Pfeiffer syndrome, affecting roughly 1 in 100,000 individuals is characterized by acrocephalosyndactyly – the premature closure of skull sutures (craniosynostosis). These acrocephalosyndactyly syndromes which are often sporadic de novo but also autosomal dominant in inheritance can be characterized by the fact that they often involve FGFR and TWIST genes. In the presented case, a 27-year old male level three trauma admission displayed skull abnormalities on physical examination that history taking confirmed was the result of pediatric surgically corrected Pfeiffer syndrome. Noncontrast brain CT as part of his trauma work-up revealed characteristic Pfeiffer syndrome imaging pattern of midface hypoplasia, nonvisualization of coronal and sagittal sutures, and a degree of obstructive hydrocephalus. Pfeiffer syndrome requires extensive pediatric surgery often with poor adult follow up. The case presented provides good visualization of characteristic skull abnormalities in a surgically corrected adult. By virtue of imaging an adult, this provides readers with a unique look at the long-term viability and the body's resulting physiological adaptations of the extensive mandatory pediatric surgery these patients undergo.
Persistent sciatic artery is a direct continuation of the internal iliac artery. It is a rare anatomic variant where the sciatic artery does not regress during fetal development. We present a case of a 43-year-old male with a right leg ulcer who has an incidental finding of persistent sciatic artery on Computed Tomography (CT) of the thigh with Intravenous (IV) contrast to evaluate for abscess formation. A major complication seen in some patients with persistent sciatic artery is aneurysm formation which predispose patients to limb-threatening thromboembolism. Asymptomatic cases such as this case require no intervention apart from follow up.
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