We report the unique findings on magnetic resonance imaging (MRI) in two cases of diet-related Wernicke encephalopathy (WE). There was no relation to alcohol in either case. The first patient presented with seizures and showed changes of WE on diffusion-weighted MRI with involvement of the motor strip. The second case illustrates extensive changes in the thalamus caused by WE, resulting in obstructive hydrocephalus requiring shunting.
Traumatic posterior dislocation of the sternoclavicular joint is an uncommon injury in children. It is not normally well seen on plain films. We report 2 cases where spiral computed tomography with intravenous contrast confirmed the clinical suspicion of sternoclavicular joint dislocation and also allowed assessment of the adjacent mediastinum for possible complications. Emergency physicians should be aware that the use of spiral computed tomography is the procedure of choice in posterior sternoclavicular joint dislocation. This is particularly helpful in allowing multiplanar reconstruction to show complications arising in the mediastinum.
Vertebrobasilar insufficiency presents with characteristic symptoms and signs due to impaired perfusion of the cerebellum, the brain stem, and the occipital cortex. This may be due to reduced perfusion usually due to atherosclerosis or thromboembolism. Choice of treatment depends on understanding the different underlying pathophysiologic mechanisms. Antiplatelet therapy; reduction of risk factors such as diabetes, hypertension, hypercholesterolemia, and cigarette smoking; and a healthy lifestyle form the first line of management. Systemic anticoagulation in the short term also has a key role in selected cases. In patients with refractory symptoms on maximal medical therapy and underlying focal stenotic lesions, endovascular revascularization using stents and balloon angioplasty may be indicated. Bypass surgery is another option if there are factors that render endovascular therapy unsuitable.
This is a case report on excellent clinical outcome and neotendon infilling at one year follow up in a degenerative rotator cuff full thickness tear following percutaneous tenotomy and platelet rich plasma injection.
This article illustrates clinical application of 64 Detector CT Angiography and Perfusion of the Brain in the triage of acute stroke in patients with a view to thrombolytic therapy. CTA and perfusion of the Brain is less expensive and relatively widely available compared to Magnetic Resonance Imaging. This technique is likely to be widely used in the triage of the acute stroke patient in the near future.
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