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Ovarian torsion, the twisting of the ovary on its supporting tissues, occurs primarily in premenopausal women, causing acute abdominal or pelvic pain. Without prompt diagnosis and surgical intervention, adnexal torsion may lead to ovarian infarction and a resulting reduction in fertility. Radiologic methodologies including ultrasound, color Doppler ultrasound, and magnetic resonance imaging (MRI) can play key roles in the diagnosis of this entity by allowing for the visualization of blood flow to the ovary.

Cerebral venous sinus thrombosis (CVST) is a rare but critical cerebrovascular condition characterized by clot formation in cerebral veins or sinuses. We present a case of a 30-year-old male with CVST, an atypical presentation of right-sided weakness and sudden loss of consciousness. While CVST typically manifests as severe headaches and neurological deficits, our patient's unique symptoms pose diagnostic challenges. Advanced imaging techniques, including MRI with venography, played a pivotal role in confirming the diagnosis. Treatment involved anticoagulation therapy and resulted in a favorable outcome. This case highlights the importance of considering CVST in patients with unusual neurological symptoms and the crucial role of early diagnosis and intervention. Advances in diagnostic modalities and treatment options have significantly improved outcomes in CVST patients, emphasizing the need for timely recognition and management.

Minh Van Le,1,* Tam Thai Thanh Tran,2,* Loc Phu Huynh,3 Tho Kieu Anh Pham,2 Thi Van Vo,4 Hung Huynh Vinh Ly1 1Department of Neurology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam; 2Department of Physiology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam; 3Department of Neurology - Can Tho Central General Hospital, Can Tho, Vietnam; 4Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam*These authors contributed equally to this workCorrespondence: Hung Huynh Vinh Ly, Department of Neurology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, No. 179, Nguyen Van Cu Street, an Khanh Ward, Ninh Kieu District, Can Tho, 900000, Vietnam, Email 1853010822@student.ctump.edu.vnBackground: Cerebral venous thrombosis (CVT) is a challenging condition with potential long-term consequences, but it is also a treatable disorder that offers the possibility of complete recovery. This study was conducted to comprehensively investigate the clinical features, brain imaging findings, and treatment outcomes of patients diagnosed with cerebral venous thrombosis.Materials and Methods: Conducted as a cross-sectional descriptive study, patients diagnosed with cerebral venous thrombosis were enrolled at Can Tho Central General Hospital between January 2021 and June 2022.Results: Notably, a substantial proportion of patients (83.4%) exhibited signs of brain damage, with intracranial hemorrhage (50%), brain infarction (30.9%), subarachnoid hemorrhage (16.6%), and hemorrhagic infarct (4.7%) being the predominant findings. Thrombosis primarily affected the superior sagittal sinus (85.7%), transverse sinus (52.4%), and sigmoid sinus (42.8%). All patients received anticoagulation treatment, resulting in a favorable recovery upon hospital discharge for the majority (90.5%), while a small percentage (9.5%) experienced critical illness or death.Conclusion: Our study on cerebral venous thrombosis found diverse clinical presentations, primarily headache. Intracranial hemorrhage was common, affecting superior sagittal, transverse, and sigmoid sinuses. Most patients achieved favorable recoveries with anticoagulation treatment, emphasizing early intervention’s importance.The plain language summary: Cerebral venous thrombosis (CVT) is a less common condition when compared to arterial thrombosis, which has received more research attention. However, CVT has not received the same level of focus and investigation. The study aimed to comprehensively examine the clinical features, brain imaging findings, and treatment outcomes of patients diagnosed with CVT. The findings revealed that patients with CVT commonly presented with symptoms such as headache, limb weakness, seizures, vomiting, and consciousness disorders. Neuroimaging showed significant brain damage, including intracranial hemorrhage and brain infarction. However, with appropriate anticoagulation treatment, the majority of patients achieved favorable recoveries. The study emphasizes the importance of early intervention and highlights the need for improved diagnostic accuracy and treatment strategies for CVT.Keywords: cerebral venous thrombosis, CVT, hemorrhagic infarct, superior sagittal sinus

Differentiating hemorrhagic infarct from parenchymal intracerebral hemorrhage can be difficult. The immediate and long-term management of the two conditions are different and hence the importance of accurate diagnosis. Using a series of intracerebral hemorrhage cases presented to our stroke unit, we aim to highlight the clues that may be helpful in distinguishing the two entities. The main clue to the presence of hemorrhagic infarct on computed tomography scan is the topographic distribution of the stroke. Additional imaging modalities such as computed tomography angiogram, perfusion, and magnetic resonance imaging may provide additional information in differentiating hemorrhagic infarct from primary hemorrhages.

We report the CT and MRI findings in two cases of hemorrhagic infarct of the basal ganglia (BG), following out-of-hospital cardiac arrest (CA). In case 1, Brain-CT realized at day 2 showed bilateral and almost symmetric hemorrhagic infarct of the BG and infarct of the tectum of the mesencephalon. In case 2, MRI realized at day 6 showed hemorrhagic infarct of both lenticular nuclei on T2 GE images. In both cases there was no medical history and the cardiovascular and the coagulation profile were normal. In these cases, the lesions are observed earlier than reported in a few previous radiological cases. Similar lesions have been reported in pathological studies. These lesions seem occur early after CA. Reperfusion is probably responsible for the hemorrhagic transformation. The reason why some patients present either BG or brainstem infarct or both remains unclear. Bilateral and symmetric hemorrhagic infarct of the BG, especially of the Lenticular nuclei, and infarct of the dorsal pons and mesencephalic tegmentum seem to be a characteristic feature of profound and prolonged hypotension or of CA., (Copyright © 2017 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)

Stroke is amongst the leading causes of morbidity and mortality globally. Majority of strokes are ischemic and up to 1/3rd ischemic strokes have infective etiology. In this post-pandemic era, SARS-CoV-2 is an established infectious agent which can precipitate it by various mechanisms. Though post-vaccination incidence of COVID-19 has dropped drastically, still new cases get reported with typical or atypical presentations. Irrespective of causation, malignant cerebral edema in stroke necessitates salvage neurosurgery. Hereby authors present an interesting diagnostic chase in a young female who presented in altered sensorium, underwent emergency decompressive craniectomy and neurologically recovered over subsequent days. Despite being double vaccinated, she developed potentially fatal COVID-encephalitis, cerebral venous sinus thrombosis (CVST), ischemic infarcts and hemorrhagic transformation. Suprisingly, there were cross reacting antibodies against antigens of herpes simplex virus (HSV), leptospira and cytomegalovirus (CMV) yielding false positivity on serology screening test, which spoofed us while carrying out infectious disease work up of stroke.

Introduction Epinephrine containing local anesthetics are used hemostasis in many cases. Otolaryngologists typically selected to decrease bleeding in surgery field for operations such as especially FESS (Functional Endoscopic Sinus Surgery), septoplasty, septorhinoplasty. In addition to known adverse effects of this local anesthetics agents they have rare complications too. Presentation of case We presented intracranial hemorrhagic infarction in a 41-year-old male patient after using lidocaine with epinephrine for local anesthesia on nasal mucosa. Discussion There are some publications like this case in the literature. In our case, a hemorrhagic infarction developed after giving the adrenaline/lidocaine infiltration to make up a local anesthesia in the mucosa of the septum. There is not any reported case like this in the literature. Conclusion We want to emphasize that all surgeons especially the ENT surgeons should be careful while using local anesthetic medicines which contains adrenaline for rare complication of intracranial hemorrhagic infarction. Another fact is that the patients must sign an informed consent form including those situations even for all minor surgical procedures to avoid a medicolegal problem. [ABSTRACT FROM AUTHOR]

Background: Cerebral venous sinus thrombosis (CVST) accounts for 10%–20% of strokes in young persons. In India, CVST accounts for around 30% of all strokes. The majority of CVSTs are caused by procoagulant circumstances, with pregnancy and early puerperium being well-established risk factors. The study aimed to look into the clinical profile, radiological characteristics, etiological variables, and outcome of CVST in venous stroke patients admitted to a tertiary care facility. Methods: We included individuals between the ages of 18 and 75 years who had a cerebral venous thrombosis (CVT) diagnosis confirmed by magnetic resonance imaging (MRI) + magnetic resonance venography computed tomography (CT) plus CT venography. The research included all individuals suspected of having CVST with or without particular neurological deficits and a confirmed imaging diagnosis. Patients were removed in situations of ambiguous neuroimaging, arterial strokes, space-occupying lesions, metabolic encephalopathy, and patient reluctance to participate. Results: This study included 82 patients, 21 (25.6%) males and 61 (74.4%) of whom were females. The most common presenting symptom was headache (79.2%), followed by vomiting (54.8%) and abnormal sensorium (35.3%). In this study, 34/82 (41.4%) patients had evident clinical triggers and were classified as induced CVT. Para infectious disease was recognized as a risk factor for CVT in 13/34 (38.2%) patients. A prothrombotic conditions could be established in 48 (58.5%) of these patients. Conclusion: CVST is a treatable and reversible cause of stroke in adolescents. The clinical presentation varies greatly, and symptoms may appear gradually over weeks or months. Although it is still an uncommon cause of headache and stroke, MRI has allowed for early detection.

Purpose: A prospective, observational study was done at the country leading tertiary care hospital to evaluate etiologies, clinical features, diagnosis, and prognosis of cerebral venous sinus thrombosis (CVST) in the Pakistani population. Methods: 34 patients with clinical and MRI features suggestive of CVST were evaluated. Modified Rankin Score (mRS) was assessed of all patients at presentation. Results: The mean age of presentation was 30.69 years with female predominance (n = 28). Headache was most common presenting symptoms (97%, n = 33) followed by seizure (59%, n = 20), hemiparesis (56%; n = 19), altered sensorium (47%; n = 16), vomiting (21%; n-7) and cranial nerve involvement (18%; n = 6). 72% of patients (n = 23) had thrombosis of superior sagittal sinus, 53% of patients (n = 17) had thrombosis of the transverse sinus, 25% patients (n = 8) of patients had sigmoid sinus thrombosis, 16 % patients (n = 8) had straight sinus thrombosis. The most common cause for provoked CVST was found to be pregnancy/puerperium in 53% (n = 18 patients), followed by previous CVST/DVT in 12% (n = 4), and then OCP and parainfectious causes which were 3% (n = 1) for each and elevated factor VIII and protein deficiency were found in 7 patients. MRS between 3 and 5 was assessed in most patients on presentation (n = 23). Conclusion: CVST is an under-recognized cause of stroke in the young population, especially in the puerperium period. Clinical presentation is highly variable, and correction with magnetic resonance imaging with venography is the current diagnostic modality of choice. Aggressive management with anticoagulants is safe with excellent clinical outcomes.