Unusual MRI abnormality in patients with nonketotic hyperglycaemia-associated seizures.

Nonketotic hyperglycaemia (NKH) is a metabolic disorder typically observed in individuals with inadequately managed or undiagnosed diabetes mellitus (DM). Seizures are a common clinical presentation in NKH, and they tend to respond better to glucose correction than anticonvulsant therapy. MRI scans may reveal both subcortical T2/fluid-attenuated inversion recovery (FLAIR) imaging hypointensity and cortical changes, including cortical grey matter T2/FLAIR imaging hyperintensity and cortical or leptomeningeal enhancement, although cortical abnormalities are less frequently observed. These alterations are reversible when the underlying metabolic disturbance is effectively addressed. We suggest the role of iron accumulation as a mechanism for subcortical T2 hypointensity using T2* weighted imaging. Our cases substantiate the significance of subcortical T2/FLAIR hypointensity as a fundamental feature of this condition. In the appropriate clinical context, the recognition of these MRI abnormalities can help prevent misdiagnosis and facilitate timely treatment.

Seizure, A Shocking Effect of a Lightning Strike on Aerodrome: A Case Report.

Lightning injuries have a high morbidity and mortality because of the electrical effects on the circulatory, respiratory, and central nervous systems. Most lightning-related deaths occur immediately after injury due to fatal arrhythmias or respiratory failure. We describe the case of a patient who experienced a seizure and respiratory distress secondary to a lightning strike and how our team was able to stabilize and transport the patient. Ultimately, in this particular case study, the patient survived with minimal residual neurologic and hemodynamic effects. Based on this clinical vignette, we review the pathophysiology of lightning injuries and the predictive factors of positive outcomes in such unusual accidents.

An unusual complication of acute appendicitis: isolated superior mesenteric venous pylephlebitis.

Septic thrombophlebitis of the portal vein or one of its tributaries is referred to as pylephlebitis. It is unusual to have superior mesenteric venous thrombophlebitis. It frequently arises as a result of an infection in the portal venous system's drainage area, such as appendicitis or diverticulitis. Preoperative diagnostic imaging can help in the early diagnosis of acute phase pylephlebitis. A case of acute appendicitis complicated by an intra-abdominal abscess and superior mesenteric venous pylephlebitis is presented. Appendicectomy, abscess drainage, and antibiotic and anticoagulant treatment resulted in a full recovery. After two months, follow-up imaging revealed that the superior mesentric vein had been completely canalised.