Four crossbred cows, 3-5 year-old, naturally infected with Mycobacterium avium subspecies paratuberculosis (MAP) were sacrificed and necropsied. Clinically, they showed profused diarrhoea, emaciation and rough coat with an area of alopecia on the tail. The most prominent macroscopic lesions were thickening, oedema and corrugation of the wall of small and large intestines. The mesenteric lymph nodes were enlarged and oedematous. Microscopically, all cows presented granulomatous enteritis. The inflammatory exudates varied from accumulation of lymphoid cells mixed with some epithelioid macrophages and giant cells to sheets of epithelioid macrophages intermingled with some lymphoid cells. The lymphatics in the submucosa of both the small and large intestines were dilatated and filled with pink homogenous proteinous materials. Acid-fast bacilli (AFB) were demonstrated in the infiltrating epithelioid macrophages and giant cells. Culture of inocula from the small and large intestines and the mesenteric lymph nodes of all animals showed small, round, smooth and glistening colonies 5-7 weeks following incubation in Herrold's Egg Yolk Medium at 37°C.
Hydrocephalus (HCP) occurs due to the injurious effect of subarachnoid haemorrhage (SAH). It causes increased morbidity and mortality. It can be acute and frequently occurs within 48 hours and up to 7 days. Subacute hydrocephalus may occur up to 14 days and is chronic if remained or develops after 2 weeks of the subarachnoid haemorrhage. Acute hydrocephalus after aneurysmal subarachnoid (aSAH) bleeding is non-communicating or obstructive and occurs due to physical obstruction by a clot, the effect of blood in the subarachnoid space, and inflammation. Chronic hydrocephalus is due to fibrosis and adhesion, which hampers cerebrospinal fluid (CSF) absorption and increased secretion of CSF from gliosis. Various risk factors for developing hydrocephalus in aneurysmal subarachnoid haemorrhage patients range from female gender to high severity scores. Acute hydrocephalus frequently requires diversion drainage of CSF by external ventricular drain (EVD); it usually subsides within a week, and EVD is removed. Fewer patients will develop or continue to have hydrocephalus, requiring either short or longer shunting of the CSF namely by ventriculoperitoneal shunt or other modes of CSF drainage.
Background:Symptomatic hydrocephalus due to vertebrobasilar dolichoectasia is a rare occurrence.Case Description:We report a patient who presented with acute confusion and vomiting. Neuroimaging revealed elongated and tortuous basilar artery indenting and elevating the floor of third ventricle causing obstructive hydrocephalus. Initially, the patient was treated with external ventricular drain and then with ventriculo-peritoneal shunt.Conclusion:We suggest prompt surgical intervention upon diagnosis as a first choice of treatment in order to avoid further complications.
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