Relapsing pulmonary embolism in a patient with a spinal cord-injury.
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Biomedical subjects
Publications and source records attributed to C H Fisher.
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C1-C2 puncture is a procedure commonly performed to assure satisfactory cervical myelography. Cord injury with neurological deficit has been reported following intramedullary injection of myelographic contrast material. We report a case of inadvertent intramedullary injection of metrizamide which was initially discovered during postmyelographic CT scanning. The patient had very minimal symptoms during the procedure and had no immediate or long-term complications.
Two sodium pertechnetate Tc 99m brain scans, done within several days of each other, demonstrated inhibition of pertechnetate localization in a cerebellar lesion after dexamethasone therapy for cerebral edema. The lesion, a metastasis from a bronchogenic mucinous adenocarcinoma, was clearly present in the first scan, which was done before treatment.
Giardia lamblia infestation can cause severe diarrhea and malabsorption, and the diagnosis is usually made by identification of cysts in the feces, but small intestinal biopsy or smears may be required. A wide spectrum of roentgen changes may be seen. In patients with a normal immune status, the small bowel is normal or shows an inflammatory bowel disease pattern. Eradication of the parasite reverses these changes. In some patients with IgA deficiency, nodular lymphoid hyperplasia occurs, and this is usually not reversible. Other patients with hypogammaglobulinemia or dysgammaglobulinemia and giardiasis may show a sprue pattern. This pattern most often persists after eradication of the parasite. Although the triad of giardiasis, IgA deficiency, and nodular lymphoid hyperplasia has a particularly high association, these, together with diarrhea, malabsorption, and various altered immune states may occur in any combination.
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