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Internal carotid artery (ICA) dissection is one of the most common causes of stroke in young patients. Ultrasonographic assessment of the carotid artery is the method of choice for early detection. The use of the conventional technique for diagnosis is limited since dissection frequently occurs in the distal portion of the ICA. Case Report: We describe the case of a 48-year-old Argentinian woman with malignant cerebral infarction secondary to ICA dissection. We diagnosed her with neck vessels using conventional ultrasonography and a transoral ultrasonographic approach combined with transcranial ultrasonography. Conclusion:We recommend the transoral assessment of ICA combined with ultrasonography as a noninvasive method for the diagnosis of ICA dissection.

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Purpose Severe Covid-19 pneumonia frequently presents with infective complications as bacterial and fungal infections, nosocomial maxillary sinusitis is one of them. We describe the role of ultrasonography in the diagnosis of nosocomial maxillary sinusitis in patients undergoing mechanical ventilation due to severe Covid-19 pneumonia. Methods Patients with severe pneumonia due to Covid-19 requiring mechanical ventilation and had maxillary sinus occupation by ultrasonography were retrospectively enrolled at intensive care unit of Sanatorio De los Arcos, Buenos Aires, Argentina, between March 2020 and May 2021. ResultsWe evaluated a total of 171 patients with severe Covid-19 pneumonia requiring mechanical ventilation during the study period. We included 26 patients that had maxillary sinus occupation by ultrasonography (15.2%). Out of the 26 patients, in 17 the diagnosis was confirmed by surgical drainage of the maxillary sinus with positive cultures with a positive predictive value of 85%. In 34.6% of the cases the maxillary sinus disease was unilateral and in 38.4% bilateral. A sinus computed tomography (CT) was performed in 30.7% of the patients. Most of the patients underwent to surgical drainage without a CT scan (66.7%). Conclusions Ultrasonography is a useful tool for the detection of maxillary sinus infection in patients with severe Covid-19 pneumonia and avoids to perform a CT scan and, therefore, unnecessary transfers.

Posterior reversible encephalopathy syndrome (PRES) is a poorly recognized and reversible condition in systemic lupus erythematosus (SLE) that could mimic neuropsychiatric lupus. The manifestations of PRES are headache, seizures, altered level of consciousness and blindness. In most cases, computed tomography of the brain shows hypodense lesions in the parieto-occipital lobe. Although this syndrome is rare, rapid and accurate recognition allows early treatment with favorable results. We present a case report of a patient with the onset of SLE following the episode of eclampsia, and who during the late puerperium presented sustained hypertension associated with seizures and deterioration of the level of consciousness in the context of PRES.