Anomalía venosa del desarrollo cerebral trombosada: hallazgos en la resonancia magnética / Developmental cerebral thrombosed venous anomaly: findings in magnetic resonance imaging

Introducción: Las anomalías venosas del desarrollo son las malformaciones vasculares cerebrales más comunes, suelen ser incidentales y benignas, aunque alrededor del 40% se asocian a malformaciones cavernosas, por lo que es esencial buscar otras anomalías vasculares o neurocutáneas asociadas. Caso clínico: Se presenta una mujer de 34 años embarazada que acude por convulsiones y disartria, a la cual se le realiza una resonancia magnética de cráneo urgente. En ella se aprecia el clásico signo de la ‘cabeza de Medusa’, y se concluye como diagnóstico anomalía venosa del desarrollo con trombosis parcial periférica y flujo lento proximal. Conclusiones: La complicación con trombosis de las anomalías venosas del desarrollo es rara y los informes de casos de la bibliografía sugieren que deben manejarse de forma conservadora, como una trombosis del seno venoso, dejando la cirugía para otras complicaciones asociadas. Como radiólogos, debemos conocer las principales características por imagen para elaborar un diagnóstico certero.(AU)

Introduction: Developmental venous anomalies are the most common cerebral vascular malformations. They are usually incidental and benign, although about 40% are associated with cavernous malformations, and so it is essential to look for other associated vascular or neurocutaneous anomalies. Case report: We report the case of a 34-year-old pregnant woman who presented with seizures and dysarthria, and was submitted to an urgent cranial MRI scan. She showed the classic ‘Medusa head’ sign and was diagnosed with developmental venous anomaly with partial peripheral thrombosis and slow proximal flow. Conclusions: Thrombosis rarely occurs as a complication of developmental venous anomalies and case reports in the literature suggest that they should be managed conservatively, leaving surgery for other associated complications. As radiologists, we must be aware of the main imaging features so as to be able to make an accurate.(AU)

Emphysematous osteomyelitis: a rare and aggressive disease.

Emphysematous osteomyelitis is an extremely rare entity consisting of the presence of intraosseous gas that can extend to the joints and adjacent soft tissues. It is an aggressive infectious process associated with high mortality, especially in patients with risk factors such as tumors or diabetes mellitus. Because early diagnosis and immediate treatment are crucial to prevent the potentially devastating consequences of this condition, imaging tests such as computed tomography play a fundamental role in its diagnosis and management. Therefore, radiologists must be aware that intraosseous gas is a rare but alarming sign that is pathognomonic of emphysematous osteomyelitis, especially in the axial skeleton.

[Developmental cerebral thrombosed venous anomaly: findings in magnetic resonance imaging]. / Anomalía venosa del desarrollo cerebral trombosada: hallazgos en la resonancia magnética.

INTRODUCTION: Developmental venous anomalies are the most common cerebral vascular malformations. They are usually incidental and benign, although about 40% are associated with cavernous malformations, and so it is essential to look for other associated vascular or neurocutaneous anomalies. CASE REPORT: We report the case of a 34-year-old pregnant woman who presented with seizures and dysarthria, and was submitted to an urgent cranial MRI scan. She showed the classic 'Medusa head' sign and was diagnosed with developmental venous anomaly with partial peripheral thrombosis and slow proximal flow. CONCLUSIONS: Thrombosis rarely occurs as a complication of developmental venous anomalies and case reports in the literature suggest that they should be managed conservatively, leaving surgery for other associated complications. As radiologists, we must be aware of the main imaging features so as to be able to make an accurate diagnosis.

TITLE: Anomalía venosa del desarrollo cerebral trombosada: hallazgos en la resonancia magnética.Introducción. Las anomalías venosas del desarrollo son las malformaciones vasculares cerebrales más comunes, suelen ser incidentales y benignas, aunque alrededor del 40% se asocian a malformaciones cavernosas, por lo que es esencial buscar otras anomalías vasculares o neurocutáneas asociadas. Caso clínico. Se presenta una mujer de 34 años embarazada que acude por convulsiones y disartria, a la cual se le realiza una resonancia magnética de cráneo urgente. En ella se aprecia el clásico signo de la 'cabeza de Medusa', y se concluye como diagnóstico anomalía venosa del desarrollo con trombosis parcial periférica y flujo lento proximal. Conclusiones. La complicación con trombosis de las anomalías venosas del desarrollo es rara y los informes de casos de la bibliografía sugieren que deben manejarse de forma conservadora, como una trombosis del seno venoso, dejando la cirugía para otras complicaciones asociadas. Como radiólogos, debemos conocer las principales características por imagen para elaborar un diagnóstico certero.

The diagnosis of the middle interhemispheric variant of holoprosencephaly with fetal MRI.

Congenital anomalies of the central nervous system comprise a wide spectrum of malformations associated with a wide variety of genetic syndromes and chromosomal anomalies, and they are among the principal causes of morbidity and mortality in infants. Among these anomalies, holoprosencephaly arises from the complete or partial failure of the brain to divide into the cerebral hemispheres. Imaging tests are fundamental for the prenatal diagnosis of holoprosencephaly; the diagnostic process usually starts with sonography and then the findings are refined with fetal MRI. Radiologists need to be familiar with the possible findings because the prognosis varies.

Variante interhemisférica media de holoprosencefalia: diagnóstico mediante resonancia magnética fetal / The diagnosis of the middle interhemispheric variant of holoprosencephaly with fetal MRI

Las anomalías congénitas del sistema nervioso central constituyen un amplio grupo de malformaciones asociadas a una gran variedad de síndromes genéticos y anomalías cromosómicas, y una de las principales causas de morbimortalidad infantil. Dentro de ellas, la holoprosencefalia conlleva un trastorno de la diferenciación del prosencéfalo, con una falta completa o parcial de división entre los hemisferios cerebrales. Para su diagnóstico prenatal es fundamental la realización de pruebas de imagen y el conocimiento de los posibles hallazgos, debido a que su pronóstico es variable, comenzando normalmente con la ecografía y confirmando lo visualizado con la resonancia magnética.(AU)

Congenital anomalies of the central nervous system comprise a wide spectrum of malformations associated with a wide variety of genetic syndromes and chromosomal anomalies, and they are among the principal causes of morbidity and mortality in infants. Among these anomalies, holoprosencephaly arises from the complete or partial failure of the brain to divide into the cerebral hemispheres. Imaging tests are fundamental for the prenatal diagnosis of holoprosencephaly; the diagnostic process usually starts with sonography and then the findings are refined with fetal MRI. Radiologists need to be familiar with the possible findings because the prognosis varies.(AU)

Afectación pulmonar en la enfermedad de Rendu-Osler-Weber: diagnóstico radiológico / Pulmonary involvement in Rendu-Osler-Weber disease: radiological diagnosis

La telangiectasia hemorrágica hereditaria (THH) o síndrome de Rendu-Osler-Weber es un trastorno sistémico infrecuente,con transmisión autosómica dominante, asociado con malformaciones vasculares pulmonares. Los síntomas más comunesincluyen telangiectasias cutáneas y mucosas, epistaxis, hemorragias gastrointestinales, pulmonares e intracerebrales. Sudiagnóstico clínico se realiza mediante los criterios de Curaçao, siendo fundamentales las pruebas de imagen tales como latomografía computarizada (TC) de tórax para el diagnóstico de las malformaciones arteriovenosas pulmonares. El tratamientoincluye medidas para el manejo de la epistaxis, así como escisión quirúrgica, radioterapia y embolización de malformacionesarteriovenosas, con énfasis en el tratamiento endovascular.(AU)

Hereditary hemorrhagic telangiectasia (HHT), or Rendu-Osler-Weber syndrome, is a rare disorder, autosomal dominant,that is closely linked to the development of pulmonary arteriovenous malformations. Most common symptoms include skin andmucosal telangiectasias, epistaxis, gastrointestinal, pulmonary and intracerebral bleeding. It clinical diagnosis is performedusing the Curaçao criteria, and imaging tests such as chest computed tomography (CT) are essential for the diagnosis of pul-monary arteriovenous malformations. Treatment includes measures for management of epistaxis, as well as surgical excision,radiotherapy and embolization of arteriovenous malformations, with emphasis on endovascular treatment.(AU)

The diagnosis of the middle interhemispheric variant of holoprosencephaly with fetal MRI. / Variante interhemisférica media de holoprosencefalia: diagnóstico mediante resonancia magnética fetal.

Congenital anomalies of the central nervous system comprise a wide spectrum of malformations associated with a wide variety of genetic syndromes and chromosomal anomalies, and they are among the principal causes of morbidity and mortality in infants. Among these anomalies, holoprosencephaly arises from the complete or partial failure of the brain to divide into the cerebral hemispheres. Imaging tests are fundamental for the prenatal diagnosis of holoprosencephaly; the diagnostic process usually starts with sonography and then the findings are refined with fetal MRI. Radiologists need to be familiar with the possible findings because the prognosis varies.

Neumomediastino espontáneo en contexto de afectación por COVID-19 / Spontaneous pneumomediastinum in the context of covid-19 involvement

El neumomediastino espontáneo en contexto de COVID-19 es una afectación rara y producida por aumento de la presión intratorácica sobre daño alveolar difuso en los casos de afectación grave. En principio se considera un cuadro autolimitado que responde favorablemente a medidas terapéuticas conservadoras. No obstante, se recomienda su vigilancia estrecha debido a sus posibilidades de complicación cardiovascular y respiratoria (AU)

Spontaneous pneumomediastinum in the context of COVID-19 is a rare condition caused by increased intrathoracic pressure on diffuse alveolar damage in cases of severe disease. In principle, it is considered a self-limited condition that responds favorably to conservative therapeutic measures. However, close monitoring is recommended due to its potential for cardiovascular and respiratory complications (AU)

Fístula traqueoesofágica por Candida galbrata: una patología infrecuente / Tracheoesophageal fistula due to candida galbrata: a rare pathology

La fístula traqueoesofágica consiste en una comunicación anómala entre el sistema respiratorio y el digestivo, que puede ser a causa de una enfermedad congénita, o bien secundaria a una patología tal como la infecciosa, la tumoral o postraumática. Entre las etiologías infecciosas, Candida o Aspergillus son dos hongos que provocan esofagitis fúngica, la cual podría complicarse con esta entidad, aunque son casos extremadamente raros. El diagnóstico de las fístulas se basa en la clínica, las pruebas de imagen como la TC y la endoscopia, donde se podrá apreciar la solución de continuidad. Este defecto debe ser tratado mediante cirugía o endoscópicamente

The tracheoesophageal fistula consists of an abnormal communication between the respiratory and digestive systems, which may be due to a congenital disease or secondary to a pathology such as infectious, tumorous or post-traumatic. Among the infectious etiologies, Candida or Aspergillus are two fungi that cause fungal esophagitis, which could be complicated by this entity, although they are extremely rare cases. The diagnosis of fistulas is based on the clinic, imaging tests such as CT and endoscopy, where the solution of continuity can be appreciated. This defect must be treated surgically or endoscopically, a technique that is currently on the rise due to its fewer complications

Paciente VIH con infección por Pneumocystis jirovecii: hallazgos en tomografía computarizada de alta resolución / HIV patient with Pneumocystis jiroveci infection: findings in high resolution tomography (HRCT)

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