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1.
BMJ Case Rep ; 14(8)2021 Aug 24.
Artículo en Inglés | MEDLINE | ID: mdl-34429290

RESUMEN

Penetrating trauma due to nail gun is an uncommon yet important clinical entity. There are numerous case reports describing these injuries, yet few describe those resulting in cerebrovascular injury. Laceration of cerebral blood vessels may result in significant intracranial haemorrhage and cerebral ischaemia, with catastrophic consequences. In the present study, we report a female patient who was shot in the face with a nail gun in a domestic assault. The nail entered her right cavernous sinus and lacerated her right internal carotid artery causing a pseudoaneurysm and a caroticocavernous fistula. This report details the approach to, and pitfalls of, managing a cerebrovascular injury due to penetrating intracranial nail. Catheter cerebral angiography is essential in the diagnosis and treatment of these injuries. Best treatment and outcomes require clinicians with expertise in endovascular and surgical repair strategies.


Asunto(s)
Aneurisma Falso , Fístula del Seno Cavernoso de la Carótida , Traumatismos Craneocerebrales , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/etiología , Aneurisma Falso/cirugía , Arteria Carótida Interna/diagnóstico por imagen , Arteria Carótida Interna/cirugía , Fístula del Seno Cavernoso de la Carótida/diagnóstico por imagen , Fístula del Seno Cavernoso de la Carótida/etiología , Fístula del Seno Cavernoso de la Carótida/cirugía , Angiografía Cerebral , Femenino , Humanos
2.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-33461996

RESUMEN

Leptomeningeal carcinomatosis is a devastating sequelae of metastatic cancer. It has protean manifestations on imaging. An elderly woman presented to our tertiary centre with symptoms suggestive of a cerebrovascular accident. Investigations revealed no evidence of this. There was clinical, contextual and radiological evidence of an underlying neoplasm.Magnetic resonance imaging (MRI) demonstrated evidence of a rare morphology (anterolateral pontine leptomeningeal enhancement) in the presence of a probable concomitant lung adenocarcinoma. Other reports have previously described this same neuroradiology, seemingly always in association with lung adenocarcinoma.The purpose of this report is to highlight an unusual case and discuss its peculiarity and pathophysiology. Our patient is the latest documented of a small cohort with this constellation of clinical and neuroradiological features.This study demonstrates the importance of differential diagnosis in stroke medicine, specifically the need to consider neoplastic phenomena in patients admitted following putative cerebrovascular events.


Asunto(s)
Adenocarcinoma/secundario , Neoplasias Pulmonares/patología , Carcinomatosis Meníngea/secundario , Puente/diagnóstico por imagen , Adenocarcinoma/diagnóstico por imagen , Anciano de 80 o más Años , Resultado Fatal , Femenino , Gadolinio , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Imagen por Resonancia Magnética , Carcinomatosis Meníngea/diagnóstico por imagen , Puente/patología , Radiofármacos , Tomografía Computarizada por Rayos X
4.
Int J Rheum Dis ; 21(2): 549-551, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29205875

RESUMEN

We report a case of a 53-year-old man who presented with a diagnostic dilemma mimicking septic arthritis. It is important to consider the diagnosis of calcific peri-arthritis clinically and recognize the hallmarks on radiograph and magnetic resonance imaging as this disease process resolves completely with conservative management like in our patient, and does not require operative intervention.


Asunto(s)
Artritis Infecciosa/diagnóstico por imagen , Artrografía , Calcinosis/diagnóstico por imagen , Fosfatos de Calcio/metabolismo , Articulación de la Cadera/diagnóstico por imagen , Imagen por Resonancia Magnética , Periartritis/diagnóstico por imagen , Antiinflamatorios no Esteroideos/uso terapéutico , Calcinosis/tratamiento farmacológico , Calcinosis/metabolismo , Cristalización , Diagnóstico Diferencial , Articulación de la Cadera/efectos de los fármacos , Articulación de la Cadera/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Periartritis/tratamiento farmacológico , Periartritis/metabolismo , Valor Predictivo de las Pruebas , Resultado del Tratamiento
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