OpenMed/multicare-articles huggingface dataset:
Open-ring enhancement in pseudotumoral multiple sclerosis: important radiological aspect
Authors: Frederico Carvalho de Medeiros, Lucas Alverne Freitas de Albuquerque, Jose Eymard Homem Pittella, Renata Brant de Souza, Antonio Pereira Gomes Neto, Paulo Pereira Christo
Journal: Case Rep Neurol Med (2014)

Introduction. Observation of open-ring enhancement in magnetic resonance imaging (MRI) is considered a specificity marker for diagnosing pseudotumoral multiple sclerosis (MS). This finding is of great value in the differential diagnosis of tumefactive lesions. Case Report. We describe a 55-year-old white woman, with previous history of ovarian cancer and recent history of fatigue and bilateral retroorbital pain. Important bilateral visual impairment evolved over one month. Physical examination detected the presence of right homonymous hemianopia. Cranial MRI showed an expanding lesion with open-ring enhancement. Given the range of diagnostic possibilities, a stereotactic biopsy was performed, and histopathological examination was consistent with an active demyelinating disease. The patient was treated with 1 g of methylprednisolone and symptoms improved following a significant reduction in the lesion. Conclusions. We highlight the MRI results suggestive of pseudotumoral MS, especially open-ring enhancement, which is an important radiologic aspect to diagnosis and can assist in avoiding unnecessary biopsies.
An Innocent Esophageal Mucosal Bridge: Case Report and Literature Review
Authors: Tagore Sunkara, Eric Omar Then, Krishna Sowjanya Yarlagadda, Manan Jhaveri, Vinaya Gaduputi
Journal: J Investig Med High Impact Case Rep (2018)
Keywords: dysphagia, endoscopy, esophagus, mucosal bridge

An esophageal mucosal bridge is a rare finding that is seldom encountered on upper endoscopy. They most commonly present secondary to an underlying inflammatory disorder and cause chest pain and dysphagia, among other symptoms. More rarely, they present asymptomatically with no identifiable inflammatory conditions. Our case consists of a 31-year-old woman who presented with an asymptomatic, noninflammatory mucosal bridge of the esophagus. To our knowledge, this makes the third such case. The rarity of this condition coupled with the lack of epidemiologic data available make this case worthy for literature review.
Two years survival of primary cardiac leiomyosarcoma managed by surgical and adjuvant therapy
Authors: K Behi, M Ayadi, E Mezni, K Meddeb, A Mokrani, Y Yahyaoui, F Ksontini, H Rais, N Chrait, A Mezlini
Journal: Clin Sarcoma Res (2017)
Keywords: cardiac tumors, chemotherapy, leiomyosarcoma, survival
MeSH terms: Case Reports

Background:
Cardiac tumors are a very rare entity. Leiomyosarcoma represents less than 1% of cases.
Case presentation:
a 51-year-old woman diagnosed with primary left atrium leiomyosarcoma. She was treated by optimal surgery and adjuvant chemotherapy. She is still alive after a follow-up of 24 months without evidence of local or distant recurrence.
Conclusions:
Cardiac leiomyosarcoma is a rare tumor with a dismal prognosis. Surgery is the mainstay of treatment. Adjuvant treatment is still controversial.
CASE REPORT Spontaneous Forearm Compartment Syndrome in a Boy With Hemophilia A: A Therapeutic Dilemma
Authors: Jennifer Kim, Jonathan Zelken, Justin Michael Sacks
Journal: Eplasty (2013)

Objective:
We present the case of a 14-year-old Factor VIII-deficient patient with no history of trauma, who developed acute spontaneous compartment syndrome of the volar forearm. We also suggest a treatment strategy.
Methods:
Fasciotomy with hematoma evacuation and ipsilateral carpal tunnel release was performed, and the wound was closed with vascular loops in "Jacob's ladder" fashion. Factor infusions were continued overnight.
Results:
The volar forearm compartment was successfully decompressed, and the patient's coagulopathy was managed with appropriate clotting factors.
Conclusions:
Hemophilic patients warrant special consideration and multispecialty care; with replenished coagulation factors and timely surgical decompression, they can expect satisfactory recovery of muscular and neurological function.
Unusual presentation of hepatocellular carcinoma invading the anterior abdominal wall muscles
Authors: Nayef AlShabyli
Journal: Pan Afr Med J (2014)
Keywords: hepatocellular carcinoma, abdominal wall, metastases
MeSH terms: Abdominal Neoplasms / diagnosis, Carcinoma, Hepatocellular / diagnosis, Liver Neoplasms / diagnosis, Case Reports, Abdominal Muscles / pathology, Abdominal Neoplasms / secondary, Abdominal Wall / pathology, Adult, Carcinoma, Hepatocellular / pathology, Humans, Liver Neoplasms / pathology, Male, Neoplasm Invasiveness

Hepatocellular carcinoma (HCC) is a common cancer all over the world. It demonstrates a tendency for vascular invasion, producing extensive intrahepatic metastases and portal vein or inferior vena cava extension. Tumor spread of abdominal diseases via hepatic ligaments has also been reported. The author reports a rare case of HCC invading the anterior abdominal wall muscles and protruding into the subcutaneous fat.
Case Report: Postmortem brain and heart pathology unveiling the pathogenesis of coexisting acute ischemic stroke and electrocardiographic abnormality
Authors: Yorito Hattori, Shuhei Ikeda, Manabu Matsumoto, Naoki Tagawa, Kinta Hatakeyama, Masafumi Ihara
Journal: Front Cardiovasc Med (2023)
Keywords: atrial fibrillation, cardiocerebral infarction, cardioembolic stroke, coronary artery embolism, myocardial infarction
MeSH terms: Case Reports

Electrocardiography abnormalities have been occasionally reported at the onset of stroke. Simultaneous electrocardiographic abnormalities and stroke require a rapid differentiated diagnosis among several diseases. However, direct causal relationships remain unclear. A 92-year-old woman presented to our emergency department in a sudden-onset coma. The patient suffered from huge acute ischemic stroke with bilateral internal carotid artery occlusion assessed by brain magnetic resonance imaging, and her electrocardiography showed ST-segment elevation at II, III, aVF and V4-6, and atrial fibrillation (AF). However, the etiology of the medical condition was clinically unknown. Eventually, the patient died on day 4 of hospitalization before the diagnosis could be completed. Therefore, an autopsy was performed to investigate pathological findings after obtaining informed consent from the family. A postmortem pathological evaluation demonstrated that fibrin mural thrombi in the left atrial appendage (LAA), and the cerebral and coronary arteries possessed CD31-positive endothelial cells, and CD68-positive and CD168-positive macrophages in a similar fashion, suggesting the fibrin thrombi observed in the three sites implicated to be identical. We concluded that nearly concurrent cerebral and coronary artery embolism because of the fibrin thrombi in LAA developed by AF. Simultaneous cerebral infarction and myocardial infarction are referred to as cardiocerebral infarction (CCI), a rare disorder for which clear pathomechanisms remain unknown, although several mechanisms of CCI have been proposed. We first revealed the clear pathology of CCI using the autopsy. Additional pathological studies are warranted to establish clear pathomechanisms and preventive strategies of CCI.
Laryngeal chondroma: a rare diagnosis in this localization
Authors: Ebru Tastekin, Semsi Altaner, Cem Uzun, Ahmet R Karasalihoglu, Cigdem Ozdemir, Ali Kemal Kutlu
Journal: Case Rep Pathol (2011)
MeSH terms: Case Reports

Primary chondroid tumors of the larynx represent less than 1% of all laryngeal tumors. Most of them are chondromas and they often involve to the cricoid cartilage. A 31-year-old male patient applied to the oto-laryngology service with a history of dysphonia and dyspnea. Microlaryngoscopy revealed 2 cm sized, ill-defined, covered with regular mucosa, porous, and hard mass on posterior surface of crycoid cartilage in subglottic area. Following the excision of the lesion, histopathologic examination revealed as chondroma. Two years later, local recurrence was detected and the diagnosis was again chondroma. There was no complaint of the patient in last 3 and half years of follow-up. Chondroma should carefully be differentiated from chondrosarcoma and the patients should be followed for possible recurrences.
Case Report: Gollop-Wolfgang Complex in a 5 month old baby
Authors: Ihtesham A Qureshi, Rohit Kumar Gudepu, Ravikanth Chava, Sravya Emmani, Syed Husain Asghar, Mohtashim A Qureshi, Nimmathota Arlappa
Journal: F1000Res (2014)
Keywords: skeletal dysplasias, gollop-wolfgang complex, limb deficiency

Skeletal dysplasias are disorders associated with a generalized abnormality in the skeleton. The Gollop-Wolfgang complex (GWC) is a limb deficiency disorder and an unusual limb malformation with highly variable manifestations. Here we report an interesting case of a 5-month old male baby from India with Gollop-Wolfgang Complex showing bifurcation of the right femur, ectrodactyly of both feet, ectrodactyly of left hand, syndactyly of right hand and unusual presentation of bilateral fibular agenesis and caudal (Sacrococcygeal) agenesis. The etiology of GWC in this 5 month old male baby could possibly be attributed to spontaneous gene mutation. The clinical, radiographic findings and the unusual presentation are presented in detail.
Effects of Piano Training in Unilateral Cerebral Palsy Using Probabilistic and Deterministic Tractography: A Case Report
Authors: Ana Alves-Pinto, Mónica Emch, Renée Lampe
Journal: Front Hum Neurosci (2021)
Keywords: diffusion tensor imaging, diffusivity, dorsal cingulate, fractional anisotropy, rehabilitation, sensorimotor
MeSH terms: Case Reports

Cerebral palsy (CP) is an umbrella term encompassing motor and often additional disabilities, resulting from insult to the developing brain and remaining throughout life. Imaging-detected alterations in white matter microstructure affect not only motor but also sensorimotor pathways. In this context, piano training is believed to promote sensorimotor rehabilitation for the multiplicity of skills and neuronal processes it involves and integrates. However, it remains unknown how this contribution may occur. Here, effects of 1.5 years of piano training in an adolescent with unilateral CP were investigated through tests of manual function and by comparing fractional anisotropy, mean diffusivity, radial and axial diffusivity in neuronal pathways pre- vs. post-training. In the absence of a control condition and of data from a larger cohort, both probabilistic neighborhood and deterministic tractography were employed to reduce bias associated with a single-case analysis and/or with user-input. No changes in manual function were detected with the tests performed. In turn, the two tractography methods yielded similar values for all studied metrics. Furthermore, post-hoc analyses yielded increased fractional anisotropy accompanied by decreases in mean diffusivity in the bilateral dorsal cingulate that were at least as large as and more consistent than in the bilateral corticospinal tract. This suggests contributions of training to the development of non-motor processes. Reduced anisotropy and correspondingly high mean diffusivity were observed for the bilateral corticospinal tract as well as for the right arcuate and the inferior longitudinal fasciculus, two sensory processing-related pathways, confirming the importance of sensorimotor rehabilitation in CP.
No Compliance Correction of Class II Malocclusion in Growing Patients Whit HERBST Appliance: A Case Report
Authors: M Portelli, A Militi, M Cicciù, A Lo Giudice, G Cervino, R Fastuca, R Nucera
Journal: Open Dent J (2018)
Keywords: functional appliance, herbst appliance, mandibular growth, mandibular retrusion, no compliance apparatus, skeletal class ii malocclusion

Background:
Class II malocclusion is the most common sagittal skeletal discrepancy, with a prevalent skeletal pattern of mandibular retrusion. The correction of mandibular retrusion with functional removable appliance needs a good patient's compliance; for this reason, some clinicians prefer to use no compliance apparatus.
Objective:
Objective of the present therapy note is to demonstrate that the use of no compliance apparatus can provide a good correction of skeletal class II malocclusion.
Methods:
In the present study, authors report a therapy note referred to a 10 years old patient, woman, affected by Class II, with mandibular retrusion and deep bite, treated in 2013 at the Dep. of Orthodontics of Messina University. An orthodontic treatment has been planned with the aim of stimulating mandibular growth; an Herbst appliance with a cantilever design, bonded on first maxillary and mandibular molars, has been used. After eleven months of functional therapy a bilateral molar class I have been obtained.
Results:
In the therapy note proposed, authors obtained a resolution of mandibular retrusion, a correction of overjet, overbite and dental crowding in both arches, and a bilateral molar and canine class I has been achieved.
Conclusion:
Herbst appliance seems to be efficient in the correction of II Class Malocclusion, independently from patient's cooperation; moreover , early correction of Class II malocclusion with functional appliances produces several clinical advantages.
Acute ischemic stroke in young women secondary to atherosclerosis: a unique ophthalmic presentation with central retinal artery occlusion: a case report
Authors: Salma Moutamani, Taha Boutaj, Amine Ennejjar, Wiame Touil, Abdellah Amazouzi, Ouafa Cherkaoui
Journal: Pan Afr Med J (2022)
Keywords: atherosclerosis, case report, ischemic stroke, neuro-ophthalmology, retina
MeSH terms: Atherosclerosis / complications, Atherosclerosis / diagnosis, Ischemic Stroke, Retinal Artery Occlusion / complications, Retinal Artery Occlusion / etiology, Case Reports, Adult, Eye, Face, Female, Humans

Central retinal artery occlusion (CRAO) is a rare condition. It is a diagnostic and therapeutic emergency. CRAO is analogous to an acute stroke of the eye. The disease usually affects patients after 60 years of age, and rarely young persons. The risk factors for a CRAO are similar to ischemic stroke. It is due to embolic, thrombotic, or coagulation disorders. Typically, patients with acute CRAO present monocular, painless, and severe loss of vision. We report a rare case of a young 33-year-old woman who presented an atypical ischemic stroke revealed by a unilateral CRAO. This case reports a rare condition affecting a young patient, and highlights the interest of ophthalmologic examination in the diagnostic of a neuro disease and the early management of ischemic stroke.
Phencyclidine Induced Oculogyric Crisis Responding Well to Conventional Treatment
Authors: Hassan Tahir, Vistasp Daruwalla
Journal: Case Rep Emerg Med (2015)

Background. Oculogyric crisis is a form of acute dystonic reaction characterized by involuntary upward deviation of eye ball. Its causes are broad with antipsychotics and antiemetics as the most common causes. Case Presentation. A 25-year-old man with the past medical history of marijuana use presented to ED with involuntary upward deviation of eye 1 day after using phencyclidine (PCP) for the first time. He did not have any other symptoms and was hemodynamically stable. All laboratory investigations were normal except urine drug screen which was positive for PCP. Patient was treated with IV diphenhydramine which improved his symptoms. Conclusion. Illicit drug abuse is a growing problem in our society with increasingly more patients presenting to ED with its complications. The differential diagnosis of acute dystonic reactions should be extended to include illicit drugs as the potential cause of reversible acute dystonias especially in high risk patients.
Successful clavicle fracture surgery performed under selective supraclavicular nerve block using the new subclavian approach
Authors: Hironobu Ueshima, Hiroshi Otake
Journal: JA Clin Rep (2016)
Keywords: cervical plexus nerve block, clavicular fracture, selective only supraclavicular nerve block
MeSH terms: Retracted Publication

Objectives:
Cervical nerves block cannot be performed on some patients because of the risk of phrenic nerve paralysis. To overcome this limitation, we discovered the site of selective only supraclavicular nerve block at the subclavian site.
Case report:
We present the case of a 62-year-old woman with clavicular fracture. We performed a selective block of the supraclavicular nerve and the fifth and sixth cervical nerves for the clavicle fracture surgery.
Conclusions:
We can perform selective supraclavicular nerve blocks for clavicular fracture surgery of patients who have bilateral pneumothorax.
Severe hydronephrosis and dysuria-hematuria syndrome after 20 years of bladder exstrophy correction: a case report
Authors: Emanuela Altobelli, Alfredo Maria Bove, Federico Sergi, Marzio Angelo Zullo, Maurizio Buscarini
Journal: Case Rep Urol (2012)

The aim of this paper is to report a case of severe hydronephrosis and incontinence 20 years after bladder exstrophy repair, managed successfully by secondary ureteroneocystostomy and by transurethral submucosal injection of Macroplastique.
Homozygous Autosomal Recessive DIAPH1 Mutation Associated with Central Nervous System Involvement and Aspergillosis: A Rare Case
Authors: Hossein Esmaeilzadeh, Rafat Noeiaghdam, Leila Johari, Seyed Ali Hosseini, Sayyed Hesamedin Nabavizadeh, Soheila Sadat Alyasin
Journal: Case Rep Genet (2022)
MeSH terms: Case Reports

The DIAPH1 gene fulfills critical immune and neurodevelopmental roles. It encodes the mammalian Diaphanous-related formin (mDia1) protein, which acts downstream of Rho GTPases to promote F-actin polymerization and stabilize microtubules. During mitosis, this protein is expressed in human neuronal precursor cells and considerably affects spindle formation and cell division. In humans, dominant gain-of-function DIAPH1 variants cause sensorineural deafness and macrothrombocytopenia (DFNA1), while homozygous DIAPH1 loss leads to seizures, cortical blindness, and microcephaly syndrome (SCBMS). To date, only 16 patients with SCBMS have been reported, none of whom were from Iran. Furthermore, aspergillosis is yet to be reported in patients with homozygous DIAPH1 loss, and the link between SCBMS and immunodeficiency remains elusive. In this study, we shed further light on this matter by reporting the clinical, genetic, and phenotypic characteristics of an Iranian boy with a long history of recurrent infections, diagnosed with SCBMS and immunodeficiency (NM_005219.5 c.3145C > T; p.R1049X variant) following aspergillosis and SARS-CoV-2 coinfection.
Prolactin-Producing Pituitary Carcinoma, Hypopituitarism, and Graves' Disease-Report of a Challenging Case and Literature Review
Authors: Rita Bettencourt-Silva, Josué Pereira, Sandra Belo, Daniela Magalhães, Joana Queirós, Davide Carvalho
Journal: Front Endocrinol (Lausanne) (2018)
Keywords: graves’ disease, adrenal insufficiency, hypopituitarism, pituitary carcinoma, pituitary surgery, prolactinoma
MeSH terms: Case Reports

Introduction:
The diagnosis of pituitary carcinoma is very rare, requires the evidence of metastatic disease, and has a poor overall survival. Malignant prolactinoma frequently requires dopamine agonist therapy, pituitary surgery, radiotherapy, and even chemotherapy.
Case description:
A 19-year-old female presented with galactorrhea, primary amenorrhea, and left hemianopsia. Complementary study detected hyperprolactinemia and a pituitary macroadenoma with cavernous sinus invasion and suprasellar growth. She was treated with cabergoline and bromocriptine without clinical or analytical improvement. Resection of the pituitary lesion was programmed and a non-contiguous lesion of the nasal mucosa was detected during the approach. This metastasis led to the diagnosis of prolactin-producing pituitary carcinoma. After partial resection, the patient was submitted to radiotherapy for residual disease with persistent symptoms. She developed growth hormone deficiency, central hypothyroidism, hypogonadism, and permanent diabetes insipidus. Six years later she was admitted for the suspicion of secondary adrenal insufficiency and thyrotoxicosis. Physical findings, laboratory data, thyroid ultrasound, and scintigraphy achieved the diagnosis of Graves' disease and hypocortisolism. She was treated with hydrocortisone and methimazole, but central hypothyroidism recurred after antithyroid drug withdrawal. Nine years after the diagnosis of a pituitary carcinoma, she maintains treatment with bromocriptine, has a locally stable disease, with no metastases.
Conclusion:
This report highlights an unusual presentation of a prolactin-producing pituitary carcinoma in a young female. The patient had multiple hormone deficiencies due to a pituitary lesion and treatments. The posterior development of hyperthyroidism and adrenal insufficiency brought an additional difficulty to the approach.
Holocord oligodendroglioma with intracranial extension in a young adult: a case report and review of literature
Authors: Romulus Emmanuel H Cruz, Ranhel C De Roxas, Carmela Concepcion A Sales-Callangan, Roland Dominic G Jamora
Journal: CNS Oncol (2018)
Keywords: holocord tumors, intramedullary spinal cord tumors, spinal gliomas, spinal oligodendroglioma, widespread spinal tumors
MeSH terms: Brain Neoplasms / diagnostic imaging, Brain Neoplasms / pathology, Oligodendroglioma / diagnostic imaging, Oligodendroglioma / pathology, Spinal Cord Neoplasms / diagnostic imaging, Spinal Cord Neoplasms / pathology, Case Reports, Review, Brain Neoplasms / genetics, Fatal Outcome, Female, Humans, Oligodendroglioma / genetics, Spinal Cord Neoplasms / genetics, Young Adult

Widespread primary spinal oligodendrogliomas are a rare variety of tumors that usually affect children. Currently, there are only two adult cases reported worldwide. We report the first case of primary holocord oligodendroglioma with intracranial extension in a young adult female. The patient presented with a 4-month history of fluctuating hemiparesis of the left upper extremity eventually becoming quadriplegic after 1 month. Imaging findings revealed a contrast-enhancing holocord neoplasm spanning from the cervical region to the conus medullaris and with extension to the lower medulla. The patient succumbed to severe pneumonia after 1 month of admission. An autopsy was done and the histopathologic findings were consistent with oligodendroglioma.
Use of zirconia to restore severely worn dentition: a case report
Authors: Manish Agrawal, Banashree Sankeshwari, Channaveer V Pattanshetti
Journal: Case Rep Dent (2012)

The management of tooth wear has been a subject of increasing interest from both preventive and restorative points of view. Severe tooth wear is frequently multifactorial and variable. Successful management is a subject of interest in dentistry. A critical aspect is to determine the occlusal vertical dimension (OVD) and a systematic approach that can lead to a predictable and favorable treatment prognosis. Management of patients with worn dentition is complex and difficult. Accurate clinical and radiographic examinations, a diagnostic wax-up, and determining OVD are crucial. This paper describes the full-mouth rehabilitation of a 47-year-old bruxer with a severely worn dentition.