Hemorrhage from recanalized umbilical vein in a patient with cirrhosis.

The formation of portosystemic collaterals occurs frequently in portal hypertension; however, the finding of a patent or recanalized umbilical vein has more often been incidental, with only six cases of recanalized umbilical veins or patent paraumbilical veins demonstrated with clinical significance This is only the second documented case of an umbilical vein with external hemorrhage significant enough to cause hemodynamic instability. It raises important questions with regard to prognostic indices for rebleeding at the umbilicus as well as at other, more common, portosystemic collateral sites.

Discordance between FDG uptake and technetium-99m-HMPAO brain perfusion in acute traumatic brain injury.

A 28-yr-old woman who sustained a mild traumatic brain injury had an 18F-fluorodeoxyglucose (FDG) PET brain study using coincidence imaging performed on a dual-head gamma camera (MCD version; ADAC, Milpitas, CA) followed 24 hr later by 99mTc-hexamethyl propyleneamine oxime SPECT brain perfusion imaging using a triple-head gamma camera (TRIONIX, Twinsburg, OH). The results of the SPECT brain perfusion study demonstrated decreased frontoparietal cortical brain perfusion, whereas 18F-FDG cerebral uptake was normal. Neuropsychological evaluation suggested frontal lobe involvement.