Epidemiology, diagnosis, and assessment on non-traumatic subarachnoid haemorrhage

Author(s):  
Chethan P. Venkatasubba Rao ◽  
Jose Ignacio Suarez

Non-traumatic subarachnoid haemorrhage (ntSAH) is a neurological emergency. Clinical presentation is usually with severe headache, with or without abnormal neurological signs on clinical examination. NtSAH affects both males and females from 30 to 70 years, and the incidence increases with age. The incidence varies widely around the world. The gender distribution also varies in different countries, although overall the incidence is higher in women than in men. The commonest cause is rupture of an intracranial aneurysm, accounting for around 80% of cases. Diagnosis is usually by finding blood in the classical subarachnoid distribution on a cranial computed tomography scan. A number of grading systems are used to classify ntSAH.

2021 ◽  
pp. 004947552110365
Author(s):  
Abhijeet Kumar ◽  
Nirmal Prasad Shah ◽  
Narendra Pandit ◽  
Suresh Prasad Sah ◽  
Rakesh Kumar Gupta ◽  
...  

Gallbladder perforation still continues to perplex surgeons; 25 such patients diagnosed either pre- or intra-operatively and managed at our institute over the last 10 years period were analysed. Only eight were diagnosed pre-operatively, while a large majority (17) had a wrong initial working diagnosis. Symptoms and signs were variable. No blood investigation was specific. A computed tomography scan was generally better than ultrasound in detecting the perforation. All our cases were managed operatively with no mortality and a mean duration of hospital stay of 6.8 days. Most perforations were extra-hepatic (84%) and those of Niemeier’s type I (52.2%). Because of its varied clinical presentation, gallbladder perforation is often an intra-operative diagnosis, but early intervention carries a good outcome.


2019 ◽  
Vol 1 (1) ◽  
pp. 48-51
Author(s):  
Prerana Kansakar ◽  
Gangadhara Sundar

A 47-year-old male presented with left sided facial cellulitis of one-week duration associated with a painful mass over the left medial canthal area. On examination, there was a firm, tender mass below the medial canthal tendon. Computed tomography scan revealed a bulky, cystic lesion at the left inferomedial orbit and medial maxilla with bony remodeling suggestive of a chronic dacryocele. The patient underwent marsupialization of the dacryocele at the inferior meatus with silicone tube intubation. His symptoms of epiphora resolved after surgery. We describe a rare clinical presentation of dacryocele in an adult and its simple, yet effective treatment option.


2012 ◽  
Vol 126 (12) ◽  
pp. 1278-1280 ◽  
Author(s):  
N Grover ◽  
F Amen ◽  
A Gallimore ◽  
G Brookes

AbstractObjective:We present the first published description of a painful paraganglioma of the external auditory canal. Atypical histopathology made the diagnosis difficult. We discuss the potential pitfalls of clinical diagnosis and treatment of such a case.Clinical presentation:A 49-year-old woman presented with left-sided otalgia, hearing loss and tinnitus. Physical examination revealed a firm swelling arising from the superior portion of the left external auditory canal. A clinical diagnosis of otitis externa was made.Intervention:There was minimal response to medical treatment. The swelling was aspirated, leading to brisk bleeding. A tumour was suspected from the computed tomography scan, and confirmed by a biopsy. The patient underwent excision of the paraganglioma. The histopathology was atypical, making diagnosis difficult.Conclusion:Such unusual masses of the external ear should always be borne in mind, especially when dealing with atypical presentations of commonly encountered diseases. Clinicians should have a low threshold for early intervention with imaging and biopsy.


2003 ◽  
pp. 201-207 ◽  
Author(s):  
J De Schepper ◽  
J Schiettecatte ◽  
B Velkeniers ◽  
Z Blumenfeld ◽  
M Shteinberg ◽  
...  

OBJECTIVE: Macroprolactinemia, which can be detected by a polyethylene glycol (PEG) precipitation test, is a clinically and biologically heterogeneous condition. In this study, we analyzed whether the clinical presentation, the hormonal findings and the in vitro lactogenic activity differed between macroprolactinemic patients with and without circulating prolactin (PRL)-IgG complexes. DESIGN: Clinical data were reviewed and additional hormonal studies were performed in 50 hyperprolactinemic patients with macroprolactinemia. METHODS: Macroprolactinemia was identified by a PRL recovery after PEG precipitation of <50%, as measured by an automated commercial immunoassay system and circulating PRL-IgG complexes by an abnormal PRL binding to anti-IgG agarose. RESULTS: PRL-IgG complexes were found in 46 patients. The origin of hyperprolactinemia in these 46 patients was idiopathic in 33 patients, while a pituitary lesion or stalk magnetic resonance imaging or computed tomography scan was detected in 13 patients found compression. Galactorrhea was found in 11 of these 46 patients, while this condition was present in three of the four patients without circulating PRL-IgG complexes. The median free PRL concentration was significantly lower in patients with PRL-IgG complexes than in the group without complexes (243 vs 969 mIU/l; P<0.005), whereas median total PRL immunoreactivity and median PRL bioactivity in the Nb2 assay were not significantly different. In patients with circulating PRL-IgG complexes, Nb2 bioassay results correlated significantly with total PRL immunoreactivity (r=0.64; P<0.0001), but not with free PRL results (r=0.24; P<0.17). CONCLUSIONS: These results indicate that PRL-IgG complexes (i) account for most cases of macroprolactinemia--as identified by PEG precipitation--in hyperprolactinemic patients presenting with a variety of diagnoses, (ii) are not associated with a specific clinical presentation, (iii) can be found in patients with diverse pituitary pathologies, and (iv) possess an in vitro lactogenic activity in the Nb2 bioassay in relation to their immunoreactivity.


2014 ◽  
Vol 99 (3) ◽  
pp. 200-202 ◽  
Author(s):  
Leonardo Solaini ◽  
Anna Bianchi ◽  
Luigi Filippini ◽  
Laura Lucini ◽  
Edda Simoncini ◽  
...  

Abstract Metastases to the breast from extramammary tumors are rare. Several clinical, radiologic, and histologic signs can help to distinguish metastases from breast primary tumors. In the present study, we present a case of a left-sided breast metastasis from renal cancer in a 44-year-old woman whose clinical presentation was a mammary nodule in the upper internal quadrant. The patient underwent quadrantectomy with sentinel lymph node biopsy. The histology revealed a clear cell carcinoma. On computed tomography scan a 5×8-cm left renal mass with pulmonary, liver, and intrapericardial nodules was found. The patient underwent palliative care and died after 4 months. Metastasis to the breast is rare, but all of those clinical, radiologic, and histologic signs more typical of extramammary malignancies should always be considered in order to choose the best treatment strategy.


2021 ◽  
pp. 014556132110265
Author(s):  
Oratile Thobejane ◽  
Shivesh Maharaj

Juvenile nasopharyngeal angiofibroma is a benign vascular tumor seen predominantly in adolescent males in the second decade of life. Extranasopharyngeal angiofibroma includes vascular fibrous masses that occur outside the nasopharynx. The diagnosis of an angiofibroma is based on the clinical presentation and imaging, with biopsies being avoided to avoid excessive bleeding. Computed tomography scan is considered sufficient for the diagnosis of extranasopharyngeal angiofibroma as it clearly delineates and identifies the tumor.


2008 ◽  
Vol 22 (1) ◽  
pp. 69-70 ◽  
Author(s):  
Ashish Mahajan ◽  
G Rao ◽  
Gordon Lees ◽  
Richard Owen

A 79-year-old woman with a fistula between a subphrenic abscess and the fundus of the stomach was successfully treated withn-Butyl-2-Cyanoacrylate. Conservative management had failed. Clinical presentation, treatment progress and imaging findings by computed tomography scan, ultrasound, gastroscopy and fluoroscopy are presented, along with a brief review of the relevant literature.


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