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BMJ Case Rep ; 14(8)2021 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429290


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.

Falso Aneurisma , Fístula Carotidocavernosa , Traumatismos Craniocerebrais , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/cirurgia , Fístula Carotidocavernosa/diagnóstico por imagem , Fístula Carotidocavernosa/etiologia , Fístula Carotidocavernosa/cirurgia , Angiografia Cerebral , Feminino , Humanos
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33461996


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.

Adenocarcinoma/secundário , Neoplasias Pulmonares/patologia , Carcinomatose Meníngea/secundário , Ponte/diagnóstico por imagem , Adenocarcinoma/diagnóstico por imagem , Idoso de 80 Anos ou mais , Evolução Fatal , Feminino , Gadolínio , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Imageamento por Ressonância Magnética , Carcinomatose Meníngea/diagnóstico por imagem , Ponte/patologia , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X
Int J Rheum Dis ; 21(2): 549-551, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29205875


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.

Artrite Infecciosa/diagnóstico por imagem , Artrografia , Calcinose/diagnóstico por imagem , Fosfatos de Cálcio/metabolismo , Articulação do Quadril/diagnóstico por imagem , Imageamento por Ressonância Magnética , Periartrite/diagnóstico por imagem , Anti-Inflamatórios não Esteroides/uso terapêutico , Calcinose/tratamento farmacológico , Calcinose/metabolismo , Cristalização , Diagnóstico Diferencial , Articulação do Quadril/efeitos dos fármacos , Articulação do Quadril/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Periartrite/tratamento farmacológico , Periartrite/metabolismo , Valor Preditivo dos Testes , Resultado do Tratamento