Menachem Hirsch

Right Atrial Thrombus and Recurrent Pulmonary Emboli Secondary to Permanent Cardiac Pacing—A Case Report and Short Review of Literature

A patient with a right atrial thrombus and recurrent pulmonary emboli sec ondary to permanent pacemaker insertion is described. Possible precipitating factors were damage to the subclavian vein, congestive heart failure, paroxys mal atrial fibrillation, and immobilization. Venography demonstrated a large atrial thrombus in the superior vena cava and right atrium. The patient was successfully treated with heparin and subsequently with warfarin and dipyrida mole.

Ectopic pituitary adenoma of the sphenoid sinus : report of a case and review of the literature

Ectopic pituitary adenoma of the sphenoid sinus in a 68‐year‐old woman is presented. The confusing discrepancy between the imaging features and the mild clinical manifestations of extensive bone destruction of the skull base is emphasized. A definite diagnosis can be established only by histopathological examination supported by immunohistochemical studies.

Radiologic assessment of the distal stomach and duodenum after gastric bypass: Percutaneous CT-guided transcatheter technique

Following some types of gastric bypass surgery for morbid obesity the conventional barium examination fails to opacify the bypassed segments of distal stomach and duodenum. The authors describe a technique for visualization of these segments by injection of contrast material through a percutaneously inserted catheter.

Computed tomography of pulmonary endometriosis

A case of pulmonary endometriosis in a woman with catamenial hemoptysis is reported. This diagnosis was established by cessation of the hemoptysis following hormonal treatment. Computed tomography appears to be the method of choice for a correct intrapulmonary localization of this disease.

Systemic-pulmonary arteriovenous fistula of traumatic origin: A case report

Arteriovenous fistulas between the systemic circulation and the pulmonary artery are extremely rare. Continuous precordial murmur is the usual clinical sign while unilateral rib notching may be the only radiologic manifestation of this condition. Selective angiographic investigation is necessary to localize the site of such an arteriovenous (AV) fistula before surgery is performed. In a review of the literature of 15 published cases, the majority were of congenital origin, with four of these systemic-pulmonary AV fistulas of traumatic origin, of which one occurred after insertion of an intercostal catheter. We describe one case of traumatic origin 9 years after percutaneous thoracic drainage for spontaneous pneumothorax, in which transcatheter embolic occlusion of the feeding arteries of an AV fistula was attempted. The advantages and the disadvantages of the nonsurgical and surgical therapeutic approaches are discussed.

Superior vena cava syndrome: presenting symptom of silent otitis media.

An extensive lateral sinus thrombosis secondary to silent otitis media, in a patient with a nephrotic syndrome, is presented. The thrombotic process progressed asymptomatically until the occlusion of the superior vena cava. Removal of the intractable pathology within the mastoid and administration of appropriate antibiotic therapy, prevented the further propagation of the life-threatening condition.

Giant cerebral echinococcus cyst with galactorrhea and amenorrhea

A case of giant left-sided frontal cerebral Echinococcus cyst causing headaches, galactorrhea--amenorrhea, secondary sterility, and gain in weight in an adult female patient is reported. The operative removal of this huge cyst led to complete neurological and endocrinologic recovery.

Pachymeningitis presenting feature of posterior sinus infection

Pachymeningitis may be the presenting symptom of an adjacent paranasal sinus or ear infection. Inflammatory disease of the posterior sinuses (sphenoid and posterior ethmoid cells) may not clinically be apparent and might be overlooked. We report three patients presenting with symptoms and signs of pachymeningitis due to posterior sinus infection. Surgical and/or medical treatment of the local disease results in resolution of the pachymeningitis.

Febrile convulsions in an adult as presenting symptom of intracranial dermoid cyst: a case report.

A 32-year-old man had generalized tonic-clonic epileptic seizures associated with episodes of recurrent high fever for 6 years. Repeated physical examinations including neurological status, EEG and nuclear brain scan were negative. Brain CT showed a non-homogeneous parasellar cyst of low density and fat-fluid levels in the lateral ventricles. The diagnosis of intracranial dermoid cyst was confirmed at surgery and histopathologically. Recurrent febrile convulsions and chemical meningitis may be the only clinical manifestations of ruptured dermoid cyst. The CT features of intracranial dermoid cyst are pathognomonic.

Klinefelter's and Takayasu's Syndromes in One Patient—A Pure Coincidence?

The patient is a classical case of Klinefelters syndrome and has, in addi tion, pulseless disease. In angiography, the involvement of the subclavian arteries and its main branches, consistent with Takayasus arteritis type 1, was demonstrated. Is it a pure coincidence that the patient with a 47 XXY karyotype also has an illness that affects mostly women?