Dyke-Davidoff-Masson syndrome (DDMS) refers to atrophy or hypoplasia of one cerebral hemisphere, due to an insult to the developing brain in fetal or early childhood period. Age of presentation depends on the time of neurologic insult, and characteristic changes may be seen only in adolescence. Male gender and left hemisphere are more frequently involved.A 17-year-old female adolescent with a history of recurrent refractory seizures, hemiplegia and mental retardation reported to Department of Radiology for computed tomography (CT) assessment of brain. On examination, she had facial asymmetry, delayed milestones, and spastic hemiplegia. The CT brain showed right cortical atrophy with ventricular dilatation, prominent sulci, and shifting of falx to the right side. Bone window image showed asymmetry in skull vault thickness, the width of diploic space, the size of paranasal air sinuses and inclination of the petrous ridge between the affected and normal sides. As the above case deviates from the usual presentation of male left sided DDMS, hence the report.
During routine dissection classes for the first-year undergraduate medical students, we encountered an anatomical variation concerning the duplication of the ureter. Usually, a single ureter connects to the posterior renal hilum. In the present case, a double ureter arises from the hilum on the left side and an enlarged suprarenal gland. The accessory ureter travels a short distance from the hilum before joining the other ureter. These anomalies are becoming more common during renal surgeries and renal transplant surgeries. Damage to the accessory ureter may result in complications following surgery. Knowledge of an accessory ureter and an enlarged suprarenal gland is clinically important for renal surgeons, radiologists, and anatomists.
AIM:To evaluate the extrinsic dorsal venous pattern of spinal cord at the thoracolumbar level hypothesizing that any variant of these intrathecal venous pattern as probable factor for post lumbar pucture hemorrhagic complications. MATERIAL and METHODS:In a tertiary teaching institution, 25 adult cadavers were dissected by standard dissection procedure and spinal cord was removed with meninges. The dorsal aspect was further dissected out and layers of meninges were removed carefully to expose the extrinsic venous system in the dorsal region. The specimens that showed engorged veins were further studied for their extent, pattern, presence of radicular veins, their level and route of exit. RESULTS:Five specimens showed variant dorsal venous pattern of the extrinsic system of veins in the thoracolumbar region. The main dorsal spinal vein was seen to be engorged, tortuous and more than 2mm with engorged radicular veins. Out of 8 engorged radicular veins observed, 6 exited through the dorsal nerve root foramen and 2 exited through a separate foramen. CONCLUSION:The variant anatomy of intrathecal extrinsic venous system with engorgement of the thoracolumbar region veins might get injured during lumbar puncture procedure. The exit of radicular veins and the dorsal nerve root through the same foramen also makes the veins susceptible to post procedural spinal hematomas.
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