Background: The clinical significance of white matter hyperintensity (WMH) on brain magnetic resonance image (MRI) in Parkinson’s disease (PD) patients was not sufficiently understood. Little is known about WMH in PD patients in sub Saharan Africa (SSA). The objectives of this study were to determine white matter hyperintensity and associated factors in Ethiopian PD patients.Method: A cross-sectional observational study was conducted in 42 PD patients with WMH and 42 PD patients with normal MRI in Addis Ababa, Ethiopia. Both descriptive and analytical statistics were used to analyze the data. Results: Total of 84 patients with PD was included in the analysis. The overall mean age was 61.5 (11.6) years. Young onset PD (≤ 50 years) accounted 16.7%. Males accounted 67.9%. Tremor dominant PD accounted 88.1%. Forgetfulness and hallucination was reported by 8.3% and 13.1% respectively. The median serum vitamin D and the mean hemoglobin level was 14.9 (8.3 – 20.2) ng/mL and 14.8 (13.8) g/L respectively. Hypovitaminosis D was observed in 40.5% of PD patients; similarly, anemia was observed in 27.4%. Negative correlation was observed between participant’s age and their respective hemoglobin level. The prevalence of hypertension, diabetes, and dyslipidemia was 29.8%, 13.1%, and 20.2% respectively. No association was observed between white matter hyperintensity and young onset PD, hypovitaminosis D, hypertension, and diabetes. Age and dyslipidemia were found to be independent predictor of white matter hyperintensity, when adjusted for the covariates.Conclusion: The present study indicates advanced age and dyslipidemia were associated with increased risk of having white matter hyperintensity on brain MRI of Ethiopian PD patients compared to those patients with normal MRI. Even though non-significant, the trend of vascular risk factors was in line with WMH.

Background Tuberculosis (TB) is the leading cause of morbidity and mortality in low and middle income countries (LMIC). Approximately 50% of cases of skeletal TB involve the spine. Failure to identify and treat these areas of involvement at an early stage may lead to serious complications such as vertebral collapse, spinal compression, and spinal deformity. The clinical and radiologic features of Pott’s disease may mimic other spine diseases such as, metastatic lesions and other infectious etiologies, this is especially imperative in older patients. Case report We report a 60-year-old right handed male patient presented with back pain, paraparesis, and sensory symptoms 2 weeks duration. He has history of dry cough, fatigue, and reduced appetite, but no history of weight loss, fever, night sweat, and bowel/bladder incontinence. No contact history with TB patients. He has a borderline hypertension and diabetes mellitus. Serology for HIV was negative. Thoraco-lumbar magnetic resonance image (MRI) showed destruction of L2 and L3 vertebral body and the inter-vertebral disc; with T2 hyper and T1 hypointensity of the affected vertebral bodies. Probable tuberculous spondylitis with paraparesis was considered and the patient was initiated on antituberculous regimen and short course steroid therapy. After five months treatment, the patient showed significant clinical and radiological improvement. Conclusion In summary, the present case describes, a patient with Pott’s paraplegia due to probable spine tuberculosis and showed significant clinical and radiological improvement following initiation of antituberculous drugs and short course of steroid; indicating the crucial role of imaging in the diagnosis of TB, especially in resource limited settings.