Pulmonary nodular lymphoid hyperplasia presenting as cavitating lung mass.

Pulmonary nodular lymphoid hyperplasia (PNLH) is a rare non-neoplastic disorder, which can mimic malignancy due to its indolent yet progressive nature. Here, we report a case of surgically proven PNLH that progressed over many years from a ground glass opacity to a solid cavitating lesion mimicking a slow growing primary lung carcinoma.

Supernumerary tooth in nasopalatine canal: a rare cause of septal cartilage collapse.

Mesiodens is the most common type of supernumerary tooth, located between the maxillary central incisors in close relation to the nasopalatine canal. A 20-year-old man presented with right-sided nasal blockage, nasal discharge and collapsed nose without history of trauma. Imaging revealed a calcified mass in the inferior meatus extending into dilated nasopalatine canal.

Chest x-ray scoring as a predictor of COVID-19 disease; correlation with comorbidities and in-hospital mortality.

Objectives: To devise a novel, simple chest x-ray (CXR) scoring system which would help in prognosticating the disease severity and ability to predict comorbidities and in-hospital mortality.

Methods: We included a total of 343 consecutive hospitalised patients with COVID-19 in this study. The chest x-rays of these patients were scored retrospectively by three radiologists independently.

Choroid plexus and CSF: an updated review.

In this article, we review the available literature about the functions of the choroid plexus (ChP), including its basic role in cerebrospinal fluid (CSF) secretion, renewal and absorption. We discuss more recently described, lesser-known functions of the ChP, such as its role in circadian rhythm regulation, chemical and immune surveillance and functional implications of ChP disruption, as occurs in neurodegenerative disorders.

Antiphospholipid syndrome leading to paradoxical embolus and stroke via secundum atrial septal defect.

We have presented a case of a 22-year-old man, presenting with cerebral infarct, subsequently found to have antiphospholipid syndrome (APS), deep venous thrombosis, pulmonary embolism and atrial septal defect (ASD), thereby confirming the presence of infarct due to paradoxical embolism in this patient. The importance of ASD in the patients of APS, resulting in paradoxical embolism is debatable, with recent studies undermining its importance. We have demonstrated that it does indeed happen.

Depiction of detailed surgical anatomy and CSF flow information using a single MRI technique.

We describe a novel MRI sequence (T2 SPACE) capable of demonstrating detailed structural anatomy and functional CSF flow information simultaneously. While traditionally, a variety of sequences are utilised for this purpose, we have highlighted the advantages of this technique over traditional approaches, using example of a patient with CSF loculation in prepontine/suprasellar cistern, causing third ventricular compression and hydrocephalus. The sequence depicted the surgical anatomy by showing the web/cyst wall as well as CSF flow entering the cyst potentially causing increased pressure.

Giant perivascular space: a rare cause of acute neurosurgical emergency.

We present a rare case of giant perivascular space in mesencephalo-thalamic region causing hydrocephalus. The patient presented insidiously over 6 months. However, the patient suddenly deteriorated in the hospital with visual symptoms, increasing headache and papilloedema, prompting urgent VP shunt and biopsy.

A rare case of non-clostridial infection in a non-diabetic patient.

A 76-year-old man presented with neck swelling associated with pain and fever. On examination, there was a submental neck swelling. His initial CT scan showed multiloculated abscess centred in the left submandibular gland.

Functional herniated choroid plexus in brain parenchyma following VP shunt removal.

We report a 4-year-old male who presented with a blocked ventriculoperitoneal (VP) shunt inserted post excision of a WHO Grade 1 cerebellar pilocytic astrocytoma complicated post-operatively by pseudo meningocoele formation. Imaging revealed choroid plexus that had herniated along the shunt tract. Subsequent MRI showed development of cystic changes around the tract.

Developing patient-centred MRI safety culture: a quality improvement report.

Objective: Despite having a detailed MRI-safety questionnaire check at the point of referral, we have encountered a significant number of near-misses with patients being identified with MRI-Unsafe devices at the time of appointments, making this an important safety hazard.

Methods And Materials: A two-part survey was performed to assess referrer compliance of asking MRI-questionnaires. 120 outpatients across 3 MRI sites were interviewed at the time of appointment to confirm whether their referrers completed the MRI questionnaires with them at the time of referral.

Xanthomatous hypophysitis causing hypogonadotropic hypogonadism resulting in delayed presentation of slipped capital femoral epiphysis.

An 18-year-old man who underwent bilateral pinning of his hip joints after a left unstable Slipped Capital Femoral Epiphysis (right pinned prophylactically) was noted to have delayed secondary sexual characteristics and post-operative diabetes insipidus. The patient also described a history of fatigue, headache and polydipsia for the past 4 years. Endocrine investigations revealed reduced androgen levels, hypocortisolism, a borderline normal Serum ACE and secondary hypothyroidism.

An unusual case of a grade I meningioma with perineural spread.

A 39-year-old lady with worsening intermittent diplopia and headaches was diagnosed with a WHO Grade I Meningothelial Meningioma with highly unusual perineural spread on imaging, making this the first reported case of this behaviour. Complete surgical resection was deemed too great a risk and the patient remains under observation. The process of perineural spread is not restricted to more aggressive brain tumours.

Unusual case of intracranial dural AV fistula presenting with acute myelopathy.

We present a case of intracranial arteriovenous fistula with perimedullary venous drainage presenting with acute myelopathy, which is an unusual presentation of this uncommon condition. Subsequent catheter angiogram defined the arterial feeders from the meningohypophyseal trunk and petrosal branch of the middle meningeal artery. The patient was successfully embolised, resulting in complete obliteration of the fistula, and significant resolution of brainstem and cervical cord changes along with clinical improvement.

Role of susceptibility-weighted imaging in demonstration of cerebral fat embolism.

Cerebral fat embolism (CFE) is a rare but potentially lethal complication of long bone fractures. Many cases of CFE occur as subclinical events and remain undiagnosed. We report a case of a 22-year-old man, with multiple long bone fractures from a road traffic accident, who subsequently developed hypoxia, neurological abnormality and petechial rash.

Chiari II malformation mimicking partial rhombencephalosynapsis? A case report.

Rhombencephalosynapsis is a rare congenital intracranial malformation with very few cases reported in literature. Partial rhombencephalosynapsis is a variation of this anomaly with fewer reported cases. We present the case of a patient with Chiari II malformation mimicking partial rhombencephalosynapsis.