Simultaneous hemorrhage in intracranial aneurysms and in renal cyst in a case of polycystic kidney disease.

We report an unusual case of simultaneous hemorrhage in intracranial aneurysms and in renal cyst in a case of polycystic kidney disease. A 27-year-old gentleman presented with progressive headache and intermittent vomiting of one month duration. Initial computerized tomography (CT) scan and magnetic resonance imaging/angiography revealed a large mass lesion in the right temporal fossa. Over the previous 15 days, he developed progressive weakness in his left upper and lower limbs, and the headache worsened in severity. A repeat of CT scan showed an evidence of aneurysmal bleed and a large temporal lobe hematoma. The patient underwent urgent evacuation of the intracerebral of hematoma and excision of the redundant aneurysmal sac. The patient made excellent recovery in the post-operative period; however, for him, the pain abdomen was persisting. Detailed work-up with contrast-enhanced abdominal CT scan revealed bilateral multiple cysts in the kidneys with evidence of intracystic hemorrhage on the left side. An extensive search of the literature revealed that this kind of presentation has not been reported previously.

Utility of lead thyroid collar in cephalometric radiography.

OBJECTIVE: To investigate whether the application of thyroid collars (TCs) affects the results of cephalometric study. STUDY DESIGN: The Steiner cephalometric analysis of the patients was performed using lateral cephalometric radiographs, which were taken twice for each patient: Once using TCs (TC group; n = 50) and once without using TCs (NTC group; n = 50). A randomized and observer-blinded diagnostic study with head films taken from the two aforementioned groups was performed and results were evaluated with the t-test and Z-test, using GraphPad Prism 4 software. RESULTS: Statistical analysis using t-test was performed. The values of the line angles used in Steiner cephalometric analysis were compared for which values of each angle remained unchanged when done using TCs and without TC to the same samples. CONCLUSIONS: Lead shielding of the thyroid gland does not affect landmark identification or the specific measurements of the angulations traced during cephalometric analysis. TCs should be routinely applied during cephalometric radiography if cephalometric analyses are limited to the structures above the second cervical vertebra.

Utility of digital volume tomography in maxillofacial trauma.

PURPOSE: To assess the diagnostic quality of images generated using the newly developed digital volume tomography (DVT) system and comparing them with conventional images from patients with maxillofacial trauma. MATERIALS AND METHODS: The study population included 22 male patients aged 18 to 60 years with a history of maxillofacial trauma. Each patient had undergone conventional radiographic and DVT examinations to analyze the number of fracture lines in the jaws and to compare the images for their diagnostic quality by an oral radiologist and a general radiologist using the χ(2) test. RESULTS: A statistically significant difference was found between the number of fracture lines evaluated on the conventional radiographs and on DVT, especially for condylar head (7) and the midface (4.41 to 4.57), zygomaticomaxillary complex and Le Fort fractures, respectively. CONCLUSIONS: The detection of fracture lines and visualization within the mandibular-maxillary area using DVT was superior to using conventional radiographs.

Utility of color Doppler ultrasound in evaluating the status of cervical lymph nodes in oral cancer.

OBJECTIVE: The aim was to study the utility of color Doppler ultrasound (CDUS) in diagnosis of cervical lymphadenopathy in oral cancer patients. STUDY DESIGN: In a prospective study, 70 cervical lymph nodes in 30 known primary oral cancer patients were evaluated with CDUS during a period of 8 months. The intranodal perfusion sites and vascular resistance were the key CDUS features used to differentiate between reactive and metastatic cervical lymph nodes. Histopathologic confirmations were obtained by excisional biopsy of the lymph nodes. The results of preoperative clinical palpation of cervical lymph nodes and CDUS evaluation were compared with histopathologic outcome. RESULTS: Clinical evaluation suspected 61 cervical lymph nodes to be malignant. According to the CDUS, out of 70 nodes, 49 lymph nodes showed features of benign lymphadenopathy and 21 lymph nodes showed features of malignant lymphadenopathy, whereas histopathologic evaluations were in favor of reactive for 57 (81.42%) and for malignant lymphadenopathy in 13 (18.57%). CONCLUSION: The CDUS evaluation was found to be highly significant with a sensitivity of 92.90% and a specificity of 84.21%, after comparing the CDUS findings with histopathologic findings.

Osteoid osteoma of the femur: masquerading the tethered cord syndrome.

We present an illustrative case of osteoid osteoma of the femur, in an 11 year old male child where the clinical features were masquerading the diagnosis of tethered cord syndrome and lead to the delay in diagnosis.