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1.
Cureus ; 16(6): e63265, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39070367

RESUMO

Lipiodol, an oil-based contrast medium first introduced in 1944, was commonly used for various radiological exams until the 1980s, when it was replaced by water-soluble contrast media due to complications such as arachnoiditis and chronic irritations. Due to its slow resorption rate, asymptomatic lipiodol deposits can occasionally be found incidentally. This case report describes a 93-year-old man who presented to the emergency department after a fall. A non-contrast head CT scan, performed to rule out subarachnoid hemorrhage, revealed numerous hyperdense droplets in the subarachnoid spaces of the brain, primarily around the temporal lobes. Further investigation uncovered a previous pelvic X-ray showing similar hyperdense droplets around the cauda equina. The patient's history indicated a lipiodol myelography performed 51 years earlier. Lipiodol deposits are generally found in the lumbar region, making an intra-cranial location particularly rare. When present, these deposits are visible as radiopaque droplets on X-rays, hyperdense droplets on CT scans, and hyper-T1 on MRI, though the T2 signal is variable. Though lipiodol deposits are generally left untreated, symptomatic spinal deposits may be surgically removed. This rare case underscores the importance of thorough patient history in diagnosing subarachnoid lipiodol deposits, a condition relevant only in older patients who underwent myelography before the 1980s.

2.
Cureus ; 15(10): e46929, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38021770

RESUMO

This innovative system for conducting pediatric MRI describes a method of calming children by allowing them to rest on their accompanying adult's abdomen during the examination. This approach reduces their agitation, enabling the acquisition of diagnostic images when anesthesia is either unavailable or not advisable.

3.
Cureus ; 15(2): e35394, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36994292

RESUMO

Rectitis caused by the administration of a caustic enema is uncommonly encountered in routine clinical practice. The reasons given for the application of caustic enemas are diverse, including but not limited to suicide attempts, murder attempts, iatrogenic causes and simple mistakes. When caustic enemas do occur the consequences can be dire, resulting in extensive injury. These injuries often prove fatal in the short term, but if the patient survives the initial injuries, they may subsequently cause severe disability. Treatment can be conservative but commonly involves surgery, with a significant proportion of patients not surviving the intervention or succumbing to complications thereafter. We present the case of a patient with a history of alcoholism, depression and a recent recurrence of oesophageal cancer who self-administered a hydrochloric acid enema in an attempted suicide. The patient subsequently suffered a stenosis of the lower bowel, resulting in diarrhoea. A colostomy was performed in order to alleviate the patient's symptoms and improve their comfort.

4.
Cureus ; 15(5): e38404, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37265882

RESUMO

Diffuse leptomeningeal glioneuronal tumours (DL-GNT) are rare, with an unknown incidence but fewer than 100 cases reported since 2012. The clinical presentation is non-specific, ranging from abdominal to neurological symptoms. Presently, definitive radiological criteria aren't established, but some features, such as nodules, characteristic extension patterns and post-contrast leptomeningeal enhancement, are found to be prominent. We present the case of a 14-year-old male with an advanced case of DL-GNT, with MRI showing all the features of what is currently thought to be the typical radiological presentation. The patient is currently undergoing treatment but remains severely handicapped by the disease.

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