Search

Key Clinical Message: A novel radiologic sign in patients with renal failure and uremic encephalopathy (UE) with metabolic acidosis has recently been identified as the lentiform fork sign. On magnetic resonance imaging (MRI), the "lentiform fork sign" has been described as bilateral symmetrical hyperintensities in the basal ganglia encircled by a hyperintese rim delineating the lentiform nucleus. Changes in uremic solute retention, aberrant blood–brain barrier transport, disordered vascular reactivity, altered electrolyte and acid–base balance, and altered hormone metabolism are the most likely causes of the condition. A 56‐year‐old male with end‐stage renal disease was brought to the emergency room for a progressive change in mental status and involuntary arm movements over the previous 5 days, which were accompanied by mild dyspnea. A brain MRI was performed, and it revealed hyperintensity on T2/FLAIR in the white matter surrounding the basal ganglia. the patient was treated with dialysis and improved greatly. Intensified hemodialysis and glycemic control are the cornerstones of treating diabetic uremic syndrome (DUS) with likely reversible clinical symptoms and remission of imaging abnormalities. [ABSTRACT FROM AUTHOR]

Epidermoid cysts (EC) are benign lesions resulting from incomplete separation of the neuroectoderm during embryonic development. The investigation of choice for EC is magnetic resonance imaging (MRI). Surgical resection is the treatment of choice. Full resection of EC including the cyst wall to prevent recurrence and malignant transformation should be considered when possible. Two main approaches were described in the literature and included craniotomy and endoscopic endonasal approach (EEA). Using of EEA to accomplish total resection could be challengeable. To best of our knowledge, only 6 manuscripts (with a total of eight patients) reported total resection of EC by using EEA. Our case should be the ninth such cases in the literature. In this paper, we reported a case of sellar and suprasellar epidermoid cyst which was resected completely by using EEA. We revealed the safety and efficacy of this approach in management of such cases. [ABSTRACT FROM AUTHOR]