scholarly journals A rare case of neurosarcoidosis occurred only in the medulla oblongata mimicking malignant brain tumor

2021 ◽  
Vol 12 ◽  
pp. 243
Author(s):  
Kentaro Murayama ◽  
Akihiro Inoue ◽  
Yawara Nakamura ◽  
Masayuki Ochi ◽  
Seiji Shigekawa ◽  
...  
Keyword(s):  
Medulla Oblongata ◽  
Rare Case ◽  
Clinical Signs ◽  
Accurate Diagnosis ◽  
Lower Limbs ◽  
Multisystem Disorder ◽  
Surgical Biopsy ◽  
Inflammatory Infiltration ◽  
Laboratory Findings ◽  
History Of

Background: Sarcoidosis is a multisystem disorder characterized by noncaseating epithelioid granulomas. However, neurosarcoidosis occurring only in the medulla oblongata is very rare and lacks specific imaging and clinical features. We report a rare case of neurosarcoidosis arising from the medulla oblongata alone, suggesting the significance of pathological findings for accurate diagnosis. Case Description: A 78-year-old woman with a history of rheumatoid arthritis was admitted to our hospital with a 3-month history of progressive numbness in bilateral lower extremities and gait disturbance. Neurological examination on admission showed mild bilateral paired paralysis of the lower limbs (manual muscle test: right 2/V; left 4/V) and marked numbness in the right lower limb. Neuroimaging revealed a solid mass with clear boundaries in the dorsal medulla oblongata appearing hypointense on T1-weighted imaging (WI), hyperintense on T2-WI, and hypointense on diffusion WI (DWI), with strong enhancement on gadolinium-enhanced T1-WI. Cerebrospinal fluid analysis showed moderately elevated levels of protein and lymphocytic cells. Biopsy to determine the exact diagnosis revealed histological findings of noncaseating epithelioid granulomas and inflammatory infiltration, consistent with sarcoidosis. Postoperatively, corticosteroid therapy with prednisolone was initiated as soon as possible, resulting in marked reductions in lesion size. Follow-up neuroimaging after 12 months showed no signs of recurrence. Conclusion: Neurosarcoidosis is difficult to diagnose from routine neuroimaging and laboratory findings. Accurate diagnosis requires careful identification of clinical signs, hypointensity on DWI, and morphological findings from surgical biopsy.

scholarly journals Psychogenic Equinovarus Caused by Dislocation of the Chopart Joint Complex

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Ichiro Tonogai ◽  
Koichi Sairyo
Keyword(s):  
Rare Case ◽  
Conversion Disorder ◽  
Accurate Diagnosis ◽  
Stressful Situation ◽  
History Taking ◽  
Foot Deformity ◽  
Neurologic Disorder ◽  
Chopart Joint ◽  
History Of ◽  
Psychological Events

Patients with conversion disorder (CD) present with weakness or unexplained movement disorder that may evolve from inciting psychological events, but presentation with rigid deformity is rare. Only one case of CD presenting as foot deformity with atraumatic rigid psychogenic equinovarus has been reported previously. Here we describe a rare case of psychogenic equinovarus in a physically healthy 10-year-old boy. He had noticed left equinovarus deformity upon waking abruptly but had no history of preceding trauma and no relevant medical history. Computed tomography (CT) images revealed dislocation of the left Chopart joint complex, but clinical examination did not suggest an organic neurologic disorder. On further history taking, he reported that he was under psychological stress because of being required to play baseball against his will. When he was given permission to withdraw from this stressful situation, the equinovarus improved without the need for surgical invention. This report highlights the importance of early and accurate diagnosis of psychogenic equinovarus, so that unnecessary surgery can be avoided. This is the first report of psychogenic equinovarus caused by dislocation of the Chopart joint complex that was confirmed with CT.

scholarly journals Wallenberg Sindrome: A Case Report

2018 ◽  
Vol 4 (1) ◽  
pp. 1141-1145
Author(s):  
German Fajardo ◽  
Sandra Orellana ◽  
Karla Reyes ◽  
Ariana Hernández ◽  
Allan Álvarez
Keyword(s):  
Medulla Oblongata ◽  
Lower Limbs ◽  
Lateral Part ◽  
Antithrombotic Treatment ◽  
Main Risk Factor ◽  
Ischemic Event ◽  
Specific Syndrome ◽  
Cerebellar Artery ◽  
History Of

Wallenberg's Syndrome represents 36 % of strokes in the brainstem. It is due to occlusion of the inferior cerebellar artery, affecting structures found in the cerebellum and the lateral part of the medulla oblongata. The main risk factor is atherosclerosis. The case is about a 57-year-old male patient with a history of lacunar infarcts in the cerebellum, type 2 diabetes mellitus, smoking and dyslipidemia. It begins with an intense and sudden occipital headache, without attenuating, concomitantly vertigo, hiccups, nausea, vomiting and paresthesia of lower limbs. At the physical examination, decreased peripheral pulses present Horner's syndrome, hypoesthesia, hypoesthesia in left hemiface, and contralateral hemibody, with ataxia, dysmetria and dysdiadochokinesia. MRI was performed with diffusion with diagnostic Hyperintense image of irregular morphology in the left lateral contour of the medulla oblongata, compatible with ischemic event (Wallenberg syndrome). Antithrombotic treatment and physical therapy was indicated. Patient was evaluated 2 months later showing ample improvement. It is a very specific syndrome, whose clinical manifestation depends on the anatomical region affected and abstracts the clinician from other diagnoses.

Leukocytoclastic Vasculitis Following COVID-19 Vaccination: A Case Report

2021 ◽  
pp. 001857872110673
Author(s):  
Juny Sebastian ◽  
Merrin Mathew ◽  
Veeranna Sharsty ◽  
Madhan Ramesh
Keyword(s):  
Causality Assessment ◽  
Leukocytoclastic Vasculitis ◽  
Lower Limbs ◽  
Temporal Association ◽  
Causal Association ◽  
Laboratory Findings ◽  
Case Presentation ◽  
The Past ◽  
History Of ◽  
Day By Day

Background: Hypersensitivity or Leukocytoclastic vasculitis (LCV) following the COVID-19 vaccination has been reported rarely all over the world. LCV can be induced by certain factors such as infections, autoimmune disorders, malignancy, or some classes of drugs. Case presentation: A 32-year-old man, who was a known case of seizure disorder from his childhood presented to the department of dermatology with itchy red lesions on extremities and abdomen for the past 1 month. He explains a history of COVID-19 vaccination 1-month back and experienced itching on his lower limbs on the same day at night. A gradual worsening of the condition was observed day by day. He was hospitalized and diagnosed as LCV through clinical and laboratory findings. Conclusion: This case highlights a temporal association with the event of vaccination. The causality assessment showed an indeterminate causal association to LCV with COVID-19 Vaccination.

scholarly journals Trilostane Treatment of Canine Alopecia X in an American Pit Bull Terrier

2007 ◽  
Vol 76 (1) ◽  
pp. 113-120
Author(s):  
J. Kolevská ◽  
V. Brunclík ◽  
L. Bartošová ◽  
M. Svoboda
Keyword(s):  
Adverse Effects ◽  
Skin Biopsy ◽  
Treatment Option ◽  
Clinical Signs ◽  
Laboratory Findings ◽  
Hair Regrowth ◽  
Dermatological Examination ◽  
History Of ◽  
One Year ◽  
Hormone Imbalance

This paper describes the case of a one-year-old female American Pit Bull Terrier, presented with the history of progressive baldness. The initial clinical signs were demonstrated by symmetric, primarily non-pruritic alopecia that began in the perineal, genital, and ventral abdominal regions and propagated cranially to the thorax and to the neck. Based on physical and dermatological examination, laboratory findings, and results of skin biopsy, a hormone-responsive dermatosis was diagnosed. Once hypothyroidism and hyperadrenocorticism were ruled out, with the help of hormonal tests, the diagnosis was specified as alopecia X. The first treatment option recommended for the patient and subsequently completed was ovariohysterectomy. After three months, the owner reported improvement; the dog was almost covered with hair. The patient was presented again six months later, showing almost the same dermatological symptoms, which, however, were of a more striking character than before ovariohysterectomy. Again a series of hormonal tests was carried out. Considering the elevated basal and post-adrenocorticothropin stimulation progesterone concentrations, the final aetiology of the disease was determined as an adrenal sex hormone imbalance. Therefore trilostan therapy was initiated. The trilostan dosage of 8 mg/kg/day was divided and given 2 times daily. This treatment led to complete hair regrowth in the dog within four months. No adverse effects associated with trilostane were recognized.

scholarly journals A Rare Case of Pericardial Tuberculoma with Impending Tamponade in a 52-Year Old Woman: A Case Report

2021 ◽  
Author(s):  
Clement `C Kabakama ◽  
Zahra Daudi Khan ◽  
Pilly Chillo ◽  
Amos Rodger Mwakigonja
Keyword(s):  
Heart Failure ◽  
Ct Scan ◽  
Rare Case ◽  
Mediastinal Mass ◽  
Rare Complication ◽  
Clinical Signs ◽  
Extra Pulmonary Tuberculosis ◽  
History Of ◽  
Extra Pulmonary ◽  
The Right

Pericardial tuberculoma is a rare complication of tuberculous pericarditis. It may mimic a compressive mediastinal mass, often misinterpreted as a mediastinal tumour. Since, it arises from the pericardium, pericardial tuberculoma invariably compresses structures of the heart and may present with features of either-sided heart failure depending on the side of the compression. Hereby, the authors present a case of a 52-year-old woman with progressive difficulty in breathing and symptoms of right-sided heart failure as well as clinical signs of impending cardiac tamponade following a history of extra-pulmonary tuberculosis. Echocardiogram examination revealed a mass compressing the right side of the heart but was inconclusive of the mass origin. CT Scan of the chest showed a mass arising from the pericardium. The mass was later surgically excised. Histopathology confirmed pericardial tuberculosis and a diagnosis of a pericardial tuberculoma was reached. Patient’s heart failure symptoms regressed after surgery and she was discharged to continue with anti-tuberculosis regime. This report discusses the inclusion of pericardial tuberculoma in the differential diagnoses of cardiac compressing masses, particularly in tuberculosis endemic areas and emphasise on prompt CT Scan imaging when echocardiogram is inconclusive.

scholarly journals Spontaneous and experimental poisoning by Merremia macrocalyx (Convolvulaceae) in cattle

2019 ◽  
Vol 39 (7) ◽  
pp. 447-453
Author(s):  
Luiz B. Brito ◽  
Givaldo B. Silva Filho ◽  
Hisadora A.S. Chaves ◽  
Ana L.O. Nascimento ◽  
Thaiza C. Braga ◽  
...  
Keyword(s):  
Clinical Signs ◽  
High Sensitivity ◽  
Wide Distribution ◽  
Northeastern Brazil ◽  
Control Group ◽  
Inflammatory Infiltration ◽  
Forest Zone ◽  
History Of ◽  
Gross Lesions ◽  
Plant Poisoning

ABSTRACT: The aim of this work was to describe the epidemiological, clinical and pathological aspects of spontaneous poisoning by Merremia macrocalyx in cattle in the Pernambuco state, northeastern Brazil, and to experimentally replicate the poisoning by this plant. To determine the occurrence of poisonings, 30 farms were visited in six municipalities at the Forest Zone of Pernambuco. The plant was found in nine farms, in which history of plant poisoning in cattle, and occasionally in sheep were also reported. Three outbreaks of spontaneous poisonings in cattle were studied. To replicate the disease experimentally, two steers received a single dose of 60g/kg and two steers received 80g/kg of the fresh leaves of M. macrocalyx in the trough for spontaneous ingestion. Two steers were also used as a control group. The main clinical signs observed in spontaneous cases consisted of restlessness, bloat, polyuria, diarrhea, and death within 48 to 72 hours after the onset of clinical signs. Cattle experimentally poisoned presented similar clinical signs to those observed in spontaneous cases. Gross lesions consisted of dryness and impaction of the rumen, omasum and reticulum contents. Abomasal content was fluid, the mucosa was hyperemic, with swollen folds and multiple ulcers. Similar lesions were observed in duodenum mucosae. Histologically, lesions observed in the abomasum and duodenum mucosa consisted of necrosis, hemorrhage and inflammatory infiltration of neutrophils and lymphocytes. The wide distribution and palatability of this plant, associated with the high sensitivity of the bovine species verified in this experiment, highlight the importance of this plant in spontaneous cases of poisoning in cattle.

scholarly journals Frontonasal dysplasia- a rare case report

2017 ◽  
Vol 5 (10) ◽  
pp. 4640
Author(s):  
Reena Sharma ◽  
Poojan Dogra ◽  
Kapil Malhotra ◽  
Vivek Kaushal
Keyword(s):  
Rare Case ◽  
Positive Family History ◽  
Clinical Signs ◽  
Developing Nations ◽  
Frontonasal Dysplasia ◽  
Male Baby ◽  
Antenatal Ultrasonography ◽  
Rare Case Report ◽  
The Face ◽  
History Of

Frontonasal dysplasia (FND) is a rare malformative complex affecting the frontal portion of the face, the eyes and the nose; it may occur singly or associated with other clinical signs. We report here a rare case of a full-term male baby who presented with features of FND. There was no history of consanguinity, no positive family history. Antenatal ultrasonography was normal. Though this baby did not survive because the defects were not compatible for the survival. But the developing nations still have handicap in the management of such cases in term of fiancés, surgical correction of such major defects, education and social support in these patients. 

scholarly journals Renal toxic disease in a cat

2021 ◽  
Vol 14 (2) ◽  
pp. 142-144
Author(s):  
Alex dos Santos ◽  
◽  
Mariana Martins ◽  
Keyword(s):  
Epithelial Cells ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Clinical History ◽  
Abdominal Ultrasound ◽  
Tubular Epithelial Cells ◽  
Moderate Amount ◽  
Laboratory Findings ◽  
Hospitalization Period ◽  
History Of

Clinical History: This 8-month-old, male, mixed breed domestic shorthaired cat had a recent history of acute apathy and anorexia. It remained under hospital care for two days, during which it did not produce any urine. On the second day of hospitalization, another cat from the same household was brought in with similar clinical signs. These cats did not have any history of recent ingestion of antibiotics or other medication. Furthermore, they did not have any street or yard access since they were kept in an apartment. Both cats died spontaneously after a brief hospitalization period. Laboratory Findings: Marked increase of urea and creatinine in both cats was reported (values not informed). On abdominal ultrasound, both cats had perirenal edema, and small amount of free abdominal effusion was observed in this cat. Necropsy Findings: There was moderate amount of translucent, slightly yellowish fluid within the abdominal cavity, thoracic cavity and pericardial sac. There was moderate diffuse pulmonary edema. Moderate perirenal edema was observed bilaterally. The kidneys were diffusely swollen and pale (Fig. 1). On histopathologic exam, the cortical tubular epithelial cells were swollen, with hypereosinophilic cytoplasm and nuclear changes (karyolysis, pyknosis and karyorrhexis). These cells were frequently detached from the basement membrane. Some other tubular epithelial cells were swollen and markedly vacuolated. Accompanying these changes, multiple granular casts filled the tubular lumens in the cortical and medullar regions (Fig. 2).

Waardenburg's Syndrome: Variations in Expressivity

1981 ◽  
Vol 89 (4) ◽  
pp. 666-670 ◽  
Author(s):  
Louis Wang ◽  
Collin S. Karmody ◽  
Hermine Pashayan
Keyword(s):  
Family History ◽  
Physical Examination ◽  
Phenotypic Expression ◽  
Clinical Signs ◽  
Accurate Diagnosis ◽  
History Of

Twenty-seven subjects with a family history of Waardenburg's syndrome were examined with respect to 18 specific characteristics of the syndrome, with particular emphasis in identifying the spectrum of the phenotypic expression of affected persons. Our results indicate that patients with the syndrome may have a variety of clinical signs, and an accurate diagnosis will therefore depend on a thorough and pertinent family history and physical examination.

scholarly journals Adenomatoid Odontogenic Tumor in the Posterior Mandible of a Young Child : A Case Report

2020 ◽  
Vol 47 (1) ◽  
pp. 87-92
Author(s):  
Dohee Sim ◽  
Yonjoo Mah
Keyword(s):  
Rare Case ◽  
Odontogenic Tumor ◽  
Adenomatoid Odontogenic Tumor ◽  
Radiological Findings ◽  
Surgical Biopsy ◽  
Anterior Maxilla ◽  
History Of ◽  
History Of Pain ◽  
Delayed Eruption ◽  
The Right

Adenomatoid odontogenic tumor (AOT) is a rare benign odontogenic jaw lesion. It usually occurs in the anterior maxilla and is mostly related to impacted canines in teenagers.<br/>A 3-year-old girl was referred from a local dental clinic due to delayed eruption of the right primary mandibular 2nd molar. There was no history of pain or swelling. Radiography revealed a large radiolucency lesion with radiopacities around the unerupted right primary mandibular 2nd molar. Surgical enucleation with extraction of the right primary mandibular 2nd molar and surgical biopsy were performed. Based on the clinical and radiological findings, this lesion was defined as an ameloblastic fibro-odontoma which often develops in the mandible of adolescents. However, this lesion was diagnosed as AOT from the results of the histological examination.<br/>This report aimed to present a rare case of AOT in the posterior mandibular area in a very young patient.

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