Leucine-rich glioma-inactivated protein 1 antibody encephalitis: A case report

OBJECTIVE: To describe a case of leucine-rich glioma-inactivated protein 1 (LGI1) antibody-associated encephalitis. METHODS: The clinical and ancillary data and brain MRIs were gathered retrospectively by chart review. Relevant literature on similar cases was also reviewed. RESULTS: The diagnosis of LGI1 antibody-associated autoimmune encephalitis was based on the typical clinical presentation of seizures, psychiatric symptoms, and memory loss as well as negative diagnostic testing for cancer; the diagnosis was confirmed by positive LGI1 antibody. The patient responded favorably to treatment with IV immunoglobulin and continues to do well. CONCLUSION: LGI1 antibody-associated encephalitis has increasingly been recognized as a primary autoimmune disorder with good prognosis and response to treatment

Temporal Bone Hyperpneumatization and Tinnitus: Clinico-Radiological Evaluation Using CT Scan

Purpose: We propose that there is increased incidence of subjective tinnitus (ST) in patients with temporal bone hyperpneumatization (TBHP). The secondary goal of this project is to assess the degrees of association of TBHP with paranasal sinus hyperpneumatization (PNSHP), chronic sinusitis (CS), otomastoiditis (OM) and concha bullosa (CB). Methods and Materials: A total of 196 patients, who had computed tomography (CT) of the head for various clinical indications, were included in this study. CT head scans of patients with TBHP (n=96) were correlated with control patients (n=100). These patients had no apparent TBHP, history of ST, PNSHP, CS, OM or CB. The TBHP was graded based upon the extent of pneumatization. Size of the maxillary and sphenoid sinuses were also measured, providing pneumatization grade. Results: Subjective tinnitus (ST) was present in 31 cases of TBHP and in 8 patients in the control group, which was statistically significant. Mean volume of maxillary sinus and the largest axial sphenoid sinus diameter were significantly larger in the cases of TBHP than in that of controls. Otomastoiditis was found in only 4 cases of TBHP (4%) and none of the controls; however, the difference was not statistically significant. Chronic sinusitis was present in 8 cases of TBHP and 5 of controls, and was also not statistically significant. Concha bullosa was significantly more frequent among cases of TBHP than controls. Conclusion: There is a significant (p \u3c 0.001) association between subjective tinnitus and increasing grade of temporal bone hyperpneumatization. There is a positive correlation between paranasal sinus hyperpneumatization and occurrence of concha bullosa, mimicking symptoms of sinusitis, with TBHP

Solitary pancreatic tuberculous abscess mimicking pancreatic cystadenocarcinoma: a case report

BACKGROUND: The incidence of pancreatic tuberculosis is extremely rare, and it frequently misdiagnosed as pancreatic neoplasms. The nonsurgical diagnosis of this entity continues to be a challenge. CASE PRESENTATION: A 33 year old male with six-month history of intermittent right epigastric vague pain and weight lost had found a solitary pancreatic cystic mass and diagnosed as pancreatic cystadenocarcinoma. The chest X-ray film and physical examination revealed no abnormalities. Abdominal ultrasound (US) examination showed an irregular hypoechoic lesion of 6.6 cm × 4.4 cm in the head of pancreas, and color Doppler flow imaging did not demonstrate blood stream in the mass. The attempts to obtain pathological evidence of the lesion by US-guided percutaneous fine needle aspiration failed, an exploratory laparotomy and incisional biopsy revealed a caseous abscess of the head of pancreas without typical changes of tuberculous granuloma, but acid-fast stain was positive. CONCLUSIONS: Pancreatic tuberculosis should be considered in the differential diagnosis of focal pancreatic lesions, especially for young people in developing countries

Hepatobiliary and pancreatic tuberculosis: A two decade experience

<p>Abstract</p> <p>Background</p> <p>Isolated hepatobiliary or pancreatic tuberculosis (TB) is rare and preoperative diagnosis is difficult. We reviewed our experience over a period two decades with this rare site of abdominal tuberculosis.</p> <p>Methods</p> <p>The records of 18 patients with proven histological diagnosis of hepatobiliary and pancreatic tuberculosis were reviewed retrospectively. The demographic features, sign and symptoms, imaging, cytology/histopathology, procedures performed, outcome and follow up data were obtained from the departmental records. The diagnosis of tuberculosis was based on granuloma with caseation necrosis on histopathology or presence of acid fast bacilli.</p> <p>Results</p> <p>Of 18 patients (11 men), 11 had hepatobiliary TB while 7 had pancreatic TB. Two-thirds of the patients were < 40 years (mean: 42 yrs; range 19–70 yrs). The duration of the symptoms varied between 2 weeks to 104 weeks (mean: 20 weeks). The most common symptom was pain in the abdomen (n = 13), followed by jaundice (n = 10), fever, anorexia and weight loss (n = 9). Five patients (28%) had associated extra-abdominal TB which helped in preoperative diagnosis in 3 patients. Imaging demonstrated extrahepatic bile duct obstruction in the patients with jaundice and in addition picked up liver, gallbladder and pancreatic masses with or without lymphadenopathy (peripancreatic/periportal). Preoperative diagnosis was made in 4 patients and the other 14 were diagnosed after surgery. Two patients developed significant postoperative complications (pancreaticojejunostomy leak <abbrgrp><abbr bid="B1">1</abbr></abbrgrp> intraabdominal abscess <abbrgrp><abbr bid="B1">1</abbr></abbrgrp>) and 3 developed ATT induced hepatotoxicity. No patient died. The median follow up period was 12 months (9 – 96 months).</p> <p>Conclusion</p> <p>Tuberculosis should be considered as a differential diagnosis, particularly in young patients, with atypical signs and symptoms coming from areas where tuberculosis is endemic and preoperative tissue and/or cytological diagnosis should be attempted before labeling them as hepatobiliary and pancreatic malignancy.</p

MCQs in Neuroradiology: Brain and Physics

Version 1.4 of this book contains 500 multiple choice questions (MCQs) in Neuroradiology dealing with subjects of brain and physics, to assist in preparing for certification exams. The MCQs are organized into easy, intermediate and difficult categories. The answer page covers not only the topic of the MCQ but also the related material. The MCQs have been prepared mostly from the review articles especially RadioGraphics

CO2-EOR Optimization through Nanomaterial Integration: A Sustainable Approach

&lt;p&gt;The pursuit of efficient and sustainable oil production has spurred advancements in Enhanced Oil Recovery (EOR) techniques. Carbon Dioxide Enhanced Oil Recovery (CO2-EOR) has gained prominence for its potential to boost hydrocarbon recovery and curtail the environmental impact of oil production. This research paper investigates the fusion of CO2 with EOR, harnessing the transformative power of nanotechnology. Nanoparticles, with their size-dependent properties, offer a promising avenue for augmenting CO2-based EOR. This study explores the nanoparticles that are experimented for reservoir conditions under CO2-EOR method, addressing challenges and future concerns. The paper assesses the on-field reality of nanoparticle-enhanced CO2-EOR methods. Environmental considerations are paramount, as nanotechnology minimizes CO2 emissions, aligning with sustainability goals, enhancing industry competitiveness, and promoting a greener energy future.&lt;/p&gt

Leucine-rich glioma-inactivated protein 1 antibody encephalitis

Objective: To describe a case of leucine-rich glioma-inactivated protein 1 (LGI1) antibody-associated encephalitis. Methods: The clinical and ancillary data and brain MRIs were gathered retrospectively by chart review. Relevant literature on similar cases was also reviewed. Results: The diagnosis of LGI1 antibody-associated autoimmune encephalitis was based on the typical clinical presentation of seizures, psychiatric symptoms, and memory loss as well as negative diagnostic testing for cancer; the diagnosis was confirmed by positive LGI1 antibody. The patient responded favorably to treatment with IV immunoglobulin and continues to do well. Conclusion: LGI1 antibody-associated encephalitis has increasingly been recognized as a primary autoimmune disorder with good prognosis and response to treatment

Revisiting the indirect signs of a temporal bone fracture: air, air, everywhere

BACKGROUND AND PURPOSE: The standard head CT protocol makes detection of a temporal bone fracture difficult. The purposes of our study are to revisit the finding of air in various locations around the temporal bone as an indirect sign of fracture and determine if findings could predict fracture pattern. MATERIALS AND METHODS: We searched the radiology reports for the keyword temporal bone fracture. We recorded the presence of air in multiple locations around the temporal bone and pneumocephalus, opacification of the mastoid air cells or the middle ear cavity, and dominant fracture pattern. Statistical analyses were performed using statistical software. RESULTS: A total of 135 patients (mean age 40 +/- 20.1 years, 101 male, 34 female, range 1-91) had 152 fractures. At least one indirect finding was present in 143 (94.1%) fractures. Air was present adjacent to the styloid process in 94 (61.8%), in the temporomandibular joint in 80 (52.6%), adjacent to the mastoid process in 57 (37.5%), and along the adjacent dural venous sinus in 33 (21.7%) fractures. Mastoid opacification was present in 139 (91.4%) fractures. Opacification of the middle ear cavity was present in 121 (79.6%) fractures. A complex fracture significantly and positively correlated with pneumocephalus. CONCLUSION: In the setting of trauma, air around the temporal bone and opacification of the mastoid air cells or middle ear cavity should prompt consideration of a temporal bone fracture even if the fracture line is not visible. The presence of pneumocephalus predicts a higher chance of complex fracture pattern