Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological entity described by Hinchey et al in late 90’s, characterised by variable associations of seizure activity, consciousness impairment ranging from confusion to coma, headaches, visual abnormalities, nausea/vomiting and focal neurological signs. Common causes are accelerated hypertension, eclampsia, preeclampsia, cytotoxic drug use and autoimmune diseases like systemic lupus erythematosus.We report a case of PRES in a 62-year-old female patient due to hypercalcemia secondary to vitamin D toxicity on treatment with calcium supplements and vitamin D for secondary hypoparathyroidism. She had seizures and visual defects on presentation which recovered completely with treatment of hypercalcemia.

Background: Cerebral venous and sinus thrombosis (CVT) is one of the common causes of stroke in young people. It is a relatively uncommon neurologic disorder that is potentially reversible with prompt diagnosis and appropriate medical care. The purpose of this study is to identify the clinical and radiological features aiding diagnosis of cortical vein thrombosisMethods: A cross-sectional study was conducted from November 2015 to May 2017 in tertiary care centre in Manipal after institutional ethical clearance. A total of 46 patients diagnosed with CVT were included in the study. Clinical symptoms and signs at admission and radiological features were documented.Results: A total of 46 subjects were included. Males (53.3%) were more affected than females (46.7%), mostly in the 3rd decade. The most common risk factors were polycythaemia (31.1%) and oral contraceptive pill intake (17.7%). Headache was the most common symptom followed by paralysis and seizures. Multiple sinuses were involved in two-thirds of the patients. Superior sagital sinus thrombosis was the most common sinus involved followed by transverse sinus thrombosisConclusions: The most common clinical feature is headache followed by paresis and seizures. Superior saggital sinus thrombosis is more common than transverse and sigmoid sinus thrombosis in Indian population. Normal CT scan of brain doesn’t rule out cerebral venous sinus thrombosis.

Pleural effusion in liver cirrhotics is more commonly transudative. A transudative pleural effusion secondary to ascites in decompensated cirrhosis is also known as hepatic hydrothorax and is usually due to fluid seepage through congenital pores in the diaphragm. The patient, a known case of decompensated chronic liver disease, presented with a massive, left-sided, rapidly accumulating and transudative pleural effusion secondary to spontaneous diaphragmatic rupture. Clinically, he developed sudden onset shortness of breath and became hypotensive. This is a rare entity, and was confirmed on CT thorax revealing a focal segment defect ~1.6 cm over the left hemidiaphragm. Ascites treatment consisting of diuretics with salt restriction and repeated thoracentesis with albumin replacement improved his symptoms and lead to a complete resolution of the effusion.