Pawan Joon

Rectal Carcinoma with Osteosclerotic Metastases-A Rare Occurrence

Colorectal carcinoma is one of the most deadly cancers worldwide. Osseous metastases are unusual until late in the disease and usually follow hepatic & pulmonary metastases. Osseous metastases in rectal carcinoma are usually osteolytic or mixed with a minor proportion presenting solely as osteosclerotic metastases. In this article, we present a rare case of rectal carcinoma showing pure, multifocal, osteosclerotic metastases at first diagnosis without any pulmonary/hepatic metastases emphasizing the role of osseous evaluation in all patients whether early or late in the disease.

Ameloblastic Transformation in Dentigerous Cyst of Ectopic Tooth in MaxillaryAntrum A Rare Entity

Dentigerous cysts are commonest type of developmental, epithelial-lined, odontogenic cysts arising in the jaw from the crowns of impacted, unerupted or embedded tooth, most often third molar. But dentigerous cysts arising from ectopic tooth in maxillary sinus is quite rare. Ameloblastoma changes in the dentigerous cysts are rare and to the best of our knowledge have not been reported to be arising from ectopic tooth in maxillary antrum. In this article, we present the radiological diagnosis, clinical features and management of this rare case of ameloblastic transformation in dentigerous cyst arising from ectopic tooth in maxillary antrum.

Can Postcontrast-T2FLAIR be a Boon over Postcontrast-T1GRE Images in MR Brain Imaging?

We are all familiar with the role of postcontrast-T1GRE images in MR brain imaging especially in the presence of space occupying lesions. But very few are aware of the role of postcontrast-T2FLAIR images in similar circumstances. Though T2-effect of gadolinium and T1-effect of T2FLAIR has been established for long yet it has not been utilized intensively and extensively in practice. However, there have been few isolated studies establishing the role of postcontrast-T2FLAIR images in variety of brain pathologies. In this study, we aim to evaluate the role of postcontrast-T2FLAIR images in various pathological conditions of brain in wider spectrum and evaluate its usefulness in comparison with postcontrast T1GRE images in clinical practice.

Unusual Pyogenic Meningitis Masquerading as Leukodystrophy

Meningitis is a frequent cause of morbidity and mortality in pediatric age-group with pyogenic cases outnumbering other etiologies especially in the Indian subcontinent. Though the diagnosis of meningitis is usually made on clinical and CSF examination yet imaging is often required to rule out focal lesions, hydrocephalus and other complications or when clinical examination is equivocal. Rarely, initial imaging may be normal or may suggest another diagnosis leading to clinicoradiological discordance making further detailed evaluation imperative. Hence, in this article, we present a rare case of pyogenic meningitis that mimicked leukodystrophy on initial imaging with unusual presentation on detailed imaging.

Pneumothorax - a Rare Presenting Sign of Sarcoidosis

Sarcoidosis is a non-infectious, inflammatory disease of unknown etiology which is characterised histologically by presence of noncaseating granulomas. It is a common pulmonary disease in Indian Subcontinent with tuberculosis as the commonest differential diagnosis. Spontaneous pneumothorax have been described in late stages of sarcoidosis but pneumothorax in early disease or the first presenting sign is very rare. This article discusses a rare case of Sarcoidosis where pneumothorax was the first presenting sign.

A Case Report of Metronidazole Induced Neurotoxicity in Liver Abscess Patient and the Usefulness of MRI for its Diagnosis.

Metronidazole is a very widely used drug for the treatment of multiple ailments caused by anaerobic bacteria as well as some protozoan parasites. Though its usual side effects are not very serious, yet sometimes it may cause profound adverse effects like neurotoxicity. We present here a case of liver abscess. The patient was treated for a long time with metronidazole and developed sudden onset neurotoxicity which was diagnosed by MRI. The present case also highlights the need of vigilant monitoring of patients on metronidazole for symptoms of neurotoxicity and the usefulness of MRI for diagnosis of the same.

Blunt Ocular Trauma - A Rare Cause of Carotico-Cavernous Fistula

Carotico-cavernous fistula (CCF) is a rare entity referring to abnormal communication between cavernous sinus and carotid arterial system (either internal or external or both) directly or through their branches. Though majority of cases have been reported secondary to head trauma yet spontaneous cases have also been described. We present an interesting case of CCF that developed secondary to blunt ocular trauma not yet described in the medical literature.

Cystic Duct Cyst with Choledochal Cyst-A Rare Coexistence

Choledochal cysts involve varying degrees of dilatation of different parts of intrahepatic and extrahepatic biliary tree. However, similar dilatation of cystic duct is of rare occurrence with few case reports in existing medical literature and majority being diagnosed during surgery. The present article discusses a rare coexistence of cystic duct cyst with choledochal cyst that was diagnosed preoperatively by characteristic imaging features.

Diffusion Tensor Tractography (DTT): An Objective Method of Determining Clinically-Relevant, Compressive, Spinal Cord Myelopathy

We commonly come across cases of compressive spinal cord myelopathy (CSCM) due to variety of clinical conditions in our day-to-day radiological practice. Magnetic resonance imaging (MRI) has long been considered as the gold-standard imaging tool for evaluation of such cases. These cases reveal signs of spinal cord compression with or without alteration in spinal cord parenchymal signal alteration. Though, diffusion tensor imaging especially fiber-tracking or tractography has been described to be superior to routine MRI in predicting prognosis and urgency of decompression yet fewer studies have been conducted to demonstrate it especially in developing world. Hence, this study aims to evaluate diffusion tensor tractography (DTT) as an advanced dimension of MRI in patients with CSCM in predicting necessity of decompression management, predicting prognosis and evaluating post-decompression outcome objectively in simplified manner. *Corresponding author: Dr. Rajul Rastogi, MD, ADND, MNAMS, FIMSA, FICRI, Department of Radiodiagnosis, Teerthanker Mahaveer Medical College and Research Center, Moradabad, U.P, India; E-mail: eesharastogi@gmail.com Received Date: August 26, 2016 Accepted Date: September 16, 2016 Published Date: September 23, 2016 Citation: Rastogi, R., et al. Diffusion Tensor Tractography (DTT) – An Objective Method of Determining Clinically Relevant, Compressive, Spinal Cord Myelopathy. (2016) Int J Neuro Brain Dis 3(3): 15. Int J Neurol Brain Disord | Volume 3: Issue 3 www.ommegaonline.org

Neuroimaging in Craniocerebral Trauma

In the present era, trauma is the commonest cause of death in the middle aged group. Cranio Cerebral Trauma (CCT) is common in both urban and rural areas and is associated with high morbidity and mortality rates. In any case of trauma, the outcome depends on two major issues: detection of type and extent of injury and the time taken for management. Though, the presenting neurologic status of the patient is the single best predictor of clinical outcome, but imaging determines the prognosis of these patients especially when the Glasgow coma scale (GCS) is high. There have been major advancements in the field of neuroimaging for CCT over the last decade.