Bilateral traumatic hemorrhage of the basal ganglia is an extremely rare neuropathologic entity. This report describes a 50year-old man with bilateral basal ganglia hemorrhage with occipital fracture of the skull after head trauma. The mechanism of development of traumatic hemorrhage of the basal ganglia has been not clear. But, it is presumed to be secondary to rupture of the lenticulostriate or anterior choroidal artery by shearing as a result of acceleration/deceleration forces. We briefly summarize our uncommon case and discuss its possible mechanisms.
Bilateral facial paralysis is a rare clinical entity. It is also diagnostic challenge which, unlike unilateral facial paralysis, it is can be difficult to recognize because of a lack of facial asymmetry. A 22 year-old man referred for neurological evaluation because of bilateral facial paralysis (House-Brackmann grade V). He has initially presented unconsciousness after he sustained closed head injury after a motor vehicle accident. Initial computed tomography (CT) scans revealed a small epidural hematoma, right temporal bone fracture and air densities around the basal cistern. On the 10 th hospital day, he was noted to have incomplete closure of both eyes and a feeding difficulty with drooling. Electrodiagnostic testing confirmed the diagnosis of bilateral facial paralysis. The high-resolution CT scans showed bilateral temporal bone fractures with no facial canal involvement. There was no surgical intervention based on delayed onset of facial paralysis and the findings of the high-resolution CT scans. He recovered incompletely on post-injury 7 month without treatment. we report a rare case of post-traumatic bilateral facial paralysis with literature review.
Follicular thyroid carcinoma with metastasis rarely manifests as spinal cord compression without any previous symptoms of its malignancy. This report describes a 64-year-old man with follicular thyroid carcinoma who presented initially with left arm motor weakness. Magnetic resonance images demonstrated severe cervical cord compression by a mass with destruction of C4 vertebra. Corpectomy of C4 and anterior interbody fusion was carried out. Histopathological study revealed a metastatic follicular carcinoma of the thyroid. We present our case, especially focused of its possible pathophysiology, with review of pertinent literatures.
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