RESUMO
Sigmoid sinus diverticulum is a rare vascular anomaly often associated with pulsatile tinnitus. It can occur in cases of chronic otitis media squamous type (unsafe type) due to dehiscence of the sigmoid sinus plate caused by cholesteatoma. The presentation of which is that of pulsatile tinnitus. However, we present an unusual case of sigmoid sinus diverticulum occurring concurrently with chronic otitis media mucosal type (safe type) but in the absence of pulsatile tinnitus. This case report highlights the diagnostic challenges and management of this rare clinical scenario.
Assuntos
Cavidades Cranianas , Divertículo , Otite Média , Zumbido , Humanos , Divertículo/complicações , Divertículo/diagnóstico por imagem , Divertículo/diagnóstico , Zumbido/etiologia , Doença Crônica , Cavidades Cranianas/anormalidades , Cavidades Cranianas/diagnóstico por imagem , Cavidades Cranianas/patologia , Otite Média/complicações , Masculino , Tomografia Computadorizada por Raios X , FemininoRESUMO
Toxic encephalopathy is an important differential diagnosis in a child with encephalopathy and seizures. Subtle circumstantial evidence and apt neuroimaging features can significantly contribute to management, especially in a case of accidental exposure. 2, 4-D (ethyl ester) poisoning is a rare diagnosis, despite the common usage of this toxic compound as weedicide in northern India. The clinical similarity to the anticholinesterase poisoning, especially in the setting of agrochemical exposure is the main cause of under-diagnosis with usually fatal outcomes. We present an interesting case of accidental 2, 4-D (ethyl ester) poisoning in a child with typical neuroimaging features. A review of the literature regarding neuroimaging patterns of bilaterally symmetrical signal abnormalities involving basal ganglia in brain magnetic resonance imaging (MRI) from the point of view of clinical significance, is also discussed.