TUBERCULOUS BRAINSTEM ABSCESS

Neurosurgery ◽  
2009 ◽  
Vol 65 (6) ◽  
pp. E1206-E1207 ◽  
Author(s):  
Yu-Gang Jiang ◽  
Jing Chen ◽  
Yong Peng
Keyword(s):  
Early Recognition ◽  
Rare Condition ◽  
Poor Response ◽  
Antituberculous Therapy ◽  
Adequate Treatment ◽  
Mortality And Morbidity ◽  
Vulnerable Patients ◽  
Tuberculous Abscess ◽  
The Right ◽  
Mass Lesions

Abstract OBJECTIVE Tuberculous brainstem abscess is a clinically rare condition with potentially high mortality and morbidity. We present this report to draw attention to the importance of early recognition and adequate treatment of tuberculous brainstem abscess. CLINICAL PRESENTATION A 24-year-old man complained of longstanding fever, headache, and weakness followed by development of progressive slurred speech and hemiparesis of the right extremities. Magnetic resonance imaging revealed a large thick-walled cystic lesion lying within the brainstem. INTERVENTION The patient demonstrated a remarkable clinical recovery after microsurgery combined with a course of antituberculous therapy. Microbiological and histological findings confirmed the diagnosis of a tuberculous abscess. CONCLUSION Despite its rarity, the tuberculous brainstem abscess must be considered in the differential diagnosis of cystic brainstem mass lesions in vulnerable patients. When confronted with progressing neurological deterioration and poor response to antituberculous therapy, stereotactic or microsurgical management should be considered. Microsurgical excision combined with a complete course of antituberculous therapy in our patient led to a good outcome.

scholarly journals A rare case of mobile ball-like mass in right atrium associated with dilated cardiomyopathy

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Jing Dong ◽  
◽  
Yiqun Gao ◽  
Shunji Liang ◽  
Guorong Deng ◽  
...  
Keyword(s):  
Anticoagulant Therapy ◽  
Right Atrium ◽  
Early Recognition ◽  
Therapeutic Option ◽  
Venous Pressure ◽  
Rare Condition ◽  
Good Clinical Condition ◽  
Mobile Mass ◽  
2D Echocardiogram ◽  
The Right

Mobile thrombus in the Right Atrium (RA) is a rare condition. Here, we described a case of a 59-year-old male who presented in emergency room with complaints of progressively worsening dyspnea for 7 years. He was normotensive, had elevated jugular venous pressure and clear lungs. ECG revealed ventricular tachycardia. After successfully electrical defibrillation, an urgent 2D echocardiogram was obtained and revealed the enlargement of all heart chambers and a ball-like, mobile mass in the right atrium. An emergent CT scan revealed no sign of pulmonary embolism. Based on morphological features on echocardiogram, we highly suspected it as RA thrombus. The patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin since he rejected surgical treatment. Repeat echocardiogram was performed 7 days after anticoagulant therapy and showed disappearance of the RA mass. He was subsequently maintained on warfarin (INR=2.4- 3.0) and other medications for heart failure. The patient was followed up as outpatient and kept in good clinical condition. We concluded that early recognition of this rare situation and prompt management can help in preventing life-threatening complications, and anticoagulant therapy was a therapeutic option for RA thrombus.

scholarly journals Maternal and foetal outcome of eclampsia in a referral hospital

2017 ◽  
Vol 6 (3) ◽  
pp. 1021
Author(s):  
Mousumi Das Ghosh ◽  
Vinita Singh ◽  
Alokananda Ray
Keyword(s):  
Antenatal Care ◽  
Early Recognition ◽  
Mode Of Delivery ◽  
Ventilatory Support ◽  
Adequate Treatment ◽  
Mortality And Morbidity ◽  
Foetal Mortality ◽  
Threatening Condition ◽  
Life Threatening ◽  
Foetal Outcome

Background: Eclampsia is a life-threatening condition, common in developing countries with high fatality rate. It is a cause of maternal and foetal mortality and morbidity. The aim of the study is to determine the maternal and foetal outcome in Tata Main Hospital, Jamshedpur, Jharkhand, India.Methods: All cases of eclampsia were analysed from January 2012 to December 2014 from admission to discharge or death of the patient.  Age, parity, antenatal care, interval between attack and admission, blood pressure on admission, gestational age and mode of delivery were  taken into account. There were 135 cases of eclampsia out of 14572 deliveries. Only singleton pregnancies were analysed.Results: The incidence of antepartum eclampsia was 84.4%, intrapartum 3% and postpartum 12.5 %. 83% patients were primigravida, 33% less than 20 yrs,42% had no antenatal checkup and 45% had < 4 visits. Only 15% patients received magnesium sulphate before referral to the hospital. There were four maternal deaths and twenty-one perinatal deaths. Eleven patients needed ventilatory support, four developed pulmonary oedema,  two patients had respiratory depression and three patients had renal failure.Conclusions: Hypertensive disease in pregnancy requires proper antenatal care, early recognition and referral, adequate treatment and timely delivery.

Posterior Fossa Tuberculous Abscess Mimicking as Mass Lesions. MRI Features

2005 ◽  
Vol 18 (2) ◽  
pp. 180-184
Author(s):  
N.K. Bodhey ◽  
S. Purkayastha ◽  
A.K. Gupta
Keyword(s):  
Posterior Fossa ◽  
Mr Spectroscopy ◽  
Antituberculous Therapy ◽  
Mri Features ◽  
Tuberculous Lesion ◽  
Tuberculous Abscess ◽  
Neoplastic Lesions ◽  
Mass Lesions ◽  
The Brain ◽  
Lactate Peak

With rising incidences of immunosuppression including HIV infection and various other factors, a resurgence of tuberculosis has been observed. We herewith describe two cases of posterior fossa tuberculomas with presentation mimicking mass lesions. Tuberculomas in the brain are not uncommon in the developing countries. Although they can mimic neoplastic lesions, the early diagnosis of tuberculous lesion with MRI and MR spectroscopy results in prompt institution of antituberculous therapy. Hypointensity in T2-weighted sequence with ring enhancement and the presence of a prominent lipid-lactate peak on MR spectroscopy is highly suggestive of the tuberculous nature of the lesion.

scholarly journals Chorea Hyperglycemia Basal Ganglia Syndrome in a 63-Year-Old Male

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Michael Sperling ◽  
Roshan Bhowansingh
Keyword(s):  
Basal Ganglia ◽  
Early Recognition ◽  
Movement Pattern ◽  
Rare Condition ◽  
Subsequent Treatment ◽  
Glucose Levels ◽  
Caudate Head ◽  
Sugar Levels ◽  
The One ◽  
The Right

Chorea hyperglycemia basal ganglia syndrome (CHBG) is a rare condition that manifests within the setting of uncontrolled nonketotic diabetes mellitus. The objective of this case report is to present a patient found to have CHBG and provide a timeline in terms of his workup and subsequent treatment. We also present a commentary on the current understanding of the pathophysiology and treatment and how this was applied to our patient. The case involves a 63-year-old poorly controlled diabetic male who presented with a one-week history of uncontrolled choreiform movements of his left upper extremity. His initial glucose level was 339 mg/dl. HbA1C was 9.9%. CT scan of the head demonstrated an abnormal increased intensity within the right lenticular nucleus and right caudate head most likely due to microcalcifications/mineralization. MRI of the brain demonstrated nonspecific T1 and T2 hyperintense abnormalities in the same area about the right basal ganglia. These findings were consistent with the movement pattern he was displaying and with a diagnosis of CHBG. Gradual control of his blood sugar levels over 48 hours led to resolution of his choreiform symptoms. After better medication adherence as an outpatient, endocrinology follow-up 6 months after discharge found his HbA1C drop to a level of 7.1%. There was no recurrence of his symptoms. CHBG is a rare manifestation of poorly controlled diabetes but is the one that clinicians should be aware of. Early recognition and gradual treatment of elevated blood glucose levels appear to lead to total resolution of choreiform symptoms.

scholarly journals Evaluation of intestinal injuries from blunt abdominal trauma

2017 ◽  
Vol 4 (12) ◽  
pp. 3971
Author(s):  
Manoranjan U. D. ◽  
Nikhil S. ◽  
Chandrashekar M. S.
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Early Recognition ◽  
Diagnostic Methods ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
Antimesenteric Border ◽  
Reduction Of Mortality ◽  
Immediate Surgery ◽  
The Right

Background: To Evaluate the cause, presentation, anatomical extent, diagnostic method, management and outcome of intestinal injuries from blunt abdominal injuries.Methods: The study included 40 patients who underwent laparotomy for intestinal injuries from blunt abdominal trauma over a period of 1 year. A retrospective study was conducted, and the patients were evaluated with respect to the cause, presentation, anatomical distribution, diagnostic methods, associated injuries, treatment and mortality.Results: 40 patients with 58 major injuries to the bowel and mesentery due to blunt abdominal trauma were reviewed. The male to female ratio was 9: 1 and the average age was 32.51 years. There were 38 injuries to the small intestine including 1 duodenal injury, 13 colonic injuries and 6 isolated injuries to the mesentery. Out of 29 patients with intestinal perforation, free peritoneal air was present on plain abdominal and chest radiography in 23 patients. The commonest injury was a perforation at the antimesenteric border of the small bowel. Treatment consisted of laparotomy followed by simple closure of the perforation, resection and anastomosis and repair followed by protective colostomy for colonic perforations. 3 (7.56%) deaths were recorded, while 6 (15%) patients developed major complications.Conclusions: Bowel and mesenteric injuries may be significant and require immediate surgery or may be nonsignificant and permit nonsurgical treatment. Although early recognition of intestinal injuries from blunt abdominal trauma is difficult only by clinical assessment, nevertheless important to establish the right diagnosis due to its high infective potential. Intestinal perforations are often found accompanying other severe intra-peritoneal injuries which probably, are the determining factors in morbidity and mortality hence the main emphasis lying on early detection of the injuries and reducing the time from admission to the surgery thus playing a role in the reduction of mortality and morbidity associated with intestinal injuries following blunt trauma abdomen.

scholarly journals Collet-Sicard Syndrome from Thrombosis of the Sigmoid-Jugular Complex: A Case Report and Review of the Literature

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Tom P. B. Handley ◽  
Mohammed S. Miah ◽  
Samit Majumdar ◽  
S. S. Musheer Hussain
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Early Recognition ◽  
Sinus Thrombosis ◽  
Cranial Nerves ◽  
Rare Condition ◽  
Team Approach ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
The Right

Purpose. Collet-Sicard syndrome is a very rare condition characterised by unilateral palsy of the IX–XII cranial nerves. It is distinguished from Villaret syndrome by lack of presence of sympathetic involvement. Current literature contains only two cases of Collet-Sicard syndrome due to idiopathic internal jugular vein thrombosis.Method and Results. We report the case of Collet-Sicard syndrome in a 30-year-old man who presented with delayed development of XIth nerve dysfunction, due to internal jugular vein-sigmoid sinus thrombosis. A multidisciplinary team approach was employed in the management of this patient. At three-month followup, he had significantly improved swallowing, and repeat computed tomography neck scan showed partial recanalisation of the right internal jugular vein.Conclusion. In suspected Collet-Sicard syndrome, a focal primary lesion or metastasis to the temporal bone must be excluded, and sigmoid-jugular complex thrombosis should be considered in the differential diagnosis. Early recognition and treatment may result in significant functional recovery.

Unilateral Obturator Hernia in Elderly Male: A Case Presentation

2021 ◽  
Vol 23 (09) ◽  
pp. 496-505
Author(s):  
Dr. Praveen K Sharma MDRD ◽  
◽  
Dr. Dinesh J Babu ◽  
Dr. Samaran Meganathan ◽  
Dr. Pavankumar Mathapati ◽  
...  
Keyword(s):  
Preoperative Diagnosis ◽  
Rare Condition ◽  
Unknown Origin ◽  
Signs And Symptoms ◽  
Obturator Hernia ◽  
Medial Aspect ◽  
Elderly Male ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
The Right

OBTURATOR HERNIA is a rare condition of pelvic hernia in which abdominal contents protrude through the obturator canal. This condition can lead to bowel obstruction with relatively high mortality and morbidity due to bowel ischemia/gangrene. Most commonly presents in elderly thin females. It is primarily asymptomatic unless there is compression of the obturator nerve. Therefore, obturator hernia in the differential diagnosis of intestinal obstruction of unknown origin. Computed tomography is the modality of choice for preoperative diagnosis as obturator hernia. Sometimes mistakenly diagnosed as femoral or inguinal hernia on Ultrasonography. Its early diagnosis is challenging since the signs and symptoms are non-specific make a preoperative diagnosis difficult. We present a case of obturator hernia in an 81-year-old male with a known prostate carcinoma who presented with a painless soft swelling in the medial aspect of the right upper thigh and a negative Howship-Romberg sign.

Cryptococcal infection of the larynx: case report

2013 ◽  
Vol 127 (S2) ◽  
pp. S54-S56 ◽  
Author(s):  
N Mittal ◽  
P Collignon ◽  
T Pham ◽  
M Robbie
Keyword(s):  
Case Report ◽  
Vocal Fold ◽  
Histopathological Examination ◽  
Rare Condition ◽  
Cryptococcus Gattii ◽  
Causative Organism ◽  
Adequate Treatment ◽  
Imaging Results ◽  
The Right ◽  
Laryngeal Involvement

AbstractObjective:Laryngeal cryptococcosis is a rare condition. In this report, we describe the findings for and treatment of a 58-year-old man withCryptococcus gattiiinfection of the right vocal fold.Method:Case report and review of the relevant English language literature.Results:The patient presented with persistent hoarseness of voice. Laryngoscopy demonstrated an irregular, red lesion on the right vocal fold. Histopathological examination identified cryptococcus. The patient was treated with oral fluconazole 400 mg/day for eight weeks.Conclusion:Laryngeal involvement byCryptococcus gattiican result from prolonged inhaled corticosteroid therapy and proximity to eucalyptus trees. The clinical presentation, laryngoscopic findings and imaging results of laryngeal involvement may mimic a neoplasm. Histopathological examination can demonstrate the causative organism. Management consists of advice from an infectious disease specialist together with adequate treatment by antifungal agents.

CLINICAL CASE OF A MALIGNANT PECOMA OF THE LUNG

2019 ◽  
Vol 65 (5) ◽  
pp. 756-759
Author(s):  
Mikhail Postolov ◽  
Nadezhda Kovalenko ◽  
K. Babina ◽  
Stanislav Panin ◽  
Yelena Levchenko ◽  
...  
Keyword(s):  
Good Condition ◽  
Lung Neoplasm ◽  
Rare Condition ◽  
Epithelioid Cell ◽  
X Ray ◽  
Perivascular Epithelioid Cell ◽  
Mesenchymal Neoplasm ◽  
Preoperative Ct ◽  
Lymph Duct ◽  
The Right

Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm characterized by expression of both mela-nocytic and smooth muscle markers. Only 10 primary malignant lung PEComas have been reported up to date. We report a 59-year-old male who presented with a lung neoplasm, found during the routine X-ray examination. Preoperative CT-scan revealed the 3,5-cm-sized mass, located at the border of the upper, middle and lower lobes of the right lung. Patient underwent a thoracotomy, resection of the upper, middle and lower lobes of the right lung accompanied with mediastinal lymphadenectomy. After surgery, chylothorax was revealed. Conservative treatment was unsuccessful, so we performed laparoscopic clipping of the thoracic lymph duct. Patient was dismissed from hospital on the 10-th day after the second operation in good condition. In this report, we intend to increase the limited knowledge relating to natural history and optimal treatment of such a rare condition as a primary malignant lung PEComa.

Rheology of right ventricular outflow tract obstruction: sub-pulmonary membrane developing months after primary intervention to treat pulmonary atresia with intact interventricular septum

2021 ◽  
pp. 1-4
Author(s):  
Baher M. Hanna ◽  
Wesam E. El-Mozy ◽  
Sonia A. El-Saiedi
Keyword(s):  
Right Ventricular ◽  
Interventricular Septum ◽  
Pulmonary Atresia ◽  
Right Ventricular Outflow Tract ◽  
Rare Condition ◽  
Surgical Excision ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
The Right

Abstract Isolated sub-pulmonary membrane is a rare condition, the origin of which has been debatable. Transcatheter treatment of pulmonary valve atresia with intact interventricular septum by radiofrequency perforation and balloon dilatation to restore biventricular circulation is gaining more popularity, with improving results over time. We report in our experience of 79 cases in 10 years the development of a sub-pulmonary membrane in 4 cases: causing significant obstruction requiring surgical excision in one case that revealed a fibrous membrane on pathology; causing mild right ventricular outflow tract obstruction in another and not yet causing obstruction in 2. On cardiac MRI, the right ventricular outflow tract and the right ventricular outflow tract/pulmonary atresia angle showed no morphological abnormalities.

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