Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings: a study from tertiary care hospital

Background: Posterior reversible encephalopathy syndrome (PRES) is a syndrome with neuroimaging findings of reversible vasogenic subcortical edema without infraction. It is potentially reversible clinico-neuro-radiological syndrome featured by clinical symptoms of headache, altered mental status and seizures, visual perception defects in collaboration with radiological findings of posterior cerebral edema appearing as hypodense area on MRI and can also involve the brain stem, cerebellum and other cerebral areas. To identify the clinical associations and radiologic findings of posterior reversible encephalopathy syndrome (PRES).Methods: One hundred twenty patients were included in the study. Demographic data, clinical history, blood pressure measurements, laboratory investigations, predisposing condition and neuroimaging were assessed. The primary etiology of PRES was determined for each case on the basis of the diagnosis of the attending clinician/s.Results: Out of the one hundred twenty retrospectively identified cases, 98 were females and 22 were males. Mean age of the patients at presentation was 28.94 years. The most common clinical presentation was seizures, seen in 94 patients (78.3%). The most common location was the parieto-occipital 69 (57.5%), followed by temporal lobe 19 (15.8%), frontal lobe 14 (11.6%) and basal ganglia 08 (6.6%).Conclusions: PRES is an under diagnosed condition, needs high degree of suspicion for diagnosis. In this study females are commonly affected, and most of them were in postpartum period and had good prognosis.

Role of magnetic resonance imaging in distinguishing fungal from nonfungal multiple brain abscesses

AbstractCladophialophora bantiana is a neurotropic dematiaceous fungus known for affecting immunocompromised and immunocompetent hosts. We report a case of 24year old immunocompetent male presenting with headache, fever and vomiting. MRI was suggestive of multiple fungal brain abscesses. He underwent total excision of abscesses. Pus culture was suggestive of brain abscess caused by C. bantiana. We report a culture proven case of C. bantiana emphasizing on specific MRI features which are critical in differentiating fungal from nonfungal brain abscesses

Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings: a study from tertiary care hospital

Background: Posterior reversible encephalopathy syndrome (PRES) is a syndrome with neuroimaging findings of reversible vasogenic subcortical edema without infraction. It is potentially reversible clinico-neuro-radiological syndrome featured by clinical symptoms of headache, altered mental status and seizures, visual perception defects in collaboration with radiological findings of posterior cerebral edema appearing as hypodense area on MRI and can also involve the brain stem, cerebellum and other cerebral areas. To identify the clinical associations and radiologic findings of posterior reversible encephalopathy syndrome (PRES).Methods: One hundred twenty patients were included in the study. Demographic data, clinical history, blood pressure measurements, laboratory investigations, predisposing condition and neuroimaging were assessed. The primary etiology of PRES was determined for each case on the basis of the diagnosis of the attending clinician/s.Results: Out of the one hundred twenty retrospectively identified cases, 98 were females and 22 were males. Mean age of the patients at presentation was 28.94 years. The most common clinical presentation was seizures, seen in 94 patients (78.3%). The most common location was the parieto-occipital 69 (57.5%), followed by temporal lobe 19 (15.8%), frontal lobe 14 (11.6%) and basal ganglia 08 (6.6%).Conclusions: PRES is an under diagnosed condition, needs high degree of suspicion for diagnosis. In this study females are commonly affected, and most of them were in postpartum period and had good prognosis.

Assessment of the changes in the stress-related salivary cortisol levels to the various dental procedures in children

Background: Fear and pain are the factors producing stress and there is evidence that dental fear acquired in childhood may persist to influence adult behavior. Dental treatment is often considered as anxiety producing and stressful. Aim: To assess the levels of stress displayed by the healthy children undergoing routine dental procedures like oral examination, restoration, and extraction by analyzing salivary levels of cortisol before, during, and after the procedures. Materials and Methods: Twenty healthy children aged between 4 and 8 years having their first dental visit and requiring at least one restoration and one extraction were selected. In each patient, three procedures were carried out: (i) Routine dental examination, (ii) restoration, and (iii) extraction. Unstimulated salivary samples were collected 10 min before, during the procedure, and 30 min after each procedure at three different visits for comparison of cortisol production in response to anxiety and stress over time. Total 180 samples were collected to determine salivary cortisol levels using UBI-MAGIWEL TM kit and the readings were noted. Statistical Analysis Used: Statistical Package for Social Sciences (SPSS) software with paired t-test, two independent sample t-tests, and analysis of variance (ANOVA) were used to analyze the findings. Results: A correlation between salivary cortisol and stress in dental procedure was noticed. Cavity preparation is more stressful procedure in children, so alternative methods can be used in anxious children. Stress associated with extraction persists to a postoperative period. No correlation exists in between Corah′s anxiety scale and salivary cortisol

Congenital giant megaureter with duplex kidney presenting as abdominal lump in a neonate

A neonate with unilateral complete duplex system with congenital giant megaureter of the upper moiety presenting as abdominal lump is reported. A left upper moiety nephroureterectomy was performed. Such an anomaly with this presentation has not been reported in neonates

Lipoma Arborescens of Knee Joint: Role of Imaging

A 23 year old Asian female presented with swelling of right knee joint for 5 years with history of exacerbations and remissions of symptoms. She was initially diagnosed as a case of suprapatellar bursitis based on clinical and X-ray findings. Further evaluation with higher imaging modalities was pathognomonic of lipoma arborescens. Patient underwent synovectomy and the diagnosis was confirmed histologically. We describe a histologically proven case of lipoma arborescens to highlight the imaging findings on X-ray, Ultrasound and Magnetic resonance imaging with arthroscopic correlation. The unique feature of this case report is multimodality imaging correlation with arthroscopy and histopathology findings. We have highlighted the pathognomonic imaging findings of this rare but benign intra-articular lesion and also discussed the differential diagnosis in detail