Biomedical subjects
Publications and source records attributed to D G Browning.
We have presented a case of unsuspected cryptococcal laryngitis, clinically masquerading as Kaposi's sarcoma in a patient with AIDS. The spectrum of laryngeal disease in AIDS patients includes a variety of infections and neoplasms, which can be treated satisfactorily when accurate and timely diagnosis is made.
Varicella may be associated with serious complications including encephalitis, Reye's syndrome, and drug toxicity. In this case, a 19-month-old child with varicella was brought to the family practice clinic by her parents when she began behaving abnormally. At the time of presentation the child exhibited dilated pupils, ataxia, urinary retention, and facial grimacing. The child's parents had treated her with acetaminophen, diphenhydramine syrup, colloidal oatmeal baths, and frequent applications of Caladryl lotion. The results of her immediate laboratory tests were within normal limits, and she was admitted to the hospital for observation. She recovered without therapeutic intervention. Although not available at the time of admission to the hospital, her diphenhydramine serum level was 1948 ng/mL. Diphenhydramine levels above 100 ng/mL have been associated with toxicity.
Braces can be divided according to their use: rehabilitative, functional, or prophylactic. Rehabilitative braces are used following injury or surgery to allow protection of the injured part while rehabilitation is taking place. Functional braces are used following injury or surgery to allow an individual player to return to athletic activities while protecting the injured part from further damage. Prophylactic braces are used in an attempt to prevent injury to a normal area while engaged in athletic endeavors. Braces are available for the neck, back, and both the upper and lower extremities. There are many commercially available braces that are quite useful and effective. It is still controversial whether or not prophylactic braces prevent knee injuries in contact sports. However, prophylactic braces and/or taping have proved to be quite effective in preventing ankle injuries. It should always be kept in mind, however, whether one is using rehabilitative, functional, or prophylactic braces, that a good rehabilitation program and conditioning should be instituted along with their use to strengthen the involved area and prevent further injuries.
PURPOSE: To report our experience with the radiographic evaluation of severe complications resulting from the functional endoscopic sinus surgery (FESS) procedure. PATIENTS: Ten major complications were reviewed retrospectively. FINDINGS: Ten major complications occurred. Eight of 10 had injury to the floor of the anterior cranial fossa, fovea ethmoidalis (roof of the ethmoid sinus), or roof of the sphenoid sinus. Six patients presented with meningitis or rhinorrhea, two presented with headache and massive pneumocephalus; one patient who presented with meningitis had a large nasal frontal encephalocele. Noncontrast brain CT that included the paranasal sinuses adequately evaluated the source of pneumocephalus. Thin-section coronal CT accurately predicted the site of leak in five patients. Both coronal sinus CT and MR imaging were useful to confirm the nasal encephalocele. Two of 10 had vascular injury secondary to FESS. One patient presented with subarachnoid hemorrhage seen on noncontrast CT and cerebral angiography demonstrated an aneurysm of the anterior cerebral artery. The second patient suffered severe intraoperative hemorrhage. Emergency angiography revealed a pseudoaneurysm of the cavernous carotid artery, and balloon occlusion of the artery was performed. No deaths occurred in this series. CONCLUSION: Radiologists should be familiar with the rare, but potential complications of this commonly performed procedure in order to help direct the work-up in an efficacious manner.