Postpartum Reversible Cerebral Vasoconstriction Syndrome Presenting with Radiological Plethora.

Reversible cerebral vasoconstriction syndrome (RCVS) is a clinicoradiological syndrome characterized by segmental vasoconstriction of cerebral arteries with resolution in most patients within 1 to 3 months. It has been known to be a benign uniphasic reversible illness but cases of fulminant RCVS with mortality have also been reported. The symptoms can be varied with presentations like transient ischemic attack (TIA), ischemic stroke (IS), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and posterior reversible encephalopathy syndrome (PRES). We report a postpartum female with RCVS with radiological features of ICH, SAH, atypical PRES, and atypical clinical presentation as well. RCVS can be frequently missed unless there is a high index of suspicion. Hence clinicians should be aware of the typical and the atypical presentation of RCVS along with the radiological findings with the potential complications. Early suspicion and detection in the emergency help in recovery and reducing morbidity.

Isolated Primary MDR Tuberculosis of a Lumbar Spinous Process, in an Immunocompetent Patient, Mimicking a Spinal Tumour.

Spinal tuberculosis (STB) accounts for a large proportion of extra-pulmonary tuberculosis. STB usually begins in the peri-discal region of the vertebral bodies and isolated involvement of the posterior elements of the spine is very rare. MDR-TB is a global concern and has been described from patients with spinal tuberculosis as well. MDR - TB in an immunocompetent patient is an extremely rare condition. The authors present a case report of an isolated MDR-TB of a lumbar spinous process in an immunocompetent patient which mimicked an osseous tumour. The diagnosis, both radiological and bacteriological, and management of this rare condition is discussed and the authors stress the need for a high degree of suspicion in its diagnosis and management.