Coexistence of Two Different Types of Intracerebral Hematomas Caused by Arteriovenous Malformation

Spontaneous intracerebral hematomas usually produce the sudden onset of devastating neurological symptoms. We describe a case showing slowly progressive clinical symptoms followed by a sudden deterioration caused by two different types of intracerebral hematomas coexisting in the adjacent area. A 72-year-old female with a 2-year history of Alzheimer’s disease and a 3-month history of occasional headache and vomiting was admitted after she experienced the sudden onset of right hemiparesis and a speech disturbance. Neuroradiological examinations demonstrated two different types of intracerebral hematomas coexisting in the left temporal lobe. The patient underwent a left frontotemporal craniotomy. A solid hematoma was found immediately below the cortex and a large hematoma cavity, which contained degraded bloody fluid, was found below the solid hematoma. Histological study demonstrated an arteriovenous malformation (AVM). The AVM may have been responsible for the pathogenesis of these two different types of intracerebral hematomas. Initially, a silent intracerebral hemorrhage from the AVM and liquefaction of the hematoma probably formed the cavity and repeated small subclinical hemorrhages into the cavity during a prolonged period of time may have caused the growth of the inner hematoma. The sudden rupture of the AVM most likely caused the outer solid hematoma, resulting in the abrupt onset of hemiparesis and speech disturbance. This is the first case to demonstrate two different types of intracerebral hematomas coexisting in the adjacent area. A possible mechanism for this rare condition is discussed. Nepal Journal of Neuroscience, Volume 2, Number 1, 2005

Download Full-text

Non traumatic spinal epidural haematoma

Acute Medicine Journal ◽

10.52964/amja.0787 ◽

2019 ◽

Vol 18 (4) ◽

pp. 255-258

Author(s):

Naureen Abdul Khalid ◽

◽

Nainal Shah ◽

Keyword(s):

Magnetic Resonance Imaging ◽

Trauma Surgery ◽

Epidural Haematoma ◽

Rare Condition ◽

Sudden Onset ◽

Resonance Imaging ◽

Spinal Epidural Haematoma ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Spinal Epidural

Spinal epidural haematoma is a rare condition, which may be due to trauma, surgery, epidural catheterisation or disorders of coagulation. We report a case of 60 year old lady who was on warfarin for Atrial fibrillation (AF) presented with history of non-traumatic sudden onset pain in both legs and difficulty in walking. Magnetic resonance imaging (MRI) spine demonstrated epidural haematoma which was treated conservatively. Another dilemma was anticoagulation for AF. We examine the options to manage such case.

Download Full-text

Self-Induced Traumatic Macroglossia: Case Report and Literature Review

Case Reports in Otolaryngology ◽

10.1155/2019/6040354 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Abdullah A. Alarfaj ◽

Ali R. AlHayek ◽

Rashid Alghanim ◽

Nasser A. Al-Jazan

Keyword(s):

Endotracheal Intubation ◽

Trisomy 21 ◽

Rare Case ◽

Rare Condition ◽

Laryngeal Edema ◽

Bite Block ◽

Distress Symptoms ◽

First Case ◽

Tongue Swelling ◽

History Of

Traumatic macroglossia is an extremely rare condition characterized by a sudden edematous swelling of the tongue due to trauma. We report a rare case of traumatic macroglossia in a 37-year-old male with known trisomy 21 and epilepsy who presented to the emergency room with a huge protruded tongue due to aggressive behavior and a history of multiple tongue tractions, leading to sudden severe tongue swelling without any respiratory distress symptoms. The examination was unremarkable; fixable nasolaryngoscopy relieved bilateral vocal cord movement, and there was no laryngeal edema. The patient was managed immediately by endotracheal intubation to secure the airway, and corticosteroids were used to diminish and stop the tongue swelling. We describe the clinical management for such patients, highlighting the different causes of traumatic macroglossia. A few cases have been reported in the literature, but this is the first case to report self-induced traumatic macroglossia in a seizure-free patient managed successfully by endotracheal intubation, corticosteroids, a bite block, and warm wet dressing.

Download Full-text

Coexistence of Ectopic Posterior Pituitary and Sellar/Suprasellar Arachnoid Cyst: A Case Report

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616666200530210847 ◽

2020 ◽

Vol 16 (8) ◽

pp. 1055-1057

Author(s):

Suzan Saylisoy ◽

Goknur Yorulmaz

Keyword(s):

Case Report ◽

Rare Condition ◽

Optic Chiasm ◽

Magnetic Resonance Images ◽

Bright Spot ◽

Posterior Pituitary ◽

First Case ◽

History Of ◽

Diaphragma Sellae ◽

Ectopic Posterior Pituitary

Background: The ectopic posterior pituitary (EPP) is a rare condition characterized by the ectopic location of the posterior pituitary lobe associated with varying degrees of stalk anomalies. The arachnoid cysts (AC) are benign lesions of the arachnoid, which account for 1% of all intracranial space-occupying lesions. Sellar/suprasellar ACs account for approximately 1% of all ACs. This is the first case of coexistence EPP with sellar/suprasellar AC. Case Report: A 67-year-old woman presented with 6 months history of fatigue. Her medical history was positive for irregular menstruation. Her endocrine examinations indicated low free thyroxine level with low TSH level, low oestradiol with low gonadotrophin level, slightly elevated prolactin level. Her Insulin-like growth factor-1 was below the normal levels. Dynamic contrast hypophysis MRI revealed a sellar cystic lesion with a dimension of 18 × 14 × 14 mm, extending from the suprasellar cistern, traversing the diaphragma sellae and reaching the level of the floor of the 3rd ventricle, consistent with sellar/suprasellar AC. There was no wall enhancement. The optic chiasm was compressed. The precontrast T1-weighted magnetic resonance images did not demonstrate the characteristic bright spot of posterior pituitary within the sella, which was higher in position, in the region of the median eminence. The pituitary stalk was not present. Conclusion: Although speculative, we have a hypothesis to explain how the EPP and sellar/- suprasellar AC coexist in this patient. Due to the absence of stalk, CSF may enter the sella tursica from the central aperture of the diaphragma sellae through which normally the stalk passes.

Download Full-text

Unusual presentation of temporal bone involvement in Churg–Strauss syndrome

The Journal of Laryngology & Otology ◽

10.1017/s0022215107007232 ◽

2007 ◽

Vol 122 (4) ◽

pp. 425-427 ◽

Cited By ~ 7

Author(s):

M Martinez Del Pero ◽

D Moffat ◽

H Sudhoff

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Otitis Media ◽

Sudden Onset ◽

Sensorineural Hearing ◽

Churg Strauss Syndrome ◽

First Case ◽

History Of ◽

Strauss Syndrome ◽

Churg Strauss

AbstractObjective:To present a case of a 60-year-old male with a history of sudden onset sensorineural hearing loss due to Churg–Strauss syndrome.Case report:The patient had a 20-year history of asthma and recurrent right otitis media and a nasal polypectomy four years prior to presenting with ear symptoms. Ear, nose and throat involvement is common in Churg–Strauss syndrome, usually manifesting as allergic rhinitis and chronic rhinosinusitis with or without polyps.Conclusions:Otolaryngologists play an important role in making an early diagnosis of this disease. To our knowledge this is the first case of Churg–Strauss syndrome primarily presenting with otological pathology: left sensorineural hearing loss and right otitis media.

Download Full-text

A Report of a Case Involving Body Lateropulsion with Numbness of the Ipsilesional Fingers Caused by a Small Infarction in the Dorsal Part of the Middle Medulla

Case Reports in Neurology ◽

10.1159/000486892 ◽

2018 ◽

Vol 10 (1) ◽

pp. 54-59

Author(s):

Yumiko Yamaoka ◽

Sadahiro Kishishita ◽

Yohei Takayama ◽

Seiji Okubo

Keyword(s):

Clinical Symptoms ◽

Functional Anatomy ◽

Sudden Onset ◽

Dorsal Part ◽

Section Thickness ◽

Resonance Imaging ◽

First Case ◽

Weighted Magnetic Resonance Imaging ◽

Vestibular Symptoms ◽

Left Middle

Based on the complexity of functional anatomy, a small infarction in the medulla can produce various types of clinical symptoms or signs depending on the location of this infarction. We describe the case of a 46-year-old man who presented with sudden onset of body lateropulsion to the left side and numbness of the ipsilateral fingers. 3-tesla diffusion-weighted magnetic resonance imaging with a section thickness of 2 mm revealed a small infarction in the dorsal part of the left middle medulla. To our knowledge, this is the first case report describing vestibular dysfunction apparent upon otoelectrophysiological examination but without vestibular symptoms or signs except for body lateropulsion.

Download Full-text

Congenital Uterine Arteriovenous Malformation Presenting as Postcoital bleeding: A Rare Presentation of a Rare Clinical Condition

Journal of Clinical Imaging Science ◽

10.4103/jcis.jcis_95_16 ◽

2017 ◽

Vol 7 ◽

pp. 11 ◽

Cited By ~ 2

Author(s):

Neha Agarwal ◽

Seema Chopra ◽

Neelam Aggarwal ◽

Ujjwal Gorsi

Keyword(s):

Arteriovenous Malformation ◽

Clinical Condition ◽

Stable Condition ◽

Rare Condition ◽

Management Options ◽

Rare Presentation ◽

Uterine Arteriovenous Malformation ◽

Multiparous Women ◽

History Of ◽

Risk Of Hemorrhage

Congenital uterine arteriovenous malformation (AVM) is an extremely rare condition with <100 cases documented in literature. We report multiparous women presenting to us with a history of postcoital bleed. Initial Doppler ultrasonography was consistent with features suggestive of AVM. Subsequently, computed tomography (CT) angiography confirmed the diagnosis. Embolization was chosen as the treatment because of the large extension of AVM and the risk of hemorrhage during hysterectomy. The patient was discharged in a stable condition with a plan of repeat embolization in the next setting. At 6 and 12 weeks of follow-up, she did not experience any further episodes of bleed. The purpose of this case report is to highlight the salient clinical features, diagnosis, and the management options available for this rare clinical condition.

Download Full-text

COVID-19 Seroepidemiology Study of Yazd Province, First Peak, Spring 2020: A Population-Based Cross-Sectional Study

Journal of Shahid Sadoughi University of Medical Sciences ◽

10.18502/ssu.v28i12.5780 ◽

2021 ◽

Author(s):

Mohammad Reza Mirjalili ◽

Seyedeh Mahdieh Namayandeh ◽

Mohammad Hasan Lotfi ◽

Mohammad Reza Dehghani ◽

Mohsen Mirzaei ◽

...

Keyword(s):

Clinical Symptoms ◽

Population Based ◽

Cross Sectional Study ◽

World Health ◽

Chi Square ◽

Cross Sectional ◽

First Case ◽

History Of ◽

Health Organization ◽

Chi Square Analysis

Introduction: SARS-COV 19 is a new coronavirus that was reported first time in 30 December 2019 in Wuhan, China. The first case of coronary heart disease in Iran was reported with a definitive test on February 18 in Qom province and the first case in Yazd province on 24 February. The World Health Organization (WHO) declared a Covid infection on March 11 a pandemic. The aim of this study was to investigate the seroepidemiology of COVID 19 in Yazd province. Methods: The present study was a cross-sectional population-based study of seroepidemiological type that was conducted to investigate the serological prevalence of Covid-19 in the period of 3 to 20 May 2020 in Yazd Province. Sampling was clustered and it was without age and sex restrictions. Information was collected including demographic information, adherence to health protocols, and history of clinical symptoms of COVID 19."Pishtaz ELISA Kit" was used to evaluate the IgG and IgM antibody titers against Covid 19. Chi-square, analysis of variance and T tests were used via SPSS.version.16 software Results: Mean age of the participants was 34.3± 17.5. Among the study participants, 507 (54.5%) were women. The serological prevalence of definite cases was 14.91% (95% CI: 12.91-16.91%) and suspicious cases were 2.85% (95% CI:1.85-3.85%). Ardakan City with 32% had the highest and Taft, Mehriz, Khatam with 7% had the lowest prevalence of COVID 19 (P <0.05). Conclusion: By June 2020, nearly 18% of the population of the province was definitively or suspiciously infected with COVID 19. Unfortunately, up to 25% of the population does not follow the early prevention protocols of COVID 19.

Download Full-text

Charcot Spine and Parkinson’s Disease

Case Reports in Orthopedics ◽

10.1155/2014/631346 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Philippe Loriaut ◽

Sylvie Rozenberg ◽

Patrick Boyer ◽

Benjamin Dallaudière ◽

Frederic Khiami ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rare Condition ◽

Response To Treatment ◽

Leg Pain ◽

First Case ◽

Circumferential Fusion ◽

History Of ◽

Charcot Spine ◽

Stable Fusion

Charcot spine is rare condition whose association with Parkinson’s disease (PD) has not been reported yet. The authors reported the cases of two patients with PD who developed Charcot spine. Both patients presented with a history of back pain and bilateral radicular leg pain. They had complete clinical and radiological assessment. Lumbar spine was involved in both patients. Clinical features and response to treatment were described. In the first case, circumferential fusion and stabilization were performed on the dislocated vertebral levels. A solid and stable fusion of the spine was obtained with satisfactory clinical outcome. Surgical treatment has been recommended to the other patient. In both cases, no other neurological etiology was found to account for Charcot spine. In conclusion, Charcot spine is associated with several neurological affections but has not previously been reported in association with Parkinson’s disease.

Download Full-text

Now you C me: a case of scurvy presenting as depression and anaemia

BMJ Case Reports ◽

10.1136/bcr-2019-233645 ◽

2020 ◽

Vol 13 (3) ◽

pp. e233645 ◽

Cited By ~ 1

Author(s):

In Sun Na ◽

Kevin Nguyen ◽

Bradley Potenzi ◽

Minz Cheah

Keyword(s):

Clinical Symptoms ◽

Serum Vitamin ◽

Rare Condition ◽

Developed Countries ◽

Clinical Findings ◽

Caucasian Woman ◽

Medical Practitioners ◽

Oral Supplementation ◽

Normocytic Anaemia ◽

History Of

A 66-year-old Caucasian woman was admitted with deteriorating mental health in the setting of background history of schizophrenia and depression. Her husband reported that she had increasing negative thoughts and decreased motivation regarding her self-care over a few weeks with no obvious stressors. Initial laboratory tests were unremarkable except for isolated normocytic anaemia. Physical examination revealed widespread bilateral upper limb ecchymoses and lower limb petechial rash. After an extensive investigation with no definitive results to explain her clinical presentations, diagnosis of scurvy was suspected and confirmed with severely low serum vitamin C level. Her clinical symptoms improved markedly with oral supplementation, which further supported the diagnosis of scurvy. Although it is now a rare condition in developed countries, this case will remind modern medical practitioners that patients with scurvy may present with non-specific symptoms and clinical findings such as depression and anaemia.

Download Full-text

Post Traumatic Chronic Encapsulated Intracerebral Hematoma in a Child: Case Report and Brief Review of Literature

Nepal Journal of Neuroscience ◽

10.3126/njn.v14i3.20527 ◽

2017 ◽

Vol 14 (3) ◽

pp. 46-48

Author(s):

Yam Bahadur Roka ◽

Mohan Karki

Keyword(s):

Case Report ◽

Clinical Symptoms ◽

Neurological Deficits ◽

Intracerebral Hematoma ◽

Diagnostic Modality ◽

Ct Guided ◽

Stereotactic Aspiration ◽

First Case ◽

History Of ◽

One Year

Chronic encapsulated intracerebral hematoma (CE-ICH) is an uncommon pathology that presents with headache, seizure, focal neurological deficits, or as a tumor. Trauma as a cause for CE-ICH is even rare and we believe this is the first case report as “trauma causing chronic encapsulated intracerebral hematoma “search in PubMed did not reveal any results. Repeated micro-hemorrhages in the CM or AVM are supposed to cause this lesion which progress from an earlier encapsulated phase to a thick capsulated stage with edema and clinical symptoms. CT or MRI is the diagnostic modality and it mimics, tumor, AVM, CM, angiomableed, cerebral abscess, metastatic mass or neurocysticercosis. Burr hole, mini-craniotomy, craniotomy, CT guided stereotactic aspiration or endoscopic excision are some options with equally good results. The present case with history of trauma was managed successfully with craniotomy with no recurrence for past one year. Nepal Journal of Neuroscience, Volume 14, Number 3, 2017, page: 46-48

Download Full-text