Hashimoto’s encephalitis (HE), also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), can be a debilitating manifestation of an autoimmune reaction against the thyroid that is often under-diagnosed primarily due to a lack of definitive diagnostic criteria. This is a case of a 52-year-old woman who has been diagnosed with HE after presenting with recurrent and severe psychosis in conjunction with paranoia and a thyroidopathy. Her symptoms are chronic, having first been documented as presenting 15 years prior and showing progressive exacerbation in both frequency and severity. The patient’s paranoia often manifested as delusions involving family members or close friends and consequently introduced an opportunity for harm to herself and others. She showed great conviction with self-diagnoses that were proven incorrect, resulting in occasional non-compliance. Between episodes, the patient did not show evidence of symptoms. This patient struggled with several incorrect diagnoses and treatments for several years before the correct diagnosis of HE was made and displayed extreme improvement upon corticosteroid administration. This case illustrates the importance of increasing awareness of HE as well as including HE in a differential diagnosis when any patient presents with psychosis and concurrent thyroidopathy. Hashimoto’s encephalitis follows putative characteristics of autoimmune diseases, exhibiting a higher incidence in women as compared to men, presenting with increased titers of autoantibodies, and showing dramatic amelioration when treated with corticosteroids.

Left atrial myxomas are benign, slow-growing primary cardiac tumors. They present with gradual onset of one or more of a triad of obstructive, embolic, or constitutional symptoms. Echocardiography aids in the detailed preoperative and intraoperative evaluation of the myxoma for surgical strategy planning. We describe a case of interstitial hemorrhage in a left atrial myxoma leading to rapid expansion of the tumor with features of acute, mitral valve obstruction. Echocardiography showed a cystic area in the left atrial tumor that corresponded to an area of recent hemorrhage confirmed on surgical removal. A 42 yrs old housewife presented with severe dyspnoea, cough and chest pain for 7 days, after detail evaluation she was diagnosed as a case of left atrial myxoma with heart failure. Subsequently she underwent emergency open heart surgery under cardiopulmonary bypass; removal of a huge LA myxoma was done, and recovered uneventfully.Cardiovasc. j. 2016; 8(2): 155-157

Closure of patent ductus arteriosus (PDA) with device or coil is presently the first line of therapy.but it has got different acute and late complications. A 3 years old male child presented with history of percutaneous closure of the PDA Amplatzer device 18 months back. Now he presented with dislodgement of the device to descending thoracic aorta and reappearance of a large PDA. The child underwent surgical closure of PDA and removal of the device from descending thoracic aorta. We are presenting this case as one of the uncommon late complications of device closure of PDA.Cardiovasc. j. 2016; 8(2): 158-160

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The nonoperative management of sylvian fissure dermoid/epidermoid cysts presents a risk that is difficult to quantify. With rupture, potentially fatal complications such as chemical meningitis, hydrocephalus, fever, seizure, or meningeal irritation may occur. In this paper, we present an asymptomatic case of such a cyst with imaging evidence of prior rupture, and we review the literature for the likelihood of future complications. We use for illustration a case of a 68-year-old woman with imaging features of a sylvian fissure epithelial inclusion cyst who refused surgical intervention and review the literature for further investigation. Conservative management of our patient has not resulted in a complication in over five years, with the continued offer of surgical resection rejected by the patient. This article suggests the possibility of a safe, non-operative management of dermoid/epidermoid cysts of the sylvian fissure; however, the paucity of literature calls for larger studies yielding reliable data regarding the comparative risk of nonoperative management, including the rate of spontaneous rupture, versus the risk and complication incidence of surgical intervention.