Childhood cerebral hemiatrophy is an uncommon clinical entity. Its aetiologies are diverse but can generally be grouped into congenital and acquired. The congenital type is intrauterine in origin while the acquired type occurs early in life, usually before two year of life.When childhood cerebral hemiatrophy occurs, it evokes a spectrum of compensatory calvarial sequlae. These include ipsilateral calvarial thickening, diploe widening, hyper-pneumatization of paranasal sinues/mastoids, elevation of petrous bone and small middle cranial fossa. MRI is very effective in high lightening brain atrophy, associated parenchymal changes and even the above enumerated skull changes.Our two case reports of left hemi-cerebral atrophy in male Cameroonian children seen in our MRI practice aptly demonstrated some of the aforementioned radiological features of childhood cerebral hemiatrophy noted in literature review.
Objective:Intracranial calcifications underlie certain brain diseases which may be de novo or systemic. But calclfications un-connected to pathologies are classified physiological.Aim:To evaluate physiological intracranial calcifications in Douala with establishment of earliest age range of detection.Materials and Methods:Prospective study of brain computed tomograms was done from April to October 2009 using Schumadzu CT Scan machine. Axial, reconstructed and bone window images as well Hounsfield unit measurements were used for final evaluations. Results were analysed with SSPS 3.Results:132 patients with 75 males and 57 females were studied and 163 separate calcifications were identified due to co-existent calcifications. The highest calcification was in choroid plexi, constituiting 56.82% of the studied population. This was followed by pineal gland. Both were commonly co-existent with advancing age. These calcifications were first seen at 10-19years. No type of physiological intracranial calcification was seen below age 10. The least calcification of 0.76% of population was in dentate nucleus.Conclusion:No intra-cranial physiological calcifications started earlier than 9years in Douala, a city in Cameroon, Central Africa.
Background: Assessment of ureteric size is imperative for diagnosis of urinary tract abnormalities especially with regard to obstructive pathologies. The ureteric opacification and distension obtained from contrast-enhanced computed tomography allows for differentiation from surrounding soft tissue and better assessment of ureteric diameter. Abdominal computed tomographic scans are commonly requested for the evaluation of the urinary tract, and we therefore aim to establish a normal reference value of the ureteral diameter using contrast-enhanced computed tomographic scans of the abdomen. Method: With the purpose of establishing our local normogram of ureteric diameter, we did a retrospective study of archived images of 170 patients referred to the radiology department of a tertiary hospital for contrast-enhanced abdominal CT from January 2016 to June 2018. The largest transverse dimension along the course of the ureter beginning 1-2 cm below the ureteropelvic junction was measured at the delayed phase and obtained data subjected to analysis using SAS software version 9.3 with statistical level of significance set at 0.05. Result: A total number of 340 ureters in 170 patients were analyzed with the mean age of 47.9 years (range 1.0-94.0 years) and male-to-female ratio of 1.2:1. The mean left ureteric diameter of all patients was 4.3 mm (range 1.7-8.0 mm) while the mean right ureteric diameter of all patients was 4.4 mm (range 1.5-8.0 mm). Ninety-five percent of ureters in our study measured 6.9 mm and less with no significant difference in ureteric sizes across gender and ages. Conclusion: The mean CT normogram for ureteric caliber is 4.3-4.4 mm with no significant age and gender difference and 7 mm proposed as upper limit of normal.
Background:Intussusception is a rare cause of intestinal obstruction in adults. Its diagnosis could be elusive based solely on clinical features because of protean presentation. Supplementary imaging allows for preoperative diagnosis, early institution of definitive management, and a better clinical outcome.Patients and Methods:Records of adults managed for intestinal obstruction by laparotomy in a surgical unit of a tertiary health facility were retrospectively examined. The subgroup having an intraoperative diagnosis of intussusception was extracted and analyzed. Data obtained included age, sex, and primary symptom at presentation. Presence of intestinal perforation, the histology of the lead point of resected tissues, and the final disposition of the patients were documented.Results:Four hundred and three patients underwent surgical management of intestinal obstruction. Eight patients (2%) had an intraoperative diagnosis of intussusception at laparotomy; four males and four females (male: female = 1:1). Abdominal pain was the presentation in 7 (87.5%) and anal protrusion in 1 (12.5%). Four patients (50%) had bowel perforation with peritonitis. Seven of the resected intestines had lead points which were benign. Two patients (25%) died from sepsis. Resection and anastomosis were done for all the patients.Conclusion:Intussusception in adults is uncommon but carries a high morbidity and mortality which can be reduced with a good clinical assessment, appropriate imaging, and early laparotomy.
Background: Proximal femoral focal deficiency is an extremely rare congenital anomaly with an incidence of 1.1-2.0 in 100,000 live births. It is a dysplastic phenomenon with predilections for the proximal two-thirds of the femur leading to limb length discrepancies. We report two cases of proximal femoral focal deficiency, which is a rare entity. Case presentations: Case 1 A 4.5-month-old baby Annang tribe girl was referred in April 2019 to our Radiology Department, University of Uyo Teaching Hospital, Nigeria for lower limb radiographs. This was on account of her shortened left lower limb from birth despite uneventful antenatal history. An examination revealed bulky left thigh with abduction of her left hip joint. Radiographic evaluations showed absent left femoral capital epiphysis, with deficient proximal left femur. A diagnosis of proximal femoral focal deficiency was made. Sadly, the parents and baby failed to honor future orthopedic consultations on intimation of sequential management protocols. Case 2 A 4-month-old baby Ibibio tribe girl was similarly referred in August 2019 to the same Radiology Department for lower limb conventional radiographs due to short left lower limb that was noticed from birth. An examination showed shortened left lower limb in external rotation. Her right and left lower limbs measured 27 cm and 23 cm, respectively, with landmark taken from anterior superior iliac spine to tip of medial malleolus. A diagnosis of proximal femoral focal deficiency was made. Corroborating radiographs showed shortened and hypoplastic left femoral shaft but preserved femoral capital epiphysis. Coincidentally, the parents have not brought back their baby to our orthopedic clinic. Conclusions: The discovery of two cases of proximal femoral focal deficiency, a rare entity, from referrals for conventional radiography in our Radiology Department encourages literature documentation. Such recognition will facilitate early institution of management, thus ensuring meaningful childhood growth.
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