Radiologically visible gallbladder calcification due to schistosomiasis.

In four out of six gallbladders with schistosomal infestation, calcified granulomas were dense enough to be seen on abdominal radiographs. In one patient, faint calcification seen on a specimen of the excised gallbladder was not visible on the abdominal radiograph. Calcification on abdominal radiographs, especially serpiginous, seen in the region of the neck of gallbladder, appears to be the clue to the diagnosis of gallbladder schistosomiasis in people from endemic areas.

Autosomal recessive ataxia, slow eye movements, dementia and extrapyramidal disturbances.

An Arab family with an autosomal recessive form of spinocerebellar degeneration with slow eye movements is reported. Hitherto all the reported cases were either sporadic or of autosomal dominant inheritance. Associated are progressive intellectual impairment and extrapyramidal dysfunction as well as peripheral neuropathy and skeletal abnormalities. Muscle biopsy revealed non-specific mitochondrial abnormalities. The spectrum of eye movement abnormalities is discussed and the literature is reviewed. It is concluded that the hallmark of this syndrome (slow or even absent saccades) is one of a group of oculomotor abnormalities, all being characterized by delayed initiation and slow velocity. The syndrome seems to be related to the olivopontocerebellar degenerations, but differs in that there is in addition selective degeneration of certain tracts and nuclei in the mesencephalon and probably more rostral structures.

Late onset cerebello-pontomesencephalic degeneration.

Two siblings are presented with late onset, rapidly progressive truncal ataxia, paralysis of down-gaze and loss of up-gaze saccades in association with other oculomotor dysfunctions as well as dementia. Electron microscopic muscle studies revealed abnormal distribution and form of the mitochondria, probably being the ultrastructural basis of the pathologic changes. A neurological syndrome as that described here has not been reported before.

A giant spinal aneurysm with cord and root compression.

A patient suffering from a giant spinal aneurysm is reported. The diagnosis was made by angiography and dynamic computed tomography. The patient was treated successfully by clipping of the feeding artery.

CT of cerebral hydatid disease.

Six cases of cerebral hydatid disease (CHD) were seen in Kuwait over a period of 8 years. The typical CT appearance of a large well-defined spherical nonenhanced unilocular cyst was seen in four cases. Two unusual but characteristic types of calcification were seen, one in each of the remaining two cases.

Internal carotid artery occlusion in a young female with mitral valve prolapse.

A healthy 28 year old housewife presented with sudden right hemiplegia and aphasia. No predisposing factors could be ascertained apart from posterior cusp mitral value prolapse on two dimensional echocardiography. Extensive investigations confirmed the presence of cerebral infarction and persistent occlusion of the left internal carotid artery near its origin.

Human cystic hydatid disease: treatment with interrupted courses of mebendazole.

Ten patients suffering from intra-abdominal cystic hydatid disease, confirmed by serological tests and CT scan were treated with mebendazole. Each received 1800 mg day-1 either as a continuous therapy for 18 weeks, or as interrupted 6-week courses for a minimum of three courses, with intervals of 19-22 weeks between the courses. One patient dropped out of the study because of the development of jaundice 11 days after initiation of treatment. Nine patients were treated and followed up for the minimum of 20 months; of these, three patients received continuous therapy and six received interrupted therapy. One patient from the continuous therapy group showed progressive regression of his cyst, one showed minimal radiological changes only, while the third patient showed minimal radiological changes plus per-operative evidence of partial destruction of the cyst. Of those treated with interrupted therapy, one patient showed continuous progression in the size of the cyst with the appearance of a new cyst, although there was radiological and operative evidence of partial destruction of the cyst. One patient initially showed regression, but later progression of his cyst, while four patients showed no benefit from the treatment.

Abdominal hydatid disease: follow-up of mebendazole therapy by CT and ultrasonography.

Computed tomography (CT) and Ultrasonography (US) were used for the diagnosis and follow-up of 10 cases of abdominal hydatid disease receiving treatment with Mebendazole because of a relative contraindication to surgery. With the exception of one case, the duration of follow-up varied from 20-36 months. There was an estimated 60% decrease in cyst size in one case, 10% decrease in another, unchanged in six (mostly calcified ones) and 60% increase in one case. CT density measurements of fluid content of the cysts increased in three cases accompanied by increased internal echoes on US in one case. The number and size of daughter cysts were reduced in one case and more calcification was noted in two cases. There was an overall slow and poor response to treatment and four cases eventually had surgery.

CT of hepatic schistosomiasis mansoni.

Schistosomal periportal fibrosis produced a typical pattern on computed tomography in five patients. Low-density periportal tissue, present throughout the liver, enhanced strongly after the administration of contrast medium. While rounded in cross section, the thickened periportal tissue produced linear and branching patterns when imaged in longitudinal section. In all cases, the sonographic features were typical of schistosomal periportal fibrosis. A lack of awareness of the distinctive features of periportal fibrosis may result in a mistaken diagnosis of hepatic metastases.

Pituitary abscess.

Three cases of pituitary abscess are presented. The history of recurrent attacks of aseptic meningitis, together with radiological and clinical features suggestive of pituitary tumor, appear to form a fairly typical picture of the condition. Long follow-up was possible in two of the cases. There are no radiological features which distinguish the lesion from pituitary tumor, hence the importance of recognizing the significance of such a clinical presentation with radiological evidence of sellar enlargement. Pituitary abscesses seem to occur in preexisting pituitary tumors. The possible relationship with pituitary infarction is discussed.

Aspergilloma of paranasal sinuses - a common cause of unilateral proptosis in Sudan.

The radiological appearances of six cases of primary fungal granuloma of the paranasal sinuses with involvement of the orbit are described. All were caused by Aspergillus flavus. Bone destruction is common and can be extensive, but is characteristically well defined, especially in the lateral wall of the antrum. The discrepancy between the gross radiological changes and the mild symptoms is a feature very suggestive of the condition. Associated displaced "floating" teeth, expansion of ethmoids, and intracranial calcification are described and discussed. It is expected that, at least in certain localities where the incidence is significant, the radiologist would be able to help in recognising the earlier cases.