Artery of percheron infarction: case reports and literature review

Author(s):  
Dinkar Kulshreshtha ◽  
Pradeep K. Maurya ◽  
Rohit Chhirolya ◽  
Ajai K. Singh ◽  
Anup K. Thacker ◽  
...  

The artery of Percheron is a rare anatomic variant supplying the thalamus and the rostral midbrain. Infarct in this territory results in a wide array of neurological signs and symptoms causing diagnostic dilemma and management issues. We describe the clinical presentations in three cases admitted and evaluated for neurological symptoms and diagnosed as artery of percheron infarct after brain imaging. In one patient, the etiology turned out to be infective while the other two patients had cerebrovascular accident secondary to dilated cardiomyopathy and hyper homcystinimea respectively. Artery of percheron infarction is a rare entity and should be considered in patients with altered sensorium and behavioral manifestations with associated eye abnormalities. MRI brain is the investigation of choice to detect this rare variant of thalamic circulation. 

2018 ◽  
pp. bcr-2018-226469 ◽  
Author(s):  
Zi Qin Ng ◽  
Sharin Pradhan ◽  
Kim Cheah ◽  
Ruwan Wijesuriya

Haemorrhagic cholecystitis is a rare entity of acute cholecystitis that carries a high morbidity and mortality rate if management is delayed. Its clinical course can mirror that of acute cholecystitis. Characteristic findings on ultrasound or CT scan are useful clues to early diagnosis. Urgent cholecystectomy is required prior to progressing to perforation of gallbladder. Most of the literature are case reports with causes associated with anticoagulation. Herein, we described a morbidly obese patient with poorly controlled diabetes presenting with non-specific right upper quadrant pain and was subsequently diagnosed with haemorrhagic cholecystitis. A review of the literature was also performed to summarise the potential clinical presentations, distinctive imaging findings and management options available for this rare condition.


2015 ◽  
Vol 8 (2) ◽  
pp. 53-57
Author(s):  
Suma R Radhakrishnan ◽  
Asjeena Andru

ABSTRACT Introduction Metastatic tumors to the nose and paranasal sinuses are unusual with 167 cases published in the literature since 1951. The most common locations of the primary tumors are renal, lung, breast, testis, gastrointestinal tract and thyroid gland. There are only 26 documented cases of metastasis to the sphenoid sinus of which only six are from follicular carcinoma thyroid. Materials and methods Case reports of two patients referred to our department with ocular symptoms having a final diagnosis of follicular carcinoma thyroid with sphenoid sinus metastasis were studied and literature review done. Discussion Metastasis to the sphenoid sinus from follicular carcinoma thyroid is a rare entity and here we present two more cases of which one was an occult thyroid carcinoma. Both patients presented with ocular symptoms and the features of metastasis was the first sign of disease. Conclusion Early diagnosis of signs and symptoms relating to metastatic sphenoid disease is necessary as these are frequently the first presentation of malignancy. Even though cure of patients with sphenoid sinus metastasis has not been reported, palliation with resolution of morbidity is possible. How to cite this article Radhakrishnan SR, Andru A, Peetta-kkandy V. Follicular Carcinoma of Thyroid Metastasizing to the Sphenoid Sinus. Clin Rhinol An Int J 2015;8(2):53-57.


2021 ◽  
Vol 14 (6) ◽  
pp. e241178
Author(s):  
Asra Tus Saleha Siddiqui ◽  
Om Parkash

Gallbladder tuberculosis (TB) as an isolated infection and is an extremely rare entity even in parts of the world with endemicity. Though it has myriad ways of presentation, it can be cured successfully. We present a case of a 53-year-old man who presented with epigastric fullness and bloating with on and off low-grade fever for 2 months and significant weight loss. He underwent a CT scan, which showed a soft tissue gallbladder mass causing mural thickening of the antrum and lesser curvature. This was followed by a CT-guided core biopsy and gastric antrum biopsy via gastroscopy. Histopathology revealed chronic granulomatous inflammation in both samples. Various clinical presentations of gallbladder TB have been reported in literature, but to the best of our knowledge, the present case has a unique presentation and has never been reported before.


Author(s):  
Nidhi Gupta ◽  
Farhat Mazhari ◽  
Neha Varun ◽  
Reva Tripathi

Endometriosis is the second most prevalent benign gynaecological condition, in reproductive age women, defined as the presence of functioning endometrial tissue outside uterine cavity. Scar endometriosis is a rare entity with an incidence of 0.3-1% among reproductive age women following obstetric and gynaecologic surgeries. Complaints of pain, tender mass, cyclical association with menstrual cycle is almost pathognomonic. Here we present two case reports of scar endometriosis recently encountered at our institute – caesarean scar endometriosis and episiotomy scar endometriosis. The quoted episiotomy scar endometriosis incidence is about 0.06 - 0.07% while that of caesarean scar endometriosis is 0.03-0.4%.


2012 ◽  
Vol 50 (05) ◽  
Author(s):  
Z Visnyei ◽  
E Schafer ◽  
K Kardos ◽  
L Szentpétery ◽  
A Iványi ◽  
...  

2020 ◽  
Vol 01 ◽  
Author(s):  
Heba Nofal ◽  
Hayder Al-Masari ◽  
Marwan Mohammed Rashed ◽  
Reham Ainawi ◽  
Desh Idnani ◽  
...  

: Acute appendicitis in elderly continue to be a diagnostic dilemma as it raises both the suspicion of malignancy and increased risk of morbidity and mortality. Cancers of the appendix are rare and most of them are found accidentally on appendectomies performed for acute appendicitis. When reviewed, majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of appendix are only 0.08% of all cancers and the treatment remains controversial. This paper presents a case of 75-year-old female presented to emergency (ER) with signs and symptoms mimicking acute appendicitis, laparoscopic appendectomy was planned after a CT scan was done as it was suggesting acute appendicitis. The specimen then was sent foe pathology lab and a diagnosis of adenocarcinoma of the appendix was made.


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Jeff John ◽  
Ken Kesner ◽  
John Lazarus

Abstract Background Squamous cell carcinoma (SCC) of the scrotum was the first malignancy known to be associated with exposure to an occupational carcinogen—in this case, soot trapped in the breeches of chimney sweeps. Better civil rules and regulations and the replacement of hearths with other forms of heating have rendered SCC of the scrotum a rarity. We report two cases of scrotal SCC with vastly differing clinical presentations and management. Case presentation Case 1 had T1 N0 M0 disease and presented with a small (< 2 cm), innocuous-looking, non-healing ulcer of eight years duration. A punch biopsy revealed a superficially invasive SCC confirmed on immunohistochemical profiling. A wide local excision of the lesion was subsequently performed. Follow-up at three years showed no signs of recurrence. Case 2 presented with T4 N1 M1 disease and rapidly progressing locally destructive mass. A punch biopsy of the scrotal lesion confirmed invasive moderately differentiated focally keratinising SCC. The metastatic evaluation confirmed the presence of metastatic, extensive para-aortic lymphadenopathy. He was managed with cisplatin-based chemoradiotherapy. Conclusion Early detection and management of patients with SCC of the scrotum are essential. If the diagnosis is delayed, treatment options become limited, and the prognosis is poor. Notwithstanding the rarity of this disease, multicentre trials are needed to provide more precise guidelines as to the optimal management of these patients.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hideto Ikarashi ◽  
Naohiko Aketa ◽  
Eisuke Shimizu ◽  
Yoji Takano ◽  
Tetsuya Kawakita ◽  
...  

Abstract Background Chronic ocular graft-versus-host disease (oGVHD) is an ocular comorbidity of graft-versus-host disease (GVHD) that usually occurs concurrently with systemic manifestations. Failure to detect and treat oGVHD in its early stages may lead to progression of ocular signs and symptoms leading to oGVHD that is refractory to conventional treatment. Case presentation We report the clinical course of a 19-year-old male and a 59-year-old female with severe and progressive chronic oGVHD without concurrent systemic signs of chronic graft-versus-host disease (cGVHD). Although their systemic conditions had been stable, both suffered from severe oGVHD and were referred to our clinic. Both cases exhibited marked improvement in conjunctival inflammation and fibrotic changes after amniotic membrane transplantation (AMT). Both cases underwent keratoplasty eventually to stabilize ocular surface conditions and to improve visual function. Conclusions We reported the clinical outcomes of 2 cases of chronic oGVHD without concurrent systemic comorbidities that were treated with AMT. The clinician should be aware that cGVHD may persist in target organs even in the absence of concurrent systemic comorbidities following seemingly successful systemic treatment. A multidisciplinary team approach is essential in the early detection and therapeutic intervention for chronic oGVHD.


2021 ◽  
Vol 14 ◽  
pp. 2632010X2110253
Author(s):  
Paul Poku Sampene Ossei ◽  
William Gilbert Ayibor ◽  
John Taylor ◽  
Lawrence Agyemang ◽  
Kwabena Owusu Aninkora ◽  
...  

With the novel coronavirus disease 2019 (COVID-19) still in pandemic mode, according to the World Health Organization (WHO), the African continent has experienced continued growth in the total tally. According to the Africa Centers for Disease Control and Prevention (CDC), the virus has spread to almost all 54 recognized African countries. Figures from the CDC indicate that the highly affected countries include South Africa, Egypt, Nigeria, Algeria, Morocco, and Ghana (with more than 55 000 cases and 400 deaths as of the time of writing). The WHO and the United Nations have projected the ongoing pandemic could push medical practitioners toward high rates of clinical misdiagnosis. So far, the coronavirus pandemic has been more devastating and life-threatening than the usual seasonal flu. As of the time of writing, here is presently no proven vaccine or treatment for the disease, with the vaccines still under development; hence, a timely and accurate diagnosis could prove critical. Patients can also receive supportive care earlier if they are diagnosed early. Considering the fact that the coronavirus infection mimics the signs and symptoms of normal flu and other respiratory infections, a problem now emerges, where these symptoms are treated as manifestations of the deadly virus. This has caused a diagnostic dilemma in the absence of laboratory tests with new cases adding to the pool daily. In Ghana, many patients on suspicion of flu-like symptoms are sometimes denied the care so deserved due to the stigma associated with the disease, often in cases where laboratory tests are absent. This study is a postmortem report of a client who died while on admission at a private medical facility. It was an unconfirmed case of COVID-19, and the client was left unattended to and died, having spent 8 days on the ward. His test report was not done initially, but the diagnosis was purely based on suspicion. Nasopharyngeal swabs conducted on the fifth day of admission proved negative. Results became available on the day of the client’s demise. Postmortem findings established the actual cause of death, and it was not COVID-19 related.


2020 ◽  
pp. 1753495X2097079
Author(s):  
Niccole Ranaei-Zamani ◽  
Mandeep K Kaler ◽  
Rehan Khan

Proteus syndrome is a rare, multi-system, genetic syndrome characterised by atypical and excessive growth of skeletal tissue. Clinical presentations include abnormal musculoskeletal growth and cutaneous lesions. Due to its rarity, there have been a limited number of published case reports of Proteus syndrome. This is the first case report on the management of Proteus syndrome in pregnancy. We present the case of a pregnant woman with Proteus syndrome in her first pregnancy in a large teaching hospital and discuss the considerations and challenges faced in her antenatal, intrapartum and postnatal care.


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