Pott's Paraplegia in a 2 Years Female: A Rare Presentation at an Early Age.

Introduction: Potts disease is extrapulmonary skeletal tuberculosis mostly affecting the thoracolumbar spine. It destroys the disc space, adjacent vertebral bodies, and spinal elements, leading to cord compression and paraplegia. Methods: This is a case report study of a 29-month-old toddler who presented to our hospital with bilateral lower limb weakness. Results: On clinical, laboratory, and radiological examination, she was diagnosed with Pott's spine, started on antitubercular therapy, and planned for surgery in her follow-up. Conclusion: Tuberculosis of the spine is still prevalent in developing countries, mainly in children. Complications of the disease can be devastating because of its ability to cause bone destruction, spinal deformity, and paraplegia. So, in a tuberculosis-endemic region, clinical suspicion should be there for Potts disease when a child presents with paraplegia of the lower limbs. Children can develop tuberculosis which can spread to the spine despite vaccination. The prognosis of spinal tuberculosis is improved by early diagnosis and rapid intervention.

Treating upper limb claudication in a patient with Takayasu's arteritis with carotid-to-subclavian bypass: A case report.

INTRODUCTION AND IMPORTANCE: Takayasu's Arteritis (TA) is a rare form of large vessel vasculitis often being apparent late in its progression with features of artery occlusion. Studies comparing endovascular approach with bypass surgeries reveal surgery to be a better option with lesser rates of postoperative restenosis. CLINICAL PRESENTATION: A 25-year-old female patient presented with dizziness, headache, claudication and paresthesias in the right arm. Her right radial pulse couldn't be appreciated and BP on the right brachial artery was unrecordable. BP on her left brachial artery was 160/110 mmHg. CT angiogram demonstrated stenosis in the right subclavian, coeliac and left renal artery. After adequate control of hypertension and ruling out the active phase of TA, she underwent right carotid to subclavian bypass with Polytetrafluoroethylene(PTFE) graft. At 1 year follow up there was significant improvement in her right arm claudication. DISCUSSION: Symptomatic cases of TA need either endovascular angioplasty or surgical intervention to establish reperfusion. Surgery must be done only in the inactive phase of the disease because of the risk of reocclusion. The remission of TA is difficult to predict with clinical findings and ESR values. Oftentimes biopsies taken from the arteries of patients who underwent surgery showed features of active inflammation. CONCLUSION: We recommend all cases of TA to be treated with a course of steroids before planning for surgery irrespective of symptomatology and ESR values. Bypass surgeries with PTFE graft along with preoperative or postoperative steroid therapy result in resolution of ischemic symptoms.