RESUMEN
Nonketotic hyperglycaemia (NKH) is a metabolic disorder typically observed in individuals with inadequately managed or undiagnosed diabetes mellitus (DM). Seizures are a common clinical presentation in NKH, and they tend to respond better to glucose correction than anticonvulsant therapy. MRI scans may reveal both subcortical T2/fluid-attenuated inversion recovery (FLAIR) imaging hypointensity and cortical changes, including cortical grey matter T2/FLAIR imaging hyperintensity and cortical or leptomeningeal enhancement, although cortical abnormalities are less frequently observed. These alterations are reversible when the underlying metabolic disturbance is effectively addressed. We suggest the role of iron accumulation as a mechanism for subcortical T2 hypointensity using T2* weighted imaging. Our cases substantiate the significance of subcortical T2/FLAIR hypointensity as a fundamental feature of this condition. In the appropriate clinical context, the recognition of these MRI abnormalities can help prevent misdiagnosis and facilitate timely treatment.
Asunto(s)
Quiste Epidérmico , Cuarto Ventrículo , Humanos , Quiste Epidérmico/diagnóstico , Quiste Epidérmico/patología , Quiste Epidérmico/cirugía , Cuarto Ventrículo/patología , Cuarto Ventrículo/diagnóstico por imagen , Masculino , Imagen por Resonancia Magnética , Femenino , Encefalopatías/diagnóstico , Encefalopatías/patologíaAsunto(s)
Hiperemesis Gravídica , Encefalopatía de Wernicke , Embarazo , Femenino , Humanos , Encefalopatía de Wernicke/diagnóstico , Encefalopatía de Wernicke/etiología , Encefalopatía de Wernicke/terapia , Hiperemesis Gravídica/complicaciones , Hiperemesis Gravídica/terapia , Tiamina , Imagen por Resonancia MagnéticaRESUMEN
Septic thrombophlebitis of the portal vein or one of its tributaries is referred to as pylephlebitis. It is unusual to have superior mesenteric venous thrombophlebitis. It frequently arises as a result of an infection in the portal venous system's drainage area, such as appendicitis or diverticulitis. Preoperative diagnostic imaging can help in the early diagnosis of acute phase pylephlebitis. A case of acute appendicitis complicated by an intra-abdominal abscess and superior mesenteric venous pylephlebitis is presented. Appendicectomy, abscess drainage, and antibiotic and anticoagulant treatment resulted in a full recovery. After two months, follow-up imaging revealed that the superior mesentric vein had been completely canalised.
RESUMEN
We report the case of a 40-year female patient, with no previous pathological history, presenting with right unilateral mechanical gonalgias with progressive onset, which increased climbing and going down stairs associated with hydarthrosis on clinical examination. After normal standard X ray, MRI showed a grease of hypertrophied Hoffa's grease with heterogeneous hyposignal on T1 (A), hypersignal on T2 with grease saturation (B), heterogeneously enhancing after gadolinium injection. The diagnosis of Hoffa's disease was made and the patient, after failure of a medical treatment, underwent arthroscopy for ablation of the Hoffa's grease with good evolution. Hoffa's disease, a cause poorly known of pain of the anterior compartment of the knee, is an acute or chronic inflammation of the infrapatellar adipose tissue. The physiopathologic theory speaks of repeated micro traumas resulting in inflammatory, hemorrhagic and fibrous changes of the adipose body of Hoffa; at the final stage of the disease osteochondroma occurs. MRI is the test of choice in the early forms. It shows poorly limited edematous infiltrate with hypersignal on T2 and hyposignal on T1, in a hypertrophic infrapatellar fat body. Treatment is based on general or local non-steroidal anti-inflammatory drugs, icing, and physiotherapy, associated with immobilization. In the case of failure of conservative treatment or of osteochondroma, arthroscopic resection is the treatment of choice.
RESUMEN
We here report the case of a 68-year old female patient presenting with a 6-month history of headaches and difficulty walking with cerebellar syndrome and balance disorders. Brain CT scan showed voluminous extradural median lesion in the Posterior Cranial Fossa (PCF) with calcifications, erosion in the occipital bone and peripheral contrast enhancement. MRI for characterizing lesions showed lesion extradural median process of PCF with hyposignal T1 (A), hypersignal T2 (B), Flair heterogeneous signal (C) with moderate peripheric enhancement (D) and diffuse hypersignal. Surgical treatment allowed complete tumor resection and histological examination confirmed the diagnosis of epidermoid cyst. Epidermoid cysts of the PCF are rare, they are slow-growing congenital tumors but they can occur at any age, without sex predominance. The most common intradural lesions occur at the level of the cerebellopontine and parasellar angle. CT scan shows well-defined tumor process without contrast enhancement. MRI allows for better characterization of the lesion as in our case. Differential diagnosis is made with arachnoid and dermoid cysts. Treatment of epidermoid cysts is based on surgery with complete removal of the tumor and the capsule.