Ectopic Infra Orbital Nerves: Case Series of a Dangerous Normal Variant.

Normal variations in the paranasal sinus region are well documented in literature. We present five cases of a little known normal variant, which can have serious implications for the patient as well as the operating surgeon. An ectopic infra orbital nerve canal coursing through the maxillary sinus has rarely been described in imaging literature. This may sometimes be mistaken for a simple septum in the maxillary sinus and may cause serious complications during Functional Endoscopic sinus surgery (FESS) surgeries. We describe the imaging findings and present a brief review of the previous publications on the same subject.

Adrenal myelolipoma, cholelithiasis and calcified spleen: retrospective diagnosis of sickle cell anemia using a novel triad of abdominal imaging findings.

Sickle cell anemia is an inherited abnormality of the globin chain with very high prevalence in the Indian subcontinent. A significant proportion of these patients present late in life and are at a risk of complications like acute chest syndrome and painful episodes till a definitive diagnosis is reached and appropriate treatment is started . We report a novel triad of abdominal imaging findings which is not reported in literature until now and which may suggest a diagnosis of sickle cell anemia in retrospect. Patients with this triad of abdominal findings should be suspected to have an underlying hemoglobinopathy and should be referred for further hematological workup. Although in our case the patient was diagnosed to have sickle cell anemia depending on the abnormal morphology of red cells and hemoglobin electrophoresis, it should be remembered that this triad of findings may be seen in other hemoglobinopathies which induce a state of chronic anemia.

Supernumerary testis: Imaging appearance of a rare entity.

Supernumerary testis is a rare congenital anomaly of the testis arising from abnormal division in the genital ridge during the embryogenesis of testis. We describe a case of polyorchidism detected incidentally in a 52-year-old with renal failure.

Von Hippel Lindau disease [VHL]: magnetic resonance imaging spectrum in a single patient.

In this case, we describe the wide magnetic resonance imaging (MRI) spectrum in a single patient who had multi organ involvement. Von Hippel Lindau Disease is a rare inherited autosomal dominant disorder characterized by development of benign and malignant lesions involving multiple organs. Imaging plays a vital role in the diagnosis and surveillance of VHL as it can differentiate benign from malignant lesions. The median life expectancy of VHL is 49 years and the commonest cause of death in patients with VHL is renal cell carcinoma and neurologic complication from cerebellar hemangioblastomas.

Communicating hydrocephalus due to cerebral venous sinus thrombosis treated with ventriculoperitoneal shunt.

Cerebral venous sinus thrombosis (CVT) is a rare cerebrovascular disease with variable presentation. CVT rarely causes hydrocephalus. Communicating hydrocephalus due to CVT is extremely rare. We describe a patient of CVT presenting with chronic headache and communicating hydrocephalus. The patient was successfully treated with ventriculoperitoneal (VP) shunt. A 40 year old man presented with moderate to severe headache since six months and progressive visual loss since two months. Head Computed tomogram showed mild hydrocephalus without obstruction. Lumbar puncture (LP) demonstrated elevated pressure but was otherwise normal. Magnetic resonance venogram showed extensive CVT. Repeated CSF drainage and thecoperitoneal shunt did not relieve the severe headache hence a VP shunt was placed. Post shunt headache subsided with resolution of hydrocephalus. CVT can present as communicating hydrocephalus. Gradual reduction of intra-ventricular pressure by repeated LPs followed by VP shunt can safely treat hydrocephalus due to CVT.

Imaging findings of disseminated cysticercosis with unusual involvement of spleen and pancreas.

In this study, we present a case of disseminated cysticercosis involving the brain, orbit, myocardium, muscle, subcutaneous tissues, pancreas, and spleen. Imaging studies are described with emphasis on pancreatic and splenic involvement which is a rare manifestation of a rather common disease and has been radiologically demonstrated only once previously. Although the involvement of the pancreas by parasites leading to pancreatitis has been described previously, in our case there was no clinical or biochemical evidence of pancreatitis due to infection by cysticerci.

Case report: Varicosity of the communicating vein between the left renal vein and the left ascending lumbar vein mimicking a renal artery aneurysm: Report of an unusual site of varicose veins and a novel hypothesis to explain its association with abdominal pain.

A communicating vein between the left renal vein and the left ascending lumbar vein has only rarely been reported in the imaging literature. There are very few reports of varicosity of this communicating vein. Nonetheless, awareness about this communicating vein is of utmost importance for surgeons performing aortoiliac surgeries and nephrectomies as it may pose technical difficulties during surgery or cause life-threatening retroperitoneal hemorrhage. Varicosity of this venous channel may be mistaken for paraaortic lymphadenopathy, adrenal pseudo-mass, or renal artery aneurysm. We report a case of a patient with varicosity of this communicating vein, which mimicked a left renal artery aneurysm. A novel hypothesis is also proposed to explain the relationship with abdominal pain.