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BACKGROUND Stroke in posterior circulation accounts for 10 - 15% of all strokes, and 80% of them are ischaemic strokes.1 But there is a paucity of studies determining aetiopathogenetic factors and outcome in PCS (Posterior Circulation Stroke). Presentation of posterior circulation stroke is diverse that differ from strokes in anterior circulation in aetiology, clinical features, and prognosis.2-6 we wanted to delineate, nature of stroke, pattern of anatomical involvement in PCS stroke by means of CT, and MRI, in a group of 50 random patients with posterior circulation stroke at a tertiary care hospital. METHODS Fifty random adult patients 40 – 80 yrs. of age presenting with posterior circulation stroke were studied over a period of one and half years. The patients were subjected to thorough clinical examination and radiological evaluation by means of CT scan and MRI. Analysis included age, sex, type of stroke, location of stroke, radiological evaluation and associated features. We tried to reach a definite diagnosis utilizing the available clinical & radiological data. RESULTS Out of 50 patients, 29 were Male (58%) & 21 were Female (42%) with a mean age of 59.04 +/- 7.05 yrs. 34 patients had ischaemic (68%) stroke and rest had haemorrhagic stroke. Isolated brainstem involvement was seen in maximum number of patients (44%), followed by cerebellum (36%). Out of 18 patients who experienced cerebellar stroke, 14 were ischaemic (78%) and 4 were haemorrhagic (22%) in nature. Six out of seven cases of right cerebellar hemispheric strokes were ischaemic in nature (85.71%) and eight out of 11 left cerebellar hemispheric strokes were ischaemic in nature (72.73%). Out of nine patients who experienced medullary strokes, seven were ischaemic (78%); whereas two were haemorrhagic (22%). Three of them (33.33%) had medial medullary stroke and six (66.67%) had lateral medullary strokes. 66.67% medial medullary strokes were haemorrhagic and all of lateral medullary strokes were ischaemic in nature. CONCLUSIONS PCS showed male predominance with a mean age 59.04 +/- 7.05 yrs. Ischaemic strokes outnumbered haemorrhagic strokes in case of PCS. The most common location of PCS was brainstem. Cerebellar ischaemic stroke was more common than haemorrhagic stroke. Pontine haemorrhage was more common in cases of brainstem haemorrhage.

BACKGROUND A seizure arises when a large number of neurons send out an electrical charge simultaneously, causing an abnormal intense wave of electricity. The present study aims to determine the frequency of abnormal neuroimaging in children with new onset seizures and to draw a correlation between clinical findings, electroencephalogram (EEG) findings and neuroimaging. METHODS This is a cross-sectional descriptive study conducted in the Department of Radiodiagnosis, Burdwan Medical College & Hospital. The entire study included recruitment of 160 subjects, data collection, data analysis, and reporting. An EEG was performed, using 18-channel EEG machine, within the first 48 hours of the first unprovoked epileptic seizure. RESULTS Partial seizure was seen in 54 (33.7%) children; complex febrile seizure in 18 (11.3%) children; and undetermined seizure in 6 (3.7%) children. Among cases of 6-12 years age group i.e. 94 (58.7%) cases, generalised seizure was found in 44 (27.5%) children; followed by partial seizure in 42 (26.2%); complex febrile seizure in 6 (3.8%); and undetermined seizure in 2 (1.2%) cases. Abnormal MRI was found in 120 (75%) cases; among them 64 (40%) cases were of generalised seizure; 44 (27.5%) partial seizures; followed by 9 (5.6%) and 3 (1.9%) cases of complex febrile seizure and undetermined seizure respectively. CONCLUSIONS 93 cases showed abnormalities in EEG findings, 111 in Computed Tomography (CT) findings, and 120 cases showed abnormality in Magnetic Resonance Imaging (MRI) findings, highlighting the superiority of MRI over CT and EEG.

BACKGROUND Peripheral arterial disease is an important cause of morbidity predominantly in males, especially of elderly age group. We wanted to evaluate the presence of peripheral arterial disease of lower limb in cases clinically indicated and referred to Department of Radio-Diagnosis and document the grey scale and Doppler features of ultrasound in cases of peripheral arterial disease of lower limbs. METHODS First 50 patients of clinically diagnosed peripheral arterial disease of lower limbs have been included for colour doppler ultrasonography (CDUSG). Those patients are examined by using HD7 USG machine. 7.5 MHz frequency probe is used in most cases. For obese patients and patients with thick subcutaneous fat 3.5 MHz frequency probe is utilized. RESULTS The findings of first 50 clinically diagnosed PAD patients have been evaluated. Age range of most patients were from 30 to 80 years with mean age was 58 year. Smoking followed by hypertension and diabetes mellitus appear most significant risk factors with intermittent claudication being the most common clinical presentation among the cases followed by the ulceration of lower extremities. On CDUSG an average of 36 out of 50 subjects show no obvious significant luminal stenosis. Only 5 out of 50 patients show mild to moderate stenosis of Infra-Renal Aorta. However, rest of the patients who were examined showed variable degrees of stenosis from mild to severe form with few having total luminal occlusion. Wall calcification, thickening of intima-medial layers of arterial wall, monophasic vascular flow, multiple collateral formation with decrease in resistance being the usual supportive findings. CONCLUSIONS Elderly subjects with features of high-risk factors are the vulnerable group of people who are most commonly affected by the peripheral arterial disease. By using CDUSG those clinically suspected patients can be diagnosed accurately and more precisely regarding the presence of lower extremity peripheral arterial disease.

BACKGROUND Hypoxic Ischaemic Injury (HII) is an important common cause of neonatal encephalopathy in newborns. Decreased cerebral blood flow and oxygen leads to acidosis, release of inflammatory mediators and excitatory neurotransmitters, and formation of free radicals. Initially, there is primary energy failure followed by a brief period of latency and secondary energy failure. The pattern of brain injury depends on duration, and severity of insult at the time of brain maturation. Clinical staging- Sarnat and Levene classification- was commonly used. Most authors describe a pattern of injury in neonates who are less than 36 weeks’ gestation that is distinct from the pattern in neonates 36 weeks or older. We wanted to determine and compare the role of Transcranial USG and MRI brain, in the evaluation of HIE in neonates with regard to its nature and extent. METHODS Consecutive fifty neonates clinically diagnosed with hypoxic-ischemic encephalopathy (HIE) by Levene’s classification were included. All cases had undergone transcranial ultrasound study of the brain. MRI Brain was performed in all patients after USG and findings were compared. The study was conducted between May 2015 and September 2017. They were collected from the Neonatology Intensive Care Unit (NICU) and Sick Newborn Care Unit (SNCU) at Burdwan Medical College & Hospital, Dept of Paediatrics. RESULTS Our study found that stages I and II showed predominantly mild to moderate HIE, presented with peripheral pattern and with white matter injuries, while stage III revealed severe HIE presented with predominantly central pattern of injury, i.e. Basal Ganglia and Thalamus (BGT). CONCLUSIONS TCUS helps in evaluation of various imaging patterns depending upon gestational age, severity, duration of insult, as depicted above. However, findings need to be corroborated with both conventional and diffusion weighted MRI findings. Both modalities are recommended as diagnostic protocol.

BACKGROUND Interstitial Lung Disease (ILD) is a group of diffuse lung parenchymal diseases characterized by the involvement of pulmonary interstitium. High resolution computed tomography (HRCT) is the cross-sectional imaging modality of choice for the diagnosis and follow up of ILD as it is accurate as well as non-invasive. The present study was done to describe the basic HRCT patterns associated with Interstitial Lung Disease and to correlate the HRCT patterns with clinical data to obtain differential diagnosis of Interstitial Lung Disease (ILD). METHODS 100 patients (41 males and 59 females) with a mean age of 50 years were included in this study during the period from July 2017 to June 2018. These patients were primarily diagnosed as having interstitial lung disease solely on the basis of clinical findings and chest x-ray by the Chest Medicine Department of BMCH and then referred to Radiology Department BMCH for HRCT assessment. RESULTS 74 patients were diagnosed to have interstitial lung disease and 26 patients had airway disease as well. The common frequent findings in interstitial lung disease (ILD) were idiopathic pulmonary fibrosis (UIP) (30%), idiopathic NSIP (21%), connective tissue disease related ILD (15%), extrinsic allergic alveolitis (EAA) (9%), pulmonary lymphangitis carcinomatosis (PLC) (6%) and 4% for each respiratory bronchiolitis associated interstitial lung disease (RB-ILD), bronchiolitis obliterans organizing pneumonia (BOOP), and occupational lung disease. Breathlessness on exertion (93.3%) and dry cough (100%) were the most common presenting symptoms of UIP. The HRCT findings of UIP included reticular shadowing (100%), nodular shadowing (16%), associated ground-glass attenuation in 73.3% and peribronchovascular thickening in 53%. The signs of lung fibrosis were honeycombing in 83.3%, traction bronchiectasis (66%), septal thickening (66%), core pulmonale in 30% and associated lung cancer in 10%. CONCLUSIONS UIP was the most common interstitial lung disease observed in our study. HRCT is the modality of choice in assessing diffuse parenchymal lung disease especially in the aspects of disease activity and earlier detection and characterization of disease.