Fifty-nine-year-old male referred to CT scan because of an anterior mediastinal mass incidentally detected at chest x-ray for check-up. Patient refers himself asymptomatic, cholecystectomy was perform...See details
Neurofibromatosis type-1 or Von Recklinghausen disease is a multisystem neurocutaneous disorder and the most common phakomatosis. One of the main characteristics of this disease is systemic and progre...See details
A coronary cameral fistula (CCF) is an abnormal communication between a coronary artery and any cardiac chamber . CCF is an uncommon disorder with an incidence of 0.1% in patients undergoing coronary ...See details
Questions and Answers:
1. The most common site of intracranial calcifications in the pediatric population is:
b. Periventricular region
c. Pineal gland
e. Falx cerebri
Answer: c. In the pediatric population, they are typically seen in the pineal gland and choroid plexus. Pineal calcifications <1cm, appear as dots and tend to be benign in 40% of individuals less than 20 years old. Whereas pineal calcifications >1cm in patients younger than 9 years should be regarded as pathologic and warrant further investigation.
2. A blush-like pattern calcifications in the bilateral basal ganglia in a child is typically seen in:
a. Tuberous sclerosis
b. Raine syndrome
c. Krabbe’s disease
d. Sturge-Weber syndrome
Answer: c. Krabbe’s disease is an autosomal recessive demyelinating disorder affecting infants due to galactocerebroside b-galactosidase deficiency leading to accumulation of abnormal lipids. A symmetrical blush-like pattern of calcifications in the bilateral basal ganglia is characteristic.
3. A 3 day-old boy was admitted to the neonatal intensive care unit after an episode of tonic-clonic seizure. His mother denied prenatal care. Non-contrast CT was showed both sub-ependymal and periventricular calcifications with cerebral volume loss. What is the most likely diagnosis?
a. Tuberous sclerosis
b. Congenital CMV
c. Congenital hypothyroidism
e. Hypoglycemia-induced seizure
Answer: b. Congenital Cytomegalovirus (CMV): Incidence is 0.2-2.4% of live births. Intracranial calcifications are seen in 77% of those with imaging abnormalities typically in the sub-ependymal and periventricular regions of the brain along with brain atrophy.
4. Among all the intra-axial brain tumors, which of the following is mostly associated with intracranial calcifications?
b. Pilocytic astrocytoma
c. Dysembryonic neuroectodermal tumors
Answer: a. Oligodendrogliomas exhibit the highest frequency of calcifications (up to 90%). Calcifications can be scattered dots or clumped together to form large nodules, located centrally or peripherally and frequently in the frontal lobes.
5. A 50-year-old female patient presented with dry cough, fatigue, and shortness of breath. On physical exam she has tender reddish bumps on the skin. Review of the systems revealed seizures and depression. CXR showed enlarged hilar lymph nodes and CT scan of the brain showed small calcified masses in the leptomeninges and periventricular white matter. What is the most likely diagnosis?
d. Chronic lead toxicity
Answer: e. Sarcoidosis affects many organs including the CNS, lungs and skin. On non-contrast CT scan of the brain, small calcified granulomas can be seen in the leptomeninges, periventricular white matter, pons, hypothalamus, pituitary stalk, and optic chiasm with varying degrees of edema.
Background: Congenital arteriovenous malformations (AVM) of the left internal mammary artery (LIMA) are exceptionally rare. Patients typically present with continuous precordial murmurs and may have a...See details
Sinus pericranii is a rare vascular anomaly consisting of abnormal transdiploic connection between the intra cranial and extra cranial venous circulations. Searching the database Medline (Ovid) using...See details
Moyamoya syndrome is a rare cerebrovasculopathy of unknown etiology but is associated with multiple risk factors. Moyamoya was first discovered in Japan and is reported to have an increased prevalence...See details
A previously well 60-year-old man presented with diarrhea to his general practitioner. He was found to have a painless epigastric mass and was referred to our institution for further investigation. La...See details
We are presenting a case of subclavian and axillary artery aneurysm, which was successfully treated with a stent graft, only to present 3 months post treatment with symptoms of graft occlusion. We ini...See details