RESUMEN
A venous aneurysm is the dilation of a single communicating venous system, with or without an associated arteriovenous fistula. The literature documents a few cases of such aneurysms. A seventy-year-old man came to our hospital complaining of increased urinary frequency for the last few months, a left leg ulcer, and swelling of the left lower quadrant of the abdomen for 2 years. Doppler ultrasonography and CT angiography demonstrated a large external femoral vein aneurysm with arteriovenous fistula formation. Surgeons managed the case surgically, using a PTFE interposition grating to ligate the artery-vein connection. Early diagnosis and appropriate management are necessary to avoid fatal complications such as pulmonary embolism and aneurysmal rupture.
RESUMEN
The standard surgical treatment for hydrocephalus is ventriculo-perioneal shunting with shunt failure being the most common complication. A rare and serious consequence is intestinal perforation. A malnourished 9-month-old boy presented with anal protrusion of the distal migrated ventriculoperitoneal (VP) shunt after 2 months of shunt placement. An abdominal X-ray and a brain CT scan were performed. Following the correction of malnourishment and electrolyte imbalance, the patient underwent surgical management, with uneventful discharge on the third day of the procedure. To avoid potentially fatal complications such as sepsis and meningitis, prompt diagnosis and treatment are crucial in these cases.
RESUMEN
Introduction: Schistosomiasis is the second most common parasite disease after malaria and a rare cause of appendicitis. It has been well-documented in the literature that schistosomiasis infection can have several multisystem effects. The unusual condition known as schistosomal appendicitis was initially described by Turner. Case presentation: We present a 48-year-old man with perforated appendicitis and schistosomiasis-like radiological findings. An appendectomy was performed, and schistosomiasis was confirmed by a histological study of the excised appendix. Praziquantel was administered in a single dosage. Conclusion: Although schistosomiasis is a rare cause of appendicitis and is very prevalent in developing nations, it should be considered when managing the condition. Anti-shistosoma drugs, which are not frequently used in post-appendectomy cases, should also be considered in the management.
RESUMEN
Introduction: Epilepsy is a neurological disorder characterized by abnormal, fast, synchronous neuronal discharge from the cerebral cortex. This abnormal excitation of the brain is usually short and self-limiting and can last anywhere from a few seconds to a few minutes. Neuroimaging and electroencephalography (EEG) are two widely used techniques to differentiate, verify, or exclude the diagnosis of epilepsy. The study aims to identify the frequency of EEG and MRI abnormalities in pediatric epilepsy and their correlations, aiming to improve diagnostic and treatment methods for these children. Materials and Methods: In this cross-sectional retrospective study, we evaluated pediatric patients aged 0-18 years who visited the Neurology Polyclinic between July 2022 and July 2023, were diagnosed with epilepsy in accordance with the ILAE 2014 epilepsy guidelines, and had undergone neuroimaging at the hospital's radiology department. Demographic information and clinical data, including the patient's age, gender, history of trauma, and congenital infection, were assessed. In all patients, a surface electroencephalogram (EEG) and brain magnetic resonance imaging (MRI) were performed. Results: Our study recruited 102 pediatric patients aged between 0-18 years, including 63 (61.8%) boys and 39 (37.2%) girls. An electroencephalogram (EEG) and MRI study have been done on all patients. An abnormal EEG study was seen in 79 (77.45%) participants, and an abnormal MRI was noted in 45 (44.1%) patients. The EEG and MRI were both abnormal in 34 cases (33.3%). The study found no significant correlation between magnetic resonance imaging and electroencephalographic findings (P =0.779). Conclusion: We observed multiple abnormalities on neuroimaging in pediatric epileptic patients. Even though our sample size was small, our results demonstrated that there is no statistically significant relationship between EEG and MRI results.
RESUMEN
The authors describe a rare case of traumatic vertebral artery dissecting pseudo-aneurysm with temporal lobe infarct in the pre-foramina segment of the left vertebral artery following knife injury of the left anterolateral neck area. A 40 years old man was admitted to the emergency department after a penetrating injury in the left anterolateral neck. On contrast-enhanced CT and Doppler ultrasonography in the neck, a dissecting pseudo-aneurysm of the vertebral artery was revealed. On day 2, MRI scanning revealed an ischemic infarct in the temporal lobe, which can be attributed to vertebral artery injury. The case was treated conservatively and the patient was discharged on the fourth hospital day. Owing to the position of the artery, traumatic vertebral artery dissections are uncommon, and they are linked with a high mortality rate due to aneurismal rupture and embolic impact of the dissections, culminating in stroke in young people. Our findings demonstrate the necessity of imaging in head and neck traumatic injuries to detect vertebral artery injuries far sooner in order to prevent complications.
RESUMEN
Polyorchidism is a congenital abnormality with distinct sonographic characteristics. In most cases, sonography is sufficient for diagnosis. In instances of complicated polyorchidism, an MRI may provide further information. Conservative treatment with sonographic follow-up is the best management option in uncomplicated cases. We present a rare case of polyorchidism with no associated complications that were managed conservatively with periodic follow-up imaging.
RESUMEN
Bifid mandibular condyle with ankylosis is an extremely rare condition and may arise as a developmental or traumatic defect. We report here a case of bilateral bifid mandibular condyle with ankylosis in a 6-year-old child. The patient had severe limitation of mouth opening and history of trauma 2 years ago.
RESUMEN
Necrotizing fasciitis and/or Fournier's Gangrene is a rare, life-threatening soft tissue infection that, if not treated promptly, can immediately develop into systemic toxicity. It affects the genital, perineal, and perineal tissues, predominantly affecting men but can be seen in women. The diagnosis is often made clinically but radiologic examinations are helpful to determine the extent of the infection and can aid preoperative planning. Treatment consists of immediate and aggressive surgical debridement of necrotized tissue, broad-spectrum antibiotics, and early resuscitation. Here, we present a 56-year-old male patient with Fournier's gangrene and describe the physical examination, bedside sonographic, and computed tomography findings. These findings can aid in the evaluation of patients with worrying symptoms so that antibiotics can be administered immediately and specialists can be consulted as needed.
RESUMEN
The aim of this study was to determine if central GABA mechanisms are involved in the cardiac vagal withdrawal at the beginning of exercise in man. We tested whether GABA-enhancing effects of a benzodiazepine could be observed in the HR change (R-R interval) immediately following the onset of a brief (10s) isometric contraction (60 % maximum) of the biceps muscle. The difference between the change in R-R interval occurring during the same phase of respiration was compared for placebo (Pla) and 10 mg oral diazepam (Dz) treatment in a double blind, crossover trial. ECG, blood pressure, respiration and biceps muscle tension were recorded. The subjects breathed to a metronome and R-R interval measurements were plotted for early and late inspiration and early and late expiration. The mean values of the first late expiration R-R interval immediately following the start of contraction in early expiration were compared to the same measurements without contraction. Contractions initiated following diazepam treatment resulted in a significantly greater reduction in R-R interval (P < 0.05) implying that GABAergic suppression of cardiac vagal outflow may be responsible for contraction-induced tachycardia in man.