The role of computerized tomographic scan in the management of children with cerebral palsy.

AIMS AND OBJECTIVES: The aim of this study was to describe the role of computed tomography (CT) scan in the management and evaluation of children with cerebral palsy (CP) and to categorize the CT findings and then relate them to their respective aetiologies, as well as the types of CP. MATERIALS AND METHODS: The CT findings in 32 children consisted of 16 boys and 16 girls with age range of 2-61 months who were diagnosed of CP and with detailed clinical information were analysed. The 84.4% positive CT findings were analyzed to evaluate their relationship with the clinical types, as well as the aetiological basis for the CP. RESULTS: The spastic type found in 78.1% of the total number of children, had the highest positive findings. The yield was increased in children with birth asphyxia (46.9%) and neonatal jaundice (37.5%). The findings were those of cerebral atrophy in 46.9%, infarcts in 12.5%, hydrocephalus in 9.4% and porencephaly 6.3% of cases. Treatable lesions, such as Dandy Walker syndrome, tumour, hydrocephalus and porencephaly were identified in 25% of cases. CONCLUSION: CT scan is no doubt efficacious in the management and evaluation of children with CP.

Sonographic analysis of adult polycystic kidney disease: retrospective data from South-East Nigeria.

BACKGROUND: Autosomal dominant polycystic kidney disease (APKD), an inheritable multisystem disease characterized by intrarenal and at times extrarenal disease, has been studied extensively among Caucasian populations. Despite the fact that being black is a risk factor for progressive disease, there is paucity of local published data. As a result, true local incidence and peculiarities in clinical and sonographic characteristics are unknown. AIM: To present data from 19 patients diagnosed with APKD in a medium-sized facility over a 16-year period. MATERIALS AND METHODS: A retrospective search was done on the ultrasound registers for patients who had undergone abdominal ultrasound in 16 years (1997-2013). Of the 29 sonographic diagnoses of bilateral PKD made, only 19 had complete records and were included in the study. Data extracted were- age, sex, working diagnosis, renal size, diameter of renal cysts, presence or absence of extrarenal cysts, family history of renal cystic disease, blood pressure at diagnosis, and patient outcome. RESULTS: A total of 19 diagnoses of APKD were made- 12 males and seven females with a sex ratio of 1:0.6. Total mean age was 54.8 years (range 31-79 years)- 40.1 years for females and 57.2 years for males. In 89.5% of cases, no family history of APKD was obtained. Only six (31.6%) patients were hypertensive at presentation and three patients (16%) were already in renal failure. Ultrasound showed a mean renal size of 88.92 cm² for the right kidney and 98.97 cm² for the left. Mean cyst diameter was 3.46 cm (range 2.08-4.85 cm). Only one patient had documented extrarenal cystic disease. Two patients were lost to renal failure and congestive cardiac failure. CONCLUSION: APKD appears to be uncommon in our environment; however, more studies may be elucidatory. Standard sonographic protocol for collecting data from patients with APKD is needed.

Utero-peritoneal fistula, a rare complication of laparoscopic myomectomy scar dehiscence: a case Report.

OBJECTIVE: The objective is to report a case of utero-peritoneal fistula caused by laparoscopic myomectomy dehiscence, diagnosed by colour Doppler ultrasound scan and confirmed by x-ray HSG and MRI. The aim of our report lies on the importance of imaging in the diagnosis of fistulous processes involving the uterus. CASE REPORT: A 36 year old woman (G6,P0)presented with intense dysmenorrheal and intermenstrual spotting since laparoscopic myomectomy 2 years before. A laparoscopic myomectomy dehiscence with utero-peritoneal fistula was diagnosed by pelvic ultrasound, hysterosalpingogram (HSG) and magnetic resonance imaging (MRI).

Recurrent depressive illness or craniopharyngioma: a diagnostic dilemma.

BACKGROUND: Brain tumors have been associated with various psychiatric and neurological manifestations. However in some patients with brain tumors psychiatric symptom might be the only clinical presentation for various lengths of time. As such they would be treated as straight forward psychiatric disorders. OBJECTIVE: To report a case of craniopharyngioma presenting as recurrent depressive illness in a 42 years old man. METHODS: Clinical follow up of a patient presenting with recurrent depressive illness till death RESULTS: recurrent severe depressive illness in the absence of focal neurological deficit that is unresponsive to anti-depressant might be due to intracranial neoplasm. CONCLUSION: Brain tumors can sometime present as psychiatric disorders and be difficult to detect in the absences of focal neurological deficit and Neuro-imaging studies.

Dicephalus dipus tetrabrachius conjoined twins of Zaria: case report and literature review.

One of the most interesting congenital malformations to manage is a conjoined twin. Conjoined twins are rare occurrences in obstetric/pediatric practice. More commonly known as Siamese twins, this phenomenon is shrouded in mystery and considered a curiosity by general public. Current technology is lending a helping hand in the early diagnosis of these conditions. Frequently, the twins are born dead, but there are few cases in which the twins survive. We presented a case of dicephalus dipud conjoined twins; a rare type of conjoined twins.

Porocephalosis due to encysted Armillifer nymph presenting as an acute abdominal emergency: case report and review of literature.

A rare case of porocephalosis infection presenting with an acute abdominal emergency in a 60 year old Nigerian is presented. The characteristic radiologic appearance of Armillifer nymph is described, and clinical findings which may be caused by this parasite are reviewed. A brief review of the epidemiology of porocephalosis is also included.

Mediastinal bronchogenic cyst with back pain.

We report a case of a mediastinal bronchogenic cyst with back pain. The rarity of this lesion and even the more uncommon association of this lesion with symptoms of back pain prompted the report of this case.

Pulmonary manifestations of ankylosing spondylitis treated as pulmonary tuberculosis: a case report and review of literature.

A 45 year old trader presented with history of persistent productive cough, progressively increasing dyspnoea, malaise and fever of 6 months prior to presentations. He also complained of severe lower backache and stiffness that radiated to both legs of 5 years duration. Chest radiograph revealed left apical fibrosis, coarse, linear shadows with cavities. There was also super infection with aspergilloma in the left apical region. The sputum AAFB was negative. Despite the fact that the patient complained of lower backache and stiffness, the plain radiograph of the affected spine was not requested for by the attending physician. Rather, the patient was commenced on antituberculous therapy based on pulmonary changes on chest radiograph. But after completing the treatment (nine months regimen), there were no improvement in patient's clinical conditions and pulmonary changes on repeated chest radiograph. The plain radiographs of the lumbosacral spine, pelvis and both hips were suggested by the author (Radiologist) who reviewed the patient's chest radiographs. The radiographs of the lumbosacral spine, as well as pelvis and both hips showed features of ankylosing spondylitis with pulmonary complication. His treatment was later reviewed based on the above new findings. This report highlights the fact that pulmonary manifestation in ankylosing spondylitis, a rare entity in our environment can present the same pattern as pulmonary tuberculosis which is far more common in this environment. A high index of suspicion will enhance early proper diagnosis.

Expression of adult polycystic renal disease in a 17-year-old male.

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is found mostly in the middle-aged group. We report a rare occurrence of ADPKD in a 17-year-old male student with clinical presentation of bilateral loin pains and total haematuria. Clinical diagnosis of Acute-on-Chronic Glomerulonephritis was made. However Ultrasound and Intravenous Urography confirmed the diagnosis of Adult Polycystic Disease. The possible embryogenesis and associated anomalies of ADPKD and the radiological findings were reviewed.

An unusual presentation of congenital bronchoesophageal fistula.

We present the case of a 5-week-old neonate with multiple congenital abnormalities including a broncho-oesophageal fistula, which showed radiological features suggestive of congenital diaphragmatic hernia. Emergency limited barium swallow done was initially reported as a case of diaphragmatic hernia. Autopsy revealed pus within the right lung, and a fistulous connection between the oesophagus and an intralobar sequestrated lung. No diaphragmatic hernia or intra-abdominal organ abnormality were seen, and an occipital meningomyelocoele was also confirmed.