Coronary Stent for Right Transverse Venous Sinus Stenosis in a Patient With Symptomatic Idiopathic Intracranial Hypertension.

A 59-year-old woman was referred to the neuro-interventional team with complaints of headache, papilledema, and visual disturbances. Imaging and Lumbar puncture revealed signs consistent with idiopathic intracranial hypertension with stenosis of the right transverse venous sinus. The neurosurgery board chose to treat her with an endovascular approach and stenting. During the procedure, the right jugular vein revealed decreased blood flow. This led to a left jugular vein access through the confluence of venous dural sinuses. However, an incomplete confluence required the catheter to ascend the superior sagittal sinus before descending to the right transverse sinus. The carotid catheter system kept herniating up the SSS, risking rupture. Given the intraoperative findings and the available equipment, a more flexible coronary catheter system was chosen. This catheter device allowed plasty and successful stent deployment. A lumbar puncture was performed, and the patient was discharged. A follow-up MRI at five weeks showed signs of intracranial hypertension improvement and the patient reported Improvement in symptoms. To our knowledge, this is the first time this type of device has been used in this anatomical location for this pathology.

Osteogenesis Imperfecta: A Case Series and Literature Review.

Osteogenesis imperfecta (OI) is a hereditary disease of connective tissue characterized by the loss of bone density and mass, which increases the fragility of the bones, thus presenting multiple fractures throughout the years followed by bone deformity and articular instability. This condition has various clinical presentations. We present four cases of OI, one case with type I, two cases with type II, and one case with type III. The clinical diagnosis in most of the cases was clinical; only one of them was confirmed with genomic sequence. The treatment of these cases was based on medication, orthopedic surgery, and recovery and physical therapy. The evolution was torpid in these cases but with prolonged life expectancy despite the severity and type of OI. It is important to highlight that the patients did not have a neurocognitive compromise. Early diagnosis and multidisciplinary medical management are crucial in obtaining better outcomes for this disease, improving the quality of life, and avoiding complications.

Getting Closer to an Underdiagnosed Disease: Hemosuccus Pancreaticus, a Rare Cause of Upper Gastrointestinal Bleeding.

Hemosuccus pancreaticus is a rare cause of upper gastrointestinal hemorrhage. It is mainly produced by bleeding from a pseudoaneurysm that runs through the pancreatic duct and flows into the second portion of the duodenum. This article presents a case of a patient in the sixth decade of life with upper gastrointestinal bleeding who underwent a computed tomography (CT) scan of the abdomen finding a pseudoaneurysm of the gastroduodenal artery. Subsequently, angiography confirmed active bleeding from the pseudoaneurysm, requiring endovascular treatment by interventional radiology, which was successful with the resolution of the bleeding. In this article, our aim is to expand the information on this pathology and to promote the optimization of diagnostic tests for the timely treatment of this rare disease that is potentially life-threatening.

Endovascular and Endoscopic Treatment of Hemobilia: A Report of Two Cases.

Hemobilia is a term used to describe bleeding caused by abnormal communication between blood vessels and bile ducts. Some vascular anomalies, such as aneurysms or arterio-biliary fistulas, facilitate the appearance of this type of biliary bleeding. Other causes have been described such as iatrogenic causes secondary to percutaneous procedures, infections, tumors, and trauma. We report two cases of hemobilia. The first one presented with acute biliary bleeding with secondary hypovolemic shock. Bleeding was controlled after percutaneous interventions with a selective embolization technique. The second case was a patient who presented to the emergency department after a fall from his height. During hospitalization, acute cholangitis was documented, associated with hemobilia. A wide papillotomy and biliary duct instrumentation were done with the extraction of a large blood clot. Angiography is the standard for diagnosis and embolization becomes the best tool for the detection and control of vascular abnormalities that can perpetuate bleeding.

Severe Frostbite Due to Extreme Altitude Climbing in South America: A Case Report.

Frostbite is a tissue injury secondary to freezing that can currently be categorized using two schemes (Cauchy and clinical scheme). However, we present a fourth-degree frostbite case with overlapping features between both classifications, generating difficulty in categorizing it using either. We wanted to raise awareness of such an atypical presentation and propose employing both classifications to define the extent and compromise of frostbite more appropriately.