Article Figures & Data
Figures
- Figure 1
CT brain A-C) There is a well defined oval shaped at the right frontal sinus as seen in arrows (B) ethmoidal air cells suggestive of a mucocele.
- Figure 2
MRI brain A) Acute arterial infarction of bilateral cerebellar hemispheres (RT>>LT), cerebellar vermis, B) bilateral occipital cortex, bilateral thalami and both hippocampi midbrain as seen in arrows.
- Figure 3
CT brain A-B) increase cerebellar and occipital lobes hypo densities as seen in arrows, post posterior fossa decompression and extra-ventricular drain insertion
Tables
- Table 1
Relevant past medical history and interventions for a 33 years old male with a past medical history of nasal polyp removal and recurrent sinusitis in the last 8 years.
Dates Summaries from initial and follow-up visits Diagnostic testing (including dates) Interventions 07-18/10/2016 This is a case of a 33 years old male complaining of severe headache, neck pain, photophobia, vomiting and high grade fever of several days. On examination patient was conscious, GCS15/15, normal limbs power but positive Babinski sign CT brain with and without contrast, Lumbar puncture, HIV, P-ANCA, C-ANCA (07-08/10/2016) Intravenous Ceftriaxon, Vancomycin, Acyclovir, Anti-tuberculus medications and Amphotricin 19-20/10/2016 Developed sever headache, dizziness, blurred of vision with right 3rd nerve palsy CT brain showed signs of increased intracranial pressure with hydrocephalus (19/10/2016) Patient seen by neurosurgery and taken immediately to operation room for external ventricular drain insertion 21-23/10/2016 Decreased level of consciousness MRI brain with and without contrast and MRV brain showed acute multiple arterial infarctions mostly on posterior territories (21-23/10/2016) Shifted to ICU and intubated.Seen by ENT and turbinectomy was carried out and samples sent to histopathology. 24-25/10/2016 Patient developed unequal pupils CT brain carried out showed increaswd diffuse brain edema on posterior fossa (24/10/2017) Taken immediately for urgent decompressive craniectomy 26-30/10/2016 Patient had more spikes of fever Histopathology results showed Aspergillosis species. EEG carried out to rule out any seizure showed mild to moderate encephalopathy (30/10/2017) Same management 02-05/11/2016 Patient started to be weaned None Tracheostomy carried out 06/11/2016 Patient developed cardiac arrest then pulseless electrical activity None Cardiopulmonary resuscitation done and patient revived 07-08/11/2016 Patient on inotropes None Same management 09-10/11/2016 Patient developed cardiac arrest None Cardiopulmonary resuscitation carried out but patient died HIV - Human Immunodeficiency Virus, P-ANCA - Perinuclear Anti-Neutrophil Cytoplasmic Antibodies, C-ANCA - Cytoplasmic Anti-Neutrophil Cytoplasmic Antibodies, GCS - Glasco Coma Scale, ENT - Ear, Nose, Throat
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