A rare case of thoracic-abdominal aortic aneurysm in conjunction with bilateral superficial femoral artery occlusion, documented with computed tomography angiography.

Aneurysms represent bulging of the weakened blood vessel area, as a result of cystic medial degeneration. Aneurysms chance of rupturing increases over time, resulting in bleeding and death. Therefore, patients with aortic aneurysms require frequent monitoring with magnetic resonance and computed tomography angiography, as well as undergoing open repair surgery and endovascular aneurysm repair. We present a case of ruptured thoracic aortic aneurysm in conjunction with bilateral superficial femoral occlusion, as incidental findings in Covid-19 positive patient. The patient, a 62-years-old female, presented with cough, shortness of breath, fever and leg claudication. Doppler ultrasonography of the lower limbs was conducted to rule out thromboembolism, revealing bilateral superficial femoral arteries occlusion. The patient was administered high doses of parenteral anticoagulants. Hemoptysis ensued, prompting an MSCT scan, that showed right pleural effusion, atelectasis, and right active perihilar infiltrates with inter-lobar pleurisy. Due to inflammatory changes on the lung parenchyma, the patient got tested for Sars-Cov-2, and resulted positive. Contrast-enhanced MSCT also revealed thoracic-abdominal aortic aneurysm with its highest diameter measuring 10 cm, and massive per-aortal thrombus and/or hematoma of 5 cm, which was further ruptured and patient died untreated in the fourth day of hospitalization. Questions arise whether Covid-19 was the primary cause of bilateral superficial femoral artery occlusion and whether high doses of parenteral anticoagulants were the primary cause of thoracic aortic aneurysm rupture. Thus, a careful balance must be made between the detrimental and protective contributions of anticoagulants in the patients presenting with Covid-19 and thoracic-abdominal aortic aneurysm.

Colloid Cyst of the Third Ventricle: Case report and Literature Review.

BACKGROUND: Colloid cysts account for approximately 1% of all intracranial tumors and are the most common type of the neuroepithelial cysts. They are benign, that most commonly occur in the third ventricle near the Monro foramen. Sometimes they have no specific sings and symptoms and may be confused and misdiagnosed with other pathology of nervous systems, but sometimes they may produce acute hydrocephalus, brain herniation, and lead to death. OBJECTIVE: We present a case of 40 years old male patient with brain colloid cyst. DISCUSSION: The patient was admitted at Clinic of Radiology, for headache and episode of vomit. He was treated for signs and symptoms of depression since 2017. In clinical examination patient had symptoms of brain tumor. The MRI scan demonstrated a cyst in foramen Monroe region with typical signal intensities in the formation that confirm the diagnosis of colloid cyst as delated of lateral ventricle as signs of early hydrocephalus. After diagnosis the patient was recommended to consult with a Neurosurgeon for intervention. The cyst was removed and similar findings revealed also on histopathological examination. Many of colloid cysts manifest with no specific signs and symptoms that may be confused with depression. CONCLUSION: On rare occasions, they may completely and irreversibly obstruct the foramen of Monroe, resulting in sudden loss of consciousness and, if patients are not treated, in coma and death. So carefully check the MRI scans is very important, not only in diagnosis but also in planning of treatment.