RESUMEN
Chiari in 1891 described a constellation of anomalies at the base of the brain inherited congenitally, the characteristic of which are (1) extension of a tongue of cerebellar tissue posterior to the medulla and cord that extends into the cervical spinal canal; (2) caudal displacement of the medulla and the inferior part of the fourth ventricle into the cervical canal; and (3) a frequent but not invariable association with syringomyelia or a spinal developmental abnormality. Chiari recognized four types of abnormalities. Presently, the term has come to be restricted to Chiari's types I and II, that is, to cerebellomedullary descent without and with a meningomyelocele, respectively. The association of Arnold-Chairi malformation and high cervical cord infarction is unusual. The most common syndrome, anterior spinal artery syndrome (ASAS), is caused by interruption of blood flow to the anterior spinal artery, producing ischaemia in the anterior two-thirds of the cord, with resulting neurologic deficits. Causes of ASAS include aortic disease, postsurgical, sepsis, hypotension and thromboembolic disorders. The authors present an interesting case of cervical cord infarction due to anterior spinal artery thrombosis in a patient of type 1 Arnold-Chiari malformation without any of the above predisposing factors.
Asunto(s)
Síndrome de la Arteria Espinal Anterior/etiología , Malformación de Arnold-Chiari/diagnóstico , Paresia/etiología , Insuficiencia Respiratoria/etiología , Adulto , Síndrome de la Arteria Espinal Anterior/diagnóstico , Malformación de Arnold-Chiari/complicaciones , Femenino , Humanos , Imagen por Resonancia Magnética , Estado Vegetativo Persistente/etiologíaRESUMEN
Extrapulmonary tuberculosis (TB) still presents a diagnostic and therapeutic challenge. Genitourinary TB constitutes about 20% of the extrapulmonary cases in regions where TB is endemic. Tuberculous infection of epididymis and testis is difficult to differentiate clinically from pyogenic infection, tumour or infarction. High-resolution sonography is currently the best readily available technique for imaging the scrotum and its contents, and accurate differentiation is important for proper diagnosis and treatment. The authors are presenting a unique case of chronic epididymo-orchitis with scrotal ulcers.
Asunto(s)
Epididimitis/complicaciones , Enfermedades de los Genitales Masculinos/etiología , Orquitis/complicaciones , Escroto , Tuberculosis de los Genitales Masculinos/complicaciones , Úlcera/etiología , Adulto , Enfermedad Crónica , Epididimitis/microbiología , Humanos , Masculino , Orquitis/microbiologíaRESUMEN
Pill-induced oesophagitis is well reported in people of all ages (range 3-98 years), with females outnumbering males by 1.5:1. Antibiotic pills, cardiac pills and non-steroidal anti-inflammatory drugs and alendronate are the most common culprits. We report a case of fluoxetine-induced pill oesophagitis in a young adult without any underlying pathological abnormalities of the oesophagus.
Asunto(s)
Esofagitis/inducido químicamente , Fluoxetina/efectos adversos , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Humanos , Masculino , Comprimidos , Adulto JovenRESUMEN
Sheehan's syndrome, first described in 1937, is characterised by postpartum haemorrhage, pituitary necrosis, lactational failure and hypopitutarism. Presentation is variable and late presentations are not unusual due to partial ischaemic injury of the pituitary and gradual loss of endocrine function. A history of postpartum haemorrhage is usual but in some cases it is not elicited. Presentations such as malaise, fatigue, hypoglycaemia, decline in cognition, hyponatraemia, pancytopoenia, osteoporosis, secondary infertility, confusion and coma have all been reported. Two interesting cases of Sheehan's syndrome are presented that were diagnosed in the eighth decade; one due to atypical presentation of recurrent hyponatraemia and confusion, another from hypoglycaemic coma and symptoms of malaise and lethargy.