Intracranial dermoid cyst is a very rare primary intracranial tumor accounting for <0.5% of intracranial masses. They are usually congenital and benign. Rupture of intracranial dermoid may occur spontaneously or with trivial trauma. Most cases of rupture are spontaneous. There are very few reported cases of traumatic rupture of intracranial dermoid cysts in world medical literature. The presentation can range from headache to signs of meningeal irritation and focal neurological deficit. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain is of paramount importance for early diagnosis and prompt treatment planning which can reduce both morbidity and mortality. The following case report gives an account of a 49-year-old female who presented with complaints of headache after an episode of fall. She was examined and no neurological deficit was found. Examination of the neurological system was within normal limits. She underwent a CT and MRI of the brain and was subsequently diagnosed as traumatic rupture of dermoid cyst based on the findings. She was treated with high-dose steroids until resolution of her symptoms and then discharged with the advice of regular follow-up. This case report highlights the role of CT and MRI in early diagnosis and treatment planning of patients with ruptured dermoid cysts which leads to a decrease in mortality and morbidity and also the ability of the same to rule out other more sinister causes of headache in patients.
Unilateral absence of internal carotid artery (ICA) is a rare congenital anomaly. We present the case of a 35-year-old man with episodes of recurrent strokes in the past and now presenting with right-sided upper limb weakness. Radiological diagnostic workup revealed a thin left ICA in the neck with non-visualization beyond petrous bone in the intracranial course. The ipsilateral brain parenchyma is supplied by vessels from the contralateral side of the Circle of Willis. As the patient had no evidence of a cerebrovascular accident on radiological evaluation and no neurological signs and symptoms, he was discharged with anticoagulant medications with the advice of follow-up. This is the first report to describe a case of ICA agenesis with a pattern of collateral circulation that doesn’t fit any of the six types described by Lie.
Eventration of the diaphragm is a condition wherein the diaphragm is abnormally elevated while retaining its normal attachments to the sternum, ribs, and dorsolumbar spine. The continuity of the diaphragm remains intact. This is a rare anomaly and is often mistaken as a diaphragmatic hernia on chest radiographs by physicians. Magnetic Resonance Imaging (MRI) gives a definitive diagnosis. We present the case of a neonate who was admitted to the Neonatal Intensive Care Unit and after X-ray and ultrasonography (USG) was presumed to have a right-sided congenital diaphragmatic hernia. But then MRI was done and the diagnosis was changed to eventration of the diaphragm as the continuity of the diaphragm was maintained. The baby was treated with surgery.
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