RESUMEN
Coxsackievirus, a common pathogen causing pediatric infection, typically causes a mild, nonspecific illness with low-grade fever, but can cause severe illness on rare occasions. Encephalitis is an uncommon but important complication of coxsackievirus infection. The magnetic resonance imaging (MRI) findings of coxsackievirus B3 (CVB3) encephalitis have not been reported in the literature, and there are few descriptions of MRI findings of encephalitis induced by coxsackieviruses of other serotypes. We report the MRI findings of CVB3 encephalitis in a two-year-old girl, review the MRI findings in previously reported cases of pediatric coxsackievirus encephalitis, and present the MRI characteristics of coxsackievirus encephalitis.
RESUMEN
Hepatocellular carcinoma with sinonasal metastasis is extremely rare. We report a case of a 49-year-old man who had a history of synchronous hepatocellular carcinoma and verrucous carcinoma of tongue. A painless and non-bleeding mass was found in the left nasal septum 16 months after hepatocellular carcinoma was diagnosed. On computed tomography, the mass was enhanced with contrast. It was resected and proved to be metastatic hepatocellular carcinoma. The patient was treated with radiotherapy to the nasal area and then with chemotherapy. He was still alive, 15 months after the appearance of the nasal metastasis.
Asunto(s)
Carcinoma Hepatocelular/secundario , Neoplasias Hepáticas/patología , Tabique Nasal , Neoplasias Nasales/secundario , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/uso terapéutico , Carcinoma Hepatocelular/terapia , Carcinoma Verrugoso/cirugía , Humanos , Masculino , Persona de Mediana Edad , Tabique Nasal/patología , Neoplasias Nasales/diagnóstico por imagen , Neoplasias Nasales/terapia , Radioterapia Adyuvante , Tomografía Computarizada por Rayos X , alfa-Fetoproteínas/análisisRESUMEN
Acute bilateral paramedian thalamic and mesencephalic infarcts are uncommon. Occlusion of the artery of Percheron (AOP) is presumed to cause this specific stroke syndrome. However, occlusion of the AOP is rare and early diagnosis is challenging. Here we described a 70-year-old male patient who presented with acute disturbance of consciousness due to acute bilateral paramedian thalamo-mesencephalic infarction secondary to AOP occlusion. Anticoagulant therapy was administered, and his consciousness gradually improved.
RESUMEN
Orgasmic headache (OH) is an "explosive" headache that occurs at orgasm. Historically, it was considered benign with no treatment needed. Reversible cerebral vasoconstriction syndrome (RCVS) refers to a group of disorders characterized by recurrent thunderclap headache (TCH) and multifocal vasoconstriction. Patients who have RCVS often recover completely, but some may have persistent neurological deficits. We report a 34-year-old woman who presented with isolated and recurrent TCH at orgasm, which fulfilled the diagnosis of OH. However, she was post-partum and had recent exposure to ecstasy, making her symptoms highly suggestive of RCVS. Brain magnetic resonance angiography showed segmental vasoconstriction. We concluded that she could be considered to have either OH or RCVS. This patient suggests the theory that OH could be a presentation of RCVS. Given that RCVS is potentially treatable, early recognition by clinicians is vital in order to prevent devastating complications.