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Thrombotic events are well-recognized complications of coronavirus disease 2019 . The incidence of such complications is highly related to the severity of COVID-19 pneumonia. Recent evidence suggests that the coagulopathy of COVID-19 may persist for some period even after the full recovery from pneumonia. We report the case of a 35-year-old man who presented with a 10-day history of fever and cough. His plain radiograph showed bilateral peripherally located opacities suggestive of COVID-19. The diagnosis was confirmed by the reverse transcriptase-polymerase chain reaction (RT-PCR) for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He was placed on a non-invasive ventilator but it failed to maintain normal oxygen saturation. Hence, the decision for intubation was made. He was extubated after 10 days in the ICU. The patient had a complete recovery. One week after discharge, the patient presented with severe abdominal pain that was out of proportion to the physical examination findings. He had an abdominal CT scan, which demonstrated a large thrombus occluding the superior mesenteric artery. There was no bowel dilatation or focal mural thickening to suggest bowel ischemia. The patient was resuscitated with intravenous fluid hydration. Opioid analgesics were administered to control the pain. After stabilizing the patient, he underwent laparotomy with thrombectomy. The patient tolerated the operation with no complications and had an uneventful recovery. The patient was discharged in good condition with no active issues after four days of hospitalization. The superior mesenteric thrombosis is an unusual complication of COVID-19 pneumonia. This case provides further evidence on the possibility of thrombotic events following the recovery from COVID-19. There is a pressing need for future studies to investigate the role of prophylactic antithrombotic and anticoagulants in patients who recovered from severe COVID-19.

Pediatric convulsive seizure is common and represents a source of major concern and anxiety for the parents. Seizures can have a broad spectrum of etiologies in children, including metabolic, traumatic, developmental, and infectious causes. Depending on the clinical presentation, laboratory testing and neuroimaging may be indicated in the workup of the first unprovoked afebrile seizure. We present a case of a six-year-old boy who was brought to the emergency department by his mother after an episode of convulsion. She reported that he had jerky repetitive movements of all extremities that lasted around two minutes with spontaneous termination. The child did not have a febrile illness. The mother reported no history of similar episodes. Upon examination, the child appeared alert and conscious. No dysmorphic features were evident. Initial laboratory investigations were within the normal limits. The child underwent magnetic resonance imaging for the brain, which demonstrated a large well-defined extra-axial cystic lesion occupying most of the left hemisphere that is connected to the ventricular system. The lesion had no grey-matter lining and it strictly followed the cerebrospinal fluid in all sequences. Such finding represented the diagnosis of a giant left porencephalic cyst. Porencephaly is an extremely rare neurological anomaly that may present with pediatric seizures. Magnetic resonance imaging is the gold standard modality for the diagnosis of porencephaly. The case demonstrated that porencephaly can have a massive size in a patient with normal psychoneurological development.

Seizure is a common neurological problem in the emergency department. First-time seizure needs careful evaluation to exclude the underlying structural brain lesions. Neuroimaging studies, including magnetic resonance imaging and computed tomography scan, are strongly recommended for all adult patients with first-time seizures. We report the case of a 35-year-old woman who was brought to the emergency department because of the first-time loss of consciousness episode. She developed bilateral jerky movements in both her upper and lower limbs. It was associated with frothy secretions from the mouth and cyanosis. The episode lasted for two minutes and terminated spontaneously. The patient was tired after gaining consciousness. The past medical history of the patient was remarkable for anxiety, depression, and polycystic ovarian syndrome. She has undergone multiple cognitive behavioral therapy sessions, but she did not take any psychiatric medications. Neurological examination did not reveal any focal neurological deficit. The patient underwent a computed tomography scan to exclude any space-occupying lesion. The unenhanced scan demonstrated bilateral symmetrical calcification of the basal ganglia. No calcification was noted in the cerebellum or the cerebral cortex. Otherwise, no intracranial pathology was seen. Such findings conferred the diagnosis of Fahr disease. The patient was discharged on carbamazepine to prevent further seizure episodes. After six months of follow-up, the patient did not experience further convulsion episodes. Fahr disease is a rare disorder with a wide spectrum of manifestations. Despite its rarity, physicians should keep this condition as a possible differential diagnosis when they encounter an adult patient with a firsttime seizure, particularly in a patient with a history of neuropsychiatric disorders.