Wernicke's encephalopathy associated with fetal loss in a patient with severe hyperemesis gravidarum

Wernicke's encephalopathy is an acute neurological condition caused by thiamine deficiency. It is a rare disorder which classically occurs in alcoholic patients due to recurrent vomiting and poor oral intake. When it occurs in non-alcoholics, it is often missed and consequent mortality and morbidity is high. Pregnancy complicated by hyperemesis gravidarum represents one important clinical setting in which Wernicke's encephalopathy may occur. We present the case of a 32-year old lady who presented in the 18[th] week of her third pregnancy with recent history of difficulty walking, visual symptoms, poor concentration and lethargy. She had suffered with hyperemesis gravidarum for the preceding 10 weeks. Obstetric ultrasound revealed a dead fetus of 16 weeks size. The patient's neurological features improved significantly after starting parenteral thiamine

Colloid cyst of the third ventricle-a benign tumor with a 'malignant' nature: a report of two cases

Colloid cysts of the third ventricle are rare benign intracranial tumors accounting for less than 1.5% of brain tumors. Two cases, both of young patients presenting with sudden neurological deterioration after a long period during which they complained of intermittent headache and personality changes, are presented in this report. In the first patient the initial working diagnosis made at the district hospital referring the patient was a central nervous system infection and a lumbar puncture was contemplated but not performed. In both patients, urgent brain imaging showed acute obstructive hydrocephalus due to a mass in the area of the third ventricle which later histologically proved to be a colloid cyst. The radiological appearances of the tumor and its consequences were rather unusual in that the third ventricle was also dilated in both cases in addition to the lateral ventricles. A brief discussion of these tumors is presented with emphasis on modes of presentation and radiological appearances

Honey comb lung

Honey comb lung is a radiological term indicating the presence of fairly thick walled cysts, usually 0.5-2 cm in diameter, which don,t fill with contrast material at bronchography. These changes may be diffuse or localized. The cysts probably represent dilated and thickened terminal and respiratory bronchioles. The main causes of diffuse honey combing are idiopathic pulmonary fibrosis; rheumatoid lung; histiocytosis X; tuberous sclerosis and neurofibromatosis