Colloid cyst of the third ventricle presenting with features of terson's syndrome

This report describes a middle-aged man presenting to the ophthalmologist with history of seeing floaters before both eyes since 2-weeks duration. A history of intermittent headache and dizziness of recent onset was elicited on questioning. Ocular examination showed bilateral early papilloedema and mild vitreous hemorrhage. Brain computed tomography [CT] disclosed features suggestive of colloid cyst of the third ventricle in the region of foramen of Monro with moderate hydrocephalus. Emergency craniotomy and excision of the cyst was done, and the patient is doing well for the last 18 months after the surgical intervention. The mechanism of this presentation, importance of early investigations, and timely intervention are highlighted in order to avoid serious neurological sequelae. The literature was extensively reviewed for atypical presentations of intraventricular colloid cyst

Blurred vision as the sole initial presentation of disseminated lung malignancy

Symptomatic choroidal metastasis [CM] is a rare presenting feature of disseminated lung malignancy. Detection of the primary malignancy usually precedes ocular findings. We report a rare case of blurred vision secondary to bilateral CM as the sole initial manifestation of disseminated lung malignancy in a female patient. Pulmonary symptoms appeared 2 months later. She received radiotherapy and palliative chemotherapy and survived for 7 months after the initial presentation.

Adult onset Still's disease in Oman

To 1. Highlight the demographic characteristics, clinical features, laboratory investigations and outcome if possible of a relatively rare disease [Adult Onset Still's Disease [AOSD]] and 2. To compare our results with those reported earlier by others. A retrospective review of the clinical, laboratory and radiological manifestations in 6 patients admitted with AOSD. Data were collected from clinical summary of each case highlighting the demographic, clinical features and relevant investigation. The diagnosis was made on clinical base and supported by the laboratory and radiological examinations to confirm the diagnosis and/or exclude other differential diagnoses. Mean age of patients [21.6], presence of fever [80.2%] and its pattern, skin rash [80.2%], arthralgia[100%], arthritis[66.65%], and the duration of morning stiffness, all these findings were compatible with earlier results. However young adult females constitute [80.2%] of our small group, which is quite high in comparison with others. Splenomegaly [33.3%], hepatomegaly[16.6%], and lymphadenopathy[16.6%] were less than that reported by others who have more serious intra-abdominal visceral involvement. One patient [16.65%] had a fatal pulmonary embolism, although usually pulmonary involvement is a mild one. None of our patients had neurological, ophthalmological or hearing involvement. The results of the investigations and radiological findings are more or less similar to those in other series. The clinical and laboratory characteristics of our small number of patients are more or less consistent with findings of others. It is important to keep in mind that AOSD is an uncommon syndrome with a range of signs and symptoms which are non-specific and may simulate a variety of connective tissue and general medical problems. Differences in the expression of AOSD were found between patients from different locations and the disease can be responsible for life-threatening complications

Osteomyelitis of the thoracic cage in patients with sickle cell disorder

Thoracic cage osteomyelitis is an extremely rare manifestation in its pure form in sickle cell disease [SCD]. However rib infarction may be a common occurrence in SCD leading to a vicious cycle of chest pain, hypoventilation atelactasis, hypoxia and acute chest syndrome. Two cases of osteomyelitis, one of ribs and the second of sternum in sickle cell disease patients are reported here. The clinical presentation laboratory and radiological abnormalities as well as the response to therapy and outcome is presented

case of recurrent abdominal pain

The paper decribes the case of a forty-year-old male patient who was admitted with recurrent abdominal pain. Investigations revealed high levels of blood lead; symptoms responded promptly to treatment. The paper also reviews lead poisoning and its treatment