RESUMO
Anterior Thoracic Myelomeningocele is a very rare condition. The diagnosis may be made before or after birth. Association with loss of physiologic curvature of the spine is common. We report the case of an 8-year-old boy with congenital dorsal sinistro-convex scoliosis, which was considered nonspecific and improved slightly after physical therapy. The onset of urinary and fecal incontinence at the age of 8 years led the parents to consult a urologist. MRI of the spinal cord revealed an anterior thoracic heterogeneous cystic lesion extending from the third to the eighth dorsal vertebrae. The heterogeneous cystic mass contained a solid spinal cord-like structure on all sequences. No abnormal enlargement, no torsion of the cauda equina or cerebellar amygdala. No malformation of the posterior fossa. CT scan showed aplasia of the right pedicle of the third thoracic vertebrae (T3) with thoracic scoliosis. The associated anterior thoracic myelomeningocele was the final diagnosis that motivated the transfer of the patient to a specialized neurosurgical center.
RESUMO
Bladder exstrophy is a rare and complex malformation. Often associated with diverse deformations, an accurate diagnosis is a must for adequate management. In the African setting, especially in a remote area, delivery rarely occurs within a healthcare structure, thus reducing the chance of an early diagnosis. Due to a low density of specialists, people in rural areas refer to traditional healers for healthcare problems, the thing that delays the time to diagnosis. We report, according to the CARE guidelines (https://www.equator-network.org/reporting-guidelines/care/), a case of an 18-year-old male patient who was transferred to us for better management of a reddish hypogastric mass leaking urine. Initially considered as a congenital wound, his parents applied traditional products to heal it. Following the poor outcomes, the parents will consult several general physicians; unfortunately, no one gave a clear diagnosis. The clinical examination on admission revealed a good general condition and noted the presence of a reddish, ovoid structure of about 9 centimeters of the minor axis and 11 centimeters of the major axis in the hypogastric region allowing urine to flow in its upper part. The external genitalia examination revealed a retracted and short penis with urine exit at its base through the reddish structure. The patient was transferred outside the country for better management due to a lack of dedicated equipment. Although vesical exstrophy is a rare disease, an early diagnosis allows adequate management and good outcome. Thus, a well-performed neonatal examination is required to avoid later diagnosis and complications.
RESUMO
We report the case of an 18-year-old girl who presented with several episodes of simple partial motor seizures compatible with the diagnosis of epilepsia partialis continua. In addition to ketotic hyperglycemia, tuberculous meningoencephalitis was diagnosed based on clinical, biological, and brain imaging findings. The seizures ceased after normalization of glycemia.
