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12/15/2009
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4 Clinical Cases
Dr R Modun
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Clinical Case 1
• 16 years old boy• Came to Hospital complaining of severe
headacheS i i h l d• Symptomatic tt with paracetamol and piriton
• Came back 2 days later• Fever severe headacheFever, severe headache• Admitted. CT Brain…
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Clinical Case 1…
• While in ward…• Epileptic fits• Lumbar Puncture. NAD.• Shifted to ICU• …by which time he developed hemiparesis
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Clinical Case 2
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Clinical Case 2
• Mrs M• Swelling left parotid region• Attended ENT• Antibiotics, allowed home• Not relieved, swelling increased in size,
fluctuant, tender, purulent discharge• Pus sent for m+c+s
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Clinical Case 3
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Clinical Case 3• Mrs P.D.• Attended with walking difficulty• Consultation with Orthopedic Surgeon• MRI Lumbosacral area… NAD• Proposed arthroscopy both knees• Came to me for 2nd opinion• Noted: - spasticity b/l lower limbs
- increased tendon reflex- no sensory deficit
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Clinical Case 3…
• Referred to Neurologist Dr Lam for confirmation of findings
• MRI thoracic region
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Clinical Case 3…
• Contacted Dr Lam again• MRI Brain requested…
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vv
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Clinical Case 4
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Clinical Case 4
• Mr P, 22 years• University Student• Complaining of cervical pain for the past 2 years• Has been attending chiropractor regularly• Presented to Orthopedic Surgeon with worsening
pain• MRI cervical spine requestedMRI cervical spine requested• Developed tetraparesis by the time he came to me
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Large Syrinx in cervical area extending to brainstem
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Clinical Case 4…
• Operation:• Posterior fossa decompression• Shunt from syrinx to subarachnoid spacey p
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