Non-Ketotic Hyperglycemia-Induced Hemichorea-Hemiballism, A Case Presentation

2021 ◽  
Vol 23 (09) ◽  
pp. 439-449
Author(s):  
Dr. Praveen K Sharma ◽  
◽  
Dr. Keerthivatsan Mani ◽  
Dr. Sai Sindhura G ◽  
Dr. Muthiah P ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Hemoglobin A1c ◽  
Corpus Striatum ◽  
Clinical Results ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Case Presentation ◽  
Cross Sectional Imaging ◽  
Hyperkinetic Movement Disorder ◽  
Ketotic Hyperglycemia

Hemiballism is a rare hyperkinetic movement disorder characterized by repetitive, uncontrolled movements unilateral /or bilateral extremities, develops as a result of insult to the contralateral basal ganglia. The leading source for this disorder is ischemia, followed by non-ketotic hyperglycemia with poorly controlled diabetes. Non-ketotic hyperglycemic induced hemichorea-hemiballism is an uncommon but unique etiology of unilateral neuro-parenchymal findings restricted to corpus striatum (caudate nucleus and putamen). Nonketotic hyperglycemia-induced hemichorea-hemiballism diagnosed by Cross-sectional imaging modalities (Computed tomography and Magnetic resonance imaging), Clinical results (hemichorea-hemiballism), Laboratory tests (elevated blood glucose and hemoglobin A1c levels).

Does imaging of the olfactory tract change the clinical management of patients with olfactory disturbance? A case series of 100 consecutive patients

2014 ◽  
Vol 128 (9) ◽  
pp. 810-813 ◽  
Author(s):  
J Powell ◽  
M Reda Elbadawey ◽  
I Zammit-Maempel
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Management ◽  
Case Series ◽  
Olfactory Dysfunction ◽  
Case Review ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Olfactory Tract ◽  
Cross Sectional Imaging

AbstractBackground:Isolated olfactory dysfunction is a common complaint; the vast majority of cases are benign and untreatable. A common dilemma is whether to image the olfactory tract of affected patients.Methods:A case review of 100 consecutive patients who underwent magnetic resonance imaging for the primary complaint of olfactory dysfunction was performed. Patients with a diagnosis of chronic rhinosinusitis, with or without nasal polyps, were excluded.Results:Magnetic resonance imaging abnormalities that were considered clinically relevant to the presentation of olfactory dysfunction were found in only seven patients (7 per cent). Of these, only one patient (1 per cent) had an abnormality found that altered their clinical management. A comparison of the findings for children (less than 16 years old,n = 5) with those for adults (equal to or more than 16 years old,n = 95) revealed that 4 per cent of adults scanned had olfactory-related pathology diagnosed, as opposed to 60 per cent of children.Conclusion:Cross-sectional imaging may not be necessary in most patients with olfactory dysfunction. Imaging adds little to the patient history and clinical examination findings.

scholarly journals Imaging of the adrenal gland lesions

2014 ◽  
Vol 47 (4) ◽  
pp. 228-239 ◽  
Author(s):  
Keith Herr ◽  
Valdair F. Muglia ◽  
Walter José Koff ◽  
Antonio Carlos Westphalen
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Adrenal Gland ◽  
Photon Emission ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Contrast Enhanced Ultrasonography ◽  
Photon Emission Tomography

With the steep increase in the use of cross-sectional imaging in recent years, the incidentally detected adrenal lesion, or "incidentaloma", has become an increasingly common diagnostic problem for the radiologist, and a need for an approach to classifying these lesions as benign, malignant or indeterminate with imaging has spurred an explosion of research. While most incidentalomas represent benign disease, typically an adenoma, the possibility of malignant involvement of the adrenal gland necessitates a reliance on imaging to inform management decisions. In this article, we review the literature on adrenal gland imaging, with particular emphasis on computed tomography, magnetic resonance imaging, and photon-emission tomography, and discuss how these findings relate to clinical practice. Emerging technologies, such as contrast-enhanced ultrasonography, dual-energy computed tomography, and magnetic resonance spectroscopic imaging will also be briefly addressed.

Imaging

2017 ◽  
Author(s):  
Robert Laureno
Keyword(s):  
Resonance Imaging ◽  
Cross Sectional ◽  
Advantages And Disadvantages ◽  
Mri Scans ◽  
Cross Sectional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Cellular Pathology ◽  
Brain And Spinal Cord ◽  
The Brain

This chapter on “Imaging” examines the relative advantages and disadvantages of computed tomography (CT) and magnetic resonance imaging (MRI) scans. It compares the modalities to each other and to gross neuropathology. For several decades, neurologists have been able to view cross-sectional images of living patients. Analogous to gross neuropathology, cross-sectional imaging displays the brain as an entire organ but does not demonstrate microscopic tissue or cellular pathology. By allowing practitioners to view sections of brain and spinal cord in vivo, imaging has improved neurologic practice and facilitated clinical research. This chapter deals with imaging topics that are important to the neurologist. The timing of scans, the effects of gravity, and the importance of plane of section are considered. Imaging is compared to gross neuropathology, and MRI is compared to CT.

scholarly journals Retroperitoneal lymphangiectasia: a great clinical masquerade

2020 ◽  
Vol 8 (2) ◽  
pp. 748
Author(s):  
Siddhant Uttam Manwar ◽  
Manisha Vishnu Joshi ◽  
Devdas Sudhakar Shetty ◽  
Upendra Diwakar Bhalerao
Keyword(s):  
Clinical Presentation ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Colour Doppler ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Anatomical Extent ◽  
Sectional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Ct And Mri

Retroperitoneal lymphangiectasia is a very rare lymphatic disorder characterized by abnormal proliferation of lymphatics. We present series of 3 cases of retroperitoneal lymphangiectasia which are diagnosed in our institute with the help of Ultrasonography (USG), Computed Tomography (CT) and Magnetic resonance imaging (MRI) of abdomen and pelvis with unusual clinical presentation. We include clinical features and imaging findings of this disorder with its pathogenesis and diagnosis. Two of the cases were clinically masquerading as hernia and one case was mimicking varicocele. Thorough clinical examination and USG, colour Doppler, CT and MRI are extremely helpful imaging investigation that aid in differentiating these lesions from hernia/ varicocele and the cross sectional imaging like CT and MRI can  depict the anatomical extent of the disease.

scholarly journals Sinonasal Chondrosarcoma, an Unusual Location

2020 ◽  
Author(s):  
Oumniya Abouhanine ◽  
Aicha Merzem ◽  
Vianney Ndayishimiye ◽  
Omar Amriss ◽  
Hasnaa Belgadir ◽  
...  
Keyword(s):  
Hard Palate ◽  
Locally Advanced ◽  
Long Bones ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Extension Work ◽  
Cross Sectional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Left Maxillary Sinus ◽  
Work Up

Introduction: Chondrosarcoma is a tumour with a cartilaginous matrix frequently encountered in long bones and the pelvis with rare sinonasal location. Patient and methods: We report the case of a 25-year-old patient who was referred to us for an extension work-up for sinonasal chondrosarcoma confirmed by anatomopathological examination. Results: Facial magnetic resonance imaging (MRI) confirmed by a CT scan showed an osteolytic tumour process of the hard palate and walls of the left maxillary sinus that was locally advanced. Conclusion: The sinonasal location of a chondrosarcoma is rare. Characterized by cross-sectional imaging, confirmation was provided by histological assessment.

scholarly journals Advanced Fusion Imaging and Contrast-Enhanced Imaging (CT/MRI–CEUS) in Oncology

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2821 ◽  
Author(s):  
Vincent Schwarze ◽  
Johannes Rübenthaler ◽  
Constantin Marschner ◽  
Matthias Philipp Fabritius ◽  
Johannes Rueckel ◽  
...  
Keyword(s):  
Fusion Imaging ◽  
Resonance Imaging ◽  
Renal Surgery ◽  
Cross Sectional ◽  
Renal Lesions ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Excellent Safety Profile ◽  
Hepatic Lesions

Fusion imaging depicts an innovative technique that facilitates combining assets and reducing restrictions of advanced ultrasound and cross-sectional imaging. The purpose of the present retrospective study was to evaluate the role of fusion imaging for assessing hepatic and renal lesions. Between 02/2011–08/2020, 92 patients in total were included in the study, of which 32 patients had hepatic lesions, 60 patients had renal lesions. Fusion imaging was technically successful in all patients. No adverse side effects upon intravenous (i.v.) application of SonoVue® (Bracco, Milan, Italy) were registered. Fusion imaging could clarify all 11 (100%) initially as indeterminate described hepatic lesions by computed tomography/magnetic resonance imaging (CT/MRI). Moreover, 5/14 (36%) initially suspicious hepatic lesions could be validated by fusion imaging, whereas in 8/14 (57%), malignant morphology was disproved. Moreover, fusion imaging allowed for the clarification of 29/30 (97%) renal lesions initially characterized as suspicious by CT/MRI, of which 19/30 (63%) underwent renal surgery, histopathology revealed malignancy in 16/19 (84%), and benignity in 3/19 (16%). Indeterminate findings could be elucidated by fusion imaging in 20/20 (100%) renal lesions. Its accessibility and repeatability, even during pregnancy and in childhood, its cost-effectiveness, and its excellent safety profile, make fusion imaging a promising instrument for the thorough evaluation of hepatic and renal lesions in the future.

scholarly journals Poor ‘Real-Life’ Negative Predictive Value of Cross-Sectional Imaging in Obstructive Jaundice

2014 ◽  
Vol 28 (7) ◽  
pp. 385-390
Author(s):  
Brian A Brunson ◽  
Robert Hawes ◽  
Brenda Hoffman ◽  
Stacie Vela ◽  
Joseph Romagnuolo
Keyword(s):  
Magnetic Resonance ◽  
Obstructive Jaundice ◽  
Predictive Value ◽  
Resonance Imaging ◽  
First Line ◽  
Cross Sectional ◽  
Post Test ◽  
Cross Sectional Imaging ◽  
Line Test ◽  
Sectional Imaging

BACKGROUND: Cross-sectional imaging remains the first-line test for obstructive jaundice despite high miss rates for pancreatobiliary tumours. Improvements in resolution and slice thickness of spiral computed tomography/magnetic resonance imaging/magnetic resonance cholangiopancreatography promised to increase accuracy.OBJECTIVE: To assess whether the post-test probability of neoplasm is truly altered by the presence or absence of a mass on computed tomography/magnetic resonance imaging in obstructive jaundice.METHODS: The institutional endoscopic ultrasound (EUS) database was retrospectively reviewed to stratify patients presenting to EUS over a two-year period for obstructive jaundice (suspicious for malignancy) according to their pre-EUS imaging results. The primary analysis involved the calculation of the positive predictive value and negative predictive value (NPV) of imaging with 95% binomial CIs. Test performance of EUS/fine-needle aspiration (FNA) was also calculated. Final diagnosis was determined by positive cytology/histology; negative EUS was supplemented by clinical follow-up.RESULTS: The positive predictive value (n=51) and NPV (n=53) of pre-EUS imaging was 98% (95% CI 90% to 100%) and 9% (95% CI 3% to 21%), respectively (accuracy 53%), with post-test suspicion of malignancy similar between imaging-positive and -negative groups. EUS demonstrated a mass in 96% of imaging-positive cases versus 85% in imaging-negative cases (exact P=0.09). Malignant or suspicious FNA cytology was obtained with EUS in 92% of the imaging-positive group, and 62% of the imaging-negative group (75% of subgroup with FNA) (P<0.001).CONCLUSION: Lack of a definite mass on pre-EUS imaging had low NPV, and was clearly not sufficiently accurate or reassuring in this clinical setting. In suspicious obstructive jaundice, EUS with FNA has a high diagnostic yield regardless of the findings of pre-EUS cross-sectional imaging and, as such, EUS may be a more reasonable first-line test in this high-suspicion setting.

Spontaneous bilateral and concurrent cerebrospinal fluid otorrhoea: case presentation and literature review

2016 ◽  
Vol 130 (8) ◽  
pp. 781-786
Author(s):  
T Tikka ◽  
A Opeodu ◽  
R Irving ◽  
J Murphy
Keyword(s):  
Cerebrospinal Fluid ◽  
Otitis Media With Effusion ◽  
Time Interval ◽  
Rare Entity ◽  
Cross Sectional ◽  
Case Presentation ◽  
Tegmen Tympani ◽  
Cross Sectional Imaging ◽  
Left And Right ◽  
Prompt Diagnosis

AbstractBackground:Cerebrospinal fluid otorrhoea is a rare entity. Only a few cases of spontaneous bilateral cerebrospinal fluid otorrhoea have been reported. In all cases, there was a definite time interval between the two (left and right) presentations.Objectives:To raise awareness and report on the very rare entity of bilateral spontaneous cerebrospinal fluid otorrhoea.Case report:This paper reports the case of a bilateral, synchronous, spontaneous cerebrospinal fluid otorrhoea in a 44-year-old female. The patient had grommets surgically inserted on two separate occasions for treatment of otitis media with effusion, and received several courses of oral and topical antibiotics. Five years following the patient's initial presentation, a suspicion of concurrent bilateral cerebrospinal fluid otorrhoea was raised. The otorrhoea sample collected proved to be cerebrospinal fluid. Cross-sectional imaging revealed bilateral defects in the tegmen tympani of the skull base. She underwent staged middle fossa craniotomies to repair the defects.Conclusion:Careful observation of the middle-ear fluid characteristics following myringotomy can allow for prompt diagnosis.

scholarly journals Postoperative Outcome of Lumbar Spinal Canal Stenosis after Fenestration: Correlation with Changes in Intradural and Extradural Tube on Magnetic Resonance Imaging

2002 ◽  
Vol 10 (2) ◽  
pp. 136-143 ◽  
Author(s):  
K Yamazaki ◽  
S Yosida ◽  
T Ito ◽  
T Toba ◽  
S Kato ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Cauda Equina ◽  
Clinical Results ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
The Cross

Purpose. To evaluate the serial changes in clinical results and the intradural and extradural spaces on magnetic resonance imaging (MRI) after bilateral fenestration in 48 patients with lumbar spinal canal stenosis (LSCS). Methods. A prospective interventional study was performed to study the clinical results, magnetic resonance imaging scans among patients who were followed up for more than 3 years. Results. All patients showed improvement in clinical symptoms after operation, but clinical results deteriorated in 9 (19%) patients. Postoperative MRI scans showed that poor dural tube expansion, grouping of the cauda equina, and decrease in the cross-sectional area of the dural tube were factors associated with poor outcomes. The cross-sectional area of the dural tube and images of the cauda equina observed by MRI, before and after fenestration and during follow-up, reflected changes in clinical symptoms involving decompressed segments. Conclusion. Serial changes in the cross-sectional area of the dural tube and images of the cauda equina observed preoperatively, postoperatively, and on follow-up by MRI may be useful when evaluating patients' condition before and after operation. It is also useful for predicting outcomes.

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