OpenMed/multicare-articles huggingface dataset:
Refined Temporal-to-Frontal Horn Shunt for Treatment of Trapped Temporal Horn After Surgery of Peri- or Intraventricular Tumor: A Case Series Study
Authors: Xiaohui Ren, Yong Cui, Chuanwei Yang, Zhongli Jiang, Song Lin, Zhiqin Lin
Journal: Front Oncol (2021)
Keywords: hydrocephalus, intraventricular tumor, outcome, surgical treatment, temporal to-frontal horn shunt, trapped temporal horn

Background:
Trapped temporal horn (TTH) is a localized hydrocephalus that can be treated with cerebrospinal fluid diversion. Refined temporal-to-frontal horn shunt (RTFHS) through the parieto-occipital approach is rarely reported in the literature and its effectiveness remains unclear. The aim of the present study is to investigate the efficacy and outcome of RTFHS for treatment of TTH.
Materials and methods:
We consecutively enrolled 10 patients who underwent RTFHS for TTH after surgical resection of peri- or intraventricular tumors from February 2018 to March 2021. Clinical, radiological, and follow-up data were collected and analyzed. The most common underlying pathology was meningioma (n=4), followed by central neurocytoma (n=3), thalamic glioblastoma (n=2), and anaplastic ependymoma (n=1).
Results:
The mean Karnofsky performance scale (KPS) score and TTH volume at onset were 54.0 ± 15.1 (range 40-80) and 71.3 ± 33.2cm3 (range 31.7-118.6cm3), respectively. All patients (10/10, 100.0%) presented with periventricular brain edema (PVBE), while midline shift was observed in 9 patients (9/10, 90.0%). RTFHSs were implanted using valveless shunting catheters. No patients developed acute intracranial hemorrhage or new neurological deficit postoperatively. During the follow-up of 17.2 ± 13.7 months (range 3-39 months), all patients showed clinical and radiological improvement. The mean KPS score at the last follow-up was significantly increased to 88.0 ± 10.3 (range 70-100, p<0.0001). RTFHS resulted in significant complete remission in PVBE and midline shift in 8 (80.0%, p=0.0007) and 9 (100.0%, p=0.0001) patients, respectively. As the postoperative follow-up duration prolonged, the mean TTH volume decreased in a consistent, linear trend (p<0.0001). At last follow-up, the mean TTH volume was significantly reduced to 15.4 ± 11.5 cm3 (range 5.6-44.1 cm3, p=0.0003), resulting in a mean relative reduction of 77.2 ± 13.1% compared with the volume of TTH at onset. Over drainage was not observed during the follow-up. No patient suffered from proximal or distal shunt obstruction or shunt related infection, and the revision rate was 0%.
Conclusion:
RTFHS seems to be safe and effective for the treatment of TTH with favorable outcomes. Advantages of this technique could be technically less complex and invasive, cost-effective, avoidance of various intraperitoneal complications, and maintaining a near-physiological CSF pathway.
Neuroendoscopic aspiration and lavage of intraventricular empyema following shunt infection in infants
Authors: Steven Tandean, Lutfi Hendriansyah, Stanislaus Djokomuljanto, Nico Adi Saputra, Andry Juliansen, Silvia Valentina, Monica Ann Mulry, Julius July
Journal: Pan Afr Med J (2018)
Keywords: neuroendoscopic, infant, intraventricular empyema, lavage, shunt infection
MeSH terms: Cerebral Ventriculitis / therapy, Empyema / therapy, Neuroendoscopy / methods, Ventriculoperitoneal Shunt / methods, Case Reports, Cerebral Ventriculitis / etiology, Empyema / etiology, Humans, Infant, Length of Stay, Male, Therapeutic Irrigation / methods, Treatment Outcome

Bacterial ventriculitis is one of the most common and serious complications of shunt placement. Shunt infection has varied management and is difficult to treat neurosurgically. We report a case of intraventricular empyema due to shunt infection. Standard management was failed for this case and reaccumulation of pus in the both ventricles. Neuroendoscopic surgery with intraventricular lavage and aspiration using cannula nasogastric tube (NGT) through a single burr hole, has successfully decreased the accumulation of intraventricular empyema. After lavage and aspiration, antibiotic can be distributed effectively to the affected area. Follow up imaging and cerebrospinal fluid (CSF) culture shown a good result and shorter length of stay in the hospital. Neuroendoscopy appears effective and safe for the management of bacterial ventriculitis due to shunt infection in infant. The strategy described in this report might be useful to treat intraventricular empyema.
Non-cirrhotic portal hypertension secondary to cholangiointestinal anastomotic stricture after choledochal cyst excision: a case report
Authors: Xu Zhang, Jun Qing Yan, Yan Ying Gao, De Zhao Song, Cheng Lou
Journal: Front Med (Lausanne) (2023)
Keywords: case report, cholangiointestinal anastomotic stricture, choledochal cyst, gastroesophageal varices, portal hypertension
MeSH terms: Case Reports

Background:
Cystectomy accompanied by biliary system reconstruction is an important treatment option for choledochal cysts, but the risk of post-operative complications is high. The most famous long-term complication is anastomotic stricture, whereas non-cirrhotic portal hypertension secondary to cholangiointestinal anastomotic stricture is rare.
Case summary:
Here we report the case of a 33-year-old female patient with a type I choledochal cyst who underwent choledochal cyst excision with Roux-en-Y hepaticojejunostomy. Thirteen years later, the patient presented with severe esophageal and gastric variceal bleeding, splenomegaly, and hypersplenism. Furthermore, cholangiointestinal anastomotic stricture with cholangiectasis was identified on imaging. A pathological examination of the liver suggested intrahepatic cholestasis, but the fibrosis was mild and inconsistent with severe portal hypertension. Therefore, the final diagnosis was portal hypertension secondary to a cholangiointestinal anastomotic stricture after choledochal cyst surgery. Fortunately, the patient recovered well after endoscopic treatment and dilated cholangiointestinal anastomotic stricture.
Conclusion:
Choledochal cyst excision with Roux-en-Y hepaticojejunostomy is the recommended standard of care for type I choledochal cysts; however, the long-term risk of cholangiointestinal anastomotic stricture requires consideration. Moreover, cholangiointestinal anastomotic stricture can lead to portal hypertension, and the degree of elevated portal pressure may be inconsistent with the degree of intrahepatic fibrosis.
Efficacy of Omalizumab Therapy in an Asthmatic with Low IgE
Authors: Divya R, Rajesh Venkitakrishnan, Jolsana Augustine, Melcy Cleetus
Journal: Case Rep Pulmonol (2020)
MeSH terms: Case Reports

Asthma is one of the most common respiratory diseases encountered in clinical practice. Although the vast majority of asthmatics can be adequately controlled with inhaled steroids and other preventer medications, a small proportion remain uncontrolled. Anti-IgE treatment with omalizumab has been proposed in patients as a preferred approach in step 5 asthma therapy according to GINA guidelines. Although therapy with this molecule is approved for patients with atopic asthma and pretreatment serum IgE levels of 30-1500 only, there have been a few reports of its efficacy in subjects outside this reference IgE range. We report the case of a middle-aged lady with severe corticosteroid-dependent asthma and low serum IgE levels who was successfully treated with 9 months of omalizumab therapy. She gained good asthma control and was tapered off steroid use by the fifth month of therapy with omalizumab. The case report stresses the need for further investigation into expanding the spectrum of omalizumab usage in asthma beyond the current IgE suitability range.
Pericardial effusion with cardiac tamponade caused by a central venous catheter in a very low birth weight infant
Authors: Fatma-Zohra Chioukh, Karim Ben Ameur, Hayet Ben Hmida, Kamel Monastiri
Journal: Pan Afr Med J (2016)
Keywords: newborn, cardiac tamponade, pericardial effusion, pericardiocentesis, umbilical central venous catheterization
MeSH terms: Cardiac Tamponade / etiology, Catheterization, Central Venous / adverse effects, Pericardial Effusion / etiology, Pericardiocentesis / methods, Case Reports, Cardiac Tamponade / diagnostic imaging, Cardiac Tamponade / therapy, Central Venous Catheters / adverse effects, Echocardiography / methods, Female, Humans, Infant, Newborn, Infant, Very Low Birth Weight, Pericardial Effusion / diagnostic imaging, Pericardial Effusion / therapy, Umbilical Veins

With more and more extreme premature and very low-birth weight babies being resuscitated, umbilical central venous catheterisation is now being used more frequently in neonatal intensive care. One of the life-threatening complications is pericardial effusion and cardiac tamponade; however, it is potentially reversible when it is caught in time. The authors present a case of cardiac tamponade following umbilical venous catheterisation in a neonate. The patient was diagnosed at the appropriate time by echocardiography and urgent pericardiocentesis proved lifesaving.
Scabies complicated by necrotizing lymphocytic vasculitis in an infant
Authors: Houda Nassih, Fatimzehra El Hanafi, Safa Elalaoui, Rabiy El Qadiry, Aicha Bourahouat, Imane Ait Sab
Journal: Pan Afr Med J (2020)
Keywords: scabies, acral necrosis, infant, necrotizing lymphocytic vasculitis
MeSH terms: Scabies / diagnosis, Vasculitis / diagnosis, Case Reports, Humans, Immunocompromised Host, Infant, Lymphocytes / pathology, Male, Necrosis / pathology, Vasculitis / parasitology, Vasculitis / physiopathology

Scabies is very common among children. It is often a harmless infectious disease, responding well to antiparasitic medication. Nevertheless, severe forms can occur in immunocompromised populations like newborns and infants. We report a unique case of scabies in a three-months-old infant, complicated by generalized cutaneous lymphocytic vasculitis and unilateral acral necroses.
A Rare Case of Heterozygous Gain of Function Thyrotropin Receptor Mutation Associated with Development of Thyroid Follicular Carcinoma
Authors: James Blackburn, Dinesh Giri, Barbara Ciolka, Nicole Gossan, Mohammad Didi, George Kokai, Alison Waghorn, Matthew Jones, Senthil Senniappan
Journal: Case Rep Genet (2018)
MeSH terms: Case Reports

Activating mutations in thyrotropin receptor (TSHR) have been previously described in the context of nonautoimmune hyperthyroidism and thyroid adenomas. We describe, for the first time, a mutation in TSHR contributing to follicular thyroid carcinoma (FTC) in an adolescent. A 12-year-old girl presented with a right-sided neck swelling, increasing in size over the previous four weeks. Clinical examination revealed a firm, nontender thyroid nodule. Ultrasound scan of the thyroid showed a heterogeneous highly vascular mass. Thyroid function tests showed suppressed TSH [<0.03mU/L], normal FT4 [10.1pmol/L, 9-19], and raised FT3 [9.1pmol/L, 3.6-6.4]. Thyroid [TPO and TRAB] antibodies were negative. A right hemithyroidectomy was performed and the histology of the sample revealed follicular carcinoma with mild to moderate nuclear pleomorphism and evidence of capsular and vascular invasion (pT1b). Sanger sequencing of DNA extracted from the tumour tissue revealed a missense somatic mutation (c.1703T>C, p.Ile568Thr) in TSHR. Papillary thyroid carcinomas constitute the most common thyroid malignancy in childhood, while FTC is rare. FTC due to TSHR mutation suggests an underlying, yet to be explored, molecular pathway leading to the development of malignancy. The case is also unique in that the clinical presentation of FTC as a toxic thyroid nodule has not been previously reported in children.
Pasteurella multocida Septic Shock: Case Report and Literature Review
Authors: A Aljameely, G Wali
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Pasteurella multocida is a small, Gram-negative, facultatively anaerobic coccobacillus that inhabits the normal microbiota of the respiratory tract of several animals, especially cats and dogs. By infecting humans, a wide range of clinical pictures can evolve varying from mild local cellulitis to more severe systemic diseases (e.g., meningitis, pneumonia, endocarditis, and bacteremia). Septic shock is an uncommon complication of P. multocida infection, with less than 100 cases reported in the literature. It is frequently associated with cirrhotic and immunocompromised individuals and rarely immunocompetent ones. Here, we present a case of Pasteurella multocida septic shock in an elderly man secondary to leg cellulitis with a review of the relevant literature.
Abdominal pregnancy: a case report and review of 17 cases
Authors: Yu Chen, Ping Peng, Chunying Li, Lirong Teng, Xinyan Liu, Juntao Liu, Dongyan Cao, Lan Zhu, Jinghe Lang
Journal: Arch Gynecol Obstet (2023)
Keywords: abdominal pregnancy, angiography, case review, magnetic resonance imaging
MeSH terms: Pregnancy, Abdominal / diagnosis, Pregnancy, Abdominal / surgery, Case Reports, Research Support, Non-U.S. Gov't, Adult, Female, Humans, Placenta, Pregnancy, Pregnancy Trimester, First, Retrospective Studies, Uterus

Purpose:
To analyze the clinical characteristics of abdominal pregnancy, and to explore the diagnosis and prognosis of different treatment methods.
Methods:
The cases of patients with abdominal pregnancy admitted to Peking Union Medical College Hospital between January 1, 1989 and January 1, 2021, were analyzed retrospectively.
Results:
The median age of 17 patients was 34 years (22-42 years); the median gestational duration was 57 days (from 41 days to 32 weeks). Among all 17 patients, 15 (88.24%) presented with abdominal pain. The implantation sites of the gestational sac included the bladder peritoneal reflection, anterior wall of the rectum, omentum, serous membrane of the uterus, and inside or on the surface of uterosacral ligament. In all, only 29.41% cases (5/17) were diagnosed before surgery. All 17 patients were treated via surgery. Further, 58.82% (10/17) patients recovered without complications, 29.41% (5/17) developed fever, 5.88% (1/17) underwent reoperation because of intra-abdominal bleeding, and 5.88% (1/17) developed double lower limb venous thrombosis. All 17 patients survived.
Conclusion:
The preoperative diagnosis rate of abdominal pregnancy is low. Planting sites in the pelvic peritoneum and pelvic organs are more common than the others. Laparoscopic surgery in the first trimester of pregnancy can achieve better therapeutic effects. However, the blood supply of the placenta should be fully evaluated before surgery. When it is expected that attempts to remove the placenta will cause fatal bleeding, the placenta can be left in place, but long-term close follow-up should be paid attention to.
Intradural Extramedullary Cavernous Malformation of the Spinal Cord with Hemorrhagic Transformation and Rapid Expansion
Authors: Prabhat Poudel, Amrit K Chiluwal, Mohsen Nouri
Journal: Case Rep Neurol Med (2022)
MeSH terms: Case Reports

Intradural extramedullary cavernous malformations in the spinal cord are rarely occurring vascular lesions. Mostly they are clinically silent unless the hemorrhagic transformation causes subarachnoid hemorrhage or neurologic deficits. We report the case of a 51-year-old man who developed a headache and weakness of the lower limb. Spinal cord magnetic resonance imaging revealed that the cause of his symptoms was a spinal intradural and extramedullary cavernous malformation with hemorrhagic transformation causing subarachnoid hemorrhage and compression of the thoracic spinal cord. Surgical decompression of the spinal cord followed by the resection of the lesion resulted in significant neurological improvement. Early diagnosis and early surgical extirpation of the lesion should be done to prevent recurrent hemorrhagic transformation and development of neurological symptoms.
Systemic sarcoidosis mimicking malignant metastatic disease
Authors: Irena Hammen, David Lee Sherson, Jesper Roemhild Davidsen
Journal: Eur Clin Respir J (2015)
Keywords: bilateral hilar lymphadenopathy, granulomatous diseases, lung cancer, malignant metastatic disease, sarcoidosis, systemic disease
MeSH terms: Case Reports

We present a case of systemic sarcoidosis involving the liver, pancreas, lungs, mediastinal and intraabdominal lymph nodes and bones. Multiple organ system manifestations mimicked malignant metastatic disease. The diagnosis was established with clinical, radiological, and pathological findings after neoplasm was ruled out by pathological tests. The patient showed rapid symptom remission with systemic steroid treatment.
A case report of multiple artery pseudoaneurysms associated with SARS-CoV-2
Authors: Zixi Zhang, Yichao Xiao, Qiuzhen Lin, Chan Liu, Qiming Liu
Journal: Front Cardiovasc Med (2023)
Keywords: sars-cov-2, case report, gallbladder artery, pathogensis, pseudoaneursym, pulomary artery
MeSH terms: Case Reports

Arterial pseudoaneurysms are rare vascular abnormalities that can occur as a complication of infections. Artery pseudoaneurysms associated with SARS-CoV-2 are a rare occurrence in COVID-19 patients, and their rupture can result in significant hemorrhage and sudden death. Few cases of SARS-CoV-2-associated artery pseudoaneurysms have been reported, and their underlying pathophysiological mechanisms remain unclear. This study presents the first reported case of a patient who developed both pulmonary and gallbladder artery pseudoaneurysms following SARS-CoV-2 infection. We investigate the potential pathogenesis of these pseudoaneurysms and aim to improve the understanding of this rare complication.
Concurrent treatment with a tumor necrosis factor-alpha inhibitor and veno-venous extracorporeal membrane oxygenation in a post-hematopoietic stem cell transplant patient with idiopathic pneumonia syndrome: a case report
Authors: Toshitaka Koinuma, Shin Nunomiya, Masahiko Wada, Kansuke Koyama, Takahiro Suzuki
Journal: J Intensive Care (2014)
Keywords: etanercept, extracorporeal carbon dioxide removal, extracorporeal membrane oxygenation, graft-versus-host disease, hematopoietic stem cell transplantation, idiopathic pneumonia syndrome, tumor necrosis factor-alpha inhibitor

Idiopathic pneumonia syndrome (IPS) is a fatal non-infectious respiratory complication that develops after hematopoietic stem cell transplantation (HSCT). Because of the poor prognosis of post-HSCT patients with IPS requiring mechanical ventilatory support, performing extracorporeal membrane oxygenation (ECMO) has been regarded as relatively contraindicated in these patients. A tumor necrosis factor-alpha inhibitor, etanercept, has been reported to be a promising treatment option for post-HSCT patients with IPS; however, the phase III clinical trial of etanercept has recently been terminated without definitive conclusion. If post-HSCT patients with IPS really benefit from etanercept, mechanical ventilation (MV)-dependent IPS patients might be worth receiving ECMO treatment in line with the protective lung strategy. We therefore performed veno-venous ECMO (VV-ECMO), which substantially acted as an extracorporeal carbon dioxide removal, on a 56-year-old post-HSCT male with severe MV-dependent IPS due to graft-versus-host disease. Although a serious bleeding complication due to post-HSCT thrombocytopenia occurred, the VV-ECMO was continued for 11 days. The patient successfully entered remission of the IPS and was finally extubated on the 12th MV day. However, the patient soon complained of dyspnea, probably due to cytomegalovirus infection and/or exacerbation of the IPS, and was reintubated after 3 days of extubation. The patient then rapidly developed irreversible type II respiratory failure despite the administration of etanercept and an anti-cytomegalovirus agent and died on the eighth re-MV day. The autopsy findings of the patient revealed diffuse alveolar damage and alveolar hemorrhage, accompanied with bronchitis obliterans in his lungs, as well as whole body cytomegalovirus infection, which were compatible with the clinical diagnosis of the patient. We think that the legitimacy of this treatment strategy is dependent on the overall prognosis of IPS, which is influenced by the complications induced by immunosuppressants and ECMO, especially infections and bleeding.
Case Report: Treatment of Oral Lichen Planus With a Focus on Psychological Methods
Authors: Xiuli Song, Xueqi Wu, Chunye Wang, Shuguang Sun, Xiangyang Zhang
Journal: Front Psychiatry (2021)
Keywords: major depressive disorder, medication, oral lichen planus, psychogenic disease, psychological counseling
MeSH terms: Case Reports

Oral lichen planus (OLP) is one of the most common chronic diseases; however, its etiology remains unknown. More and more studies have revealed that emotional instability is one of the risk factors for the onset and expansion of OLP, especially in patients suffering from depression, anxiety disorder, and acute stress. In this case report, we had a 32-year-old female OLP patient who had no obvious response to conventional OLP drugs. Then we switched to a combination of psychotropic drugs and psychotherapies. By regulating mood through drugs and psychological counseling, the patient's oral disease was alleviated. Our case shows that clinicians should consider the mental problems of OLP patients. It also emphasizes the importance of medications and psychological counseling in the treatment of somatic diseases.
Case report: Bitter vertigo
Authors: Nicolina Goldschagg, Christian Brem, Michael Strupp
Journal: Front Neurol (2022)
Keywords: basilar artery aneurysm, case report, dolichoectasia, dysgeusia, vertigo, vestibular paroxysmia
MeSH terms: Case Reports

Background:
There are many causes of episodes of vertigo and very few causes of episodes of changes in taste, and the combination of the two is very rare. Here, we describe a patient with recurrent short episodes of vertigo in combination with simultaneous episodes of recurrent paroxysmal dysgeusia and altered feeling on the left side of face. The symptoms were caused by compression of the vestibulocochlear nerve and the facial nerve due to dolichoectasia of the basilar artery.
Methods:
The patient was diagnosed in our routine clinical practice and underwent a complete neurological and neuro-otological examination, including video head impulse test, caloric irrigation, ocular and cervical vestibular evoked myogenic potentials, acoustic-evoked potentials, neuro-orthoptic examination, cranial MRI, and MR angiography. The patient was seen twice for follow-up.
Case:
A 71-year-old patient primarily presented with a 2-year history of recurrent short episodes of spinning vertigo. Each of the episodes began with an altered feeling on the left side of the face, followed by a bitter taste on the left half of the tongue, and subsequently vertigo lasting for up to 15 s. The frequency of the attacks was high: up to 80 times per day. Laboratory tests revealed signs of a peripheral vestibular deficit on the left side. There were no signs of sensory or motor deficits or of altered taste between the episodes. An MRI of the brain showed an elongated basilar artery leading to an indentation of the facial and vestibulocochlear nerves on the left side.
Conclusion:
We propose a neurovascular compression in the proximal part of two cranial nerves because of pulsatile compression by the elongated basilar artery with ephatic discharges as the cause of the recurrent episodes. Consistent with the theory of ephatic discharges, treatment with the sodium channel blocker lacosamide for over six months with a final dosage of 200 mg per day p.o. led to a significant reduction of the attack frequency and intensity. This treatment option with a sodium channel blocker should therefore not only be considered in vestibular paroxysmia but also in cases of paroxysmal dysgeusia.