injury and A-Beta toxicity. We demonstrated an increased survival rate in AEURA treated cells by comparison to control cells. In examining the therapeutic potential of AEURA in PC12 cells this homeopathic agent was found to be neuroprotective against either glutamate induced toxicity, hypoxia /re-oxygenation stress or cell stress resulting from viral infection (with either HSV-1 or rhinovirus). Our ongoing studies involve examining the neuroprotective potential AEURA in vivo using rodent models of stroke & AD.
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