MyMedR

Fulltext Brain imaging findings in COVID-19: What do we know so far?

Md Noh MSF

J Neuroradiol, 2020 Sep;47(5):329-330.

PMID: 32444286 DOI: 10.1016/j.neurad.2020.05.004

Fulltext Accidental Puncture of a Dialysis Catheter into the Brachiocephalic Trunk

Md Noh MSF

Aorta (Stamford), 2020 Oct;8(5):159-160.

PMID: 33368104 DOI: 10.1055/s-0040-1715466

A 22-year-old male with underlying end-stage renal failure was referred to our center for a malpositioned dialysis catheter. Imaging showed the tip of the catheter to be placed in the brachiocephalic trunk; the patient was, however, asymptomatic. Surgical removal of the malpositioned catheter followed, with no postoperative complications.

Fulltext The middle cerebral artery (MCA) dot sign

Md Noh MSF

Clin Case Rep, 2021 Aug;9(8).

PMID: 34466227 DOI: 10.1002/ccr3.3319

The middle cerebral artery (MCA) dot sign is an important radiological sign in patients presenting with acute ischemic stroke (AIS). If identified and intervened early, a good clinical outcome may be achieved.

Fulltext Myelin oligodendrocyte glycoprotein-antibody (MOG-IgG) associated disease with centrally located long spinal cord lesion in a 14-month old child

Md Noh MSF

J Cent Nerv Syst Dis, 2020;12:1179573520955008.

PMID: 32973377 DOI: 10.1177/1179573520955008

Myelin oligodendrocyte glycoprotein-antibodies (MOG-IgG) are associated with acquired inflammatory demyelinating syndromes, seen predominantly in children and young adults. The overlapping clinical and radiological features of the heterogenous spectrum of demyelinating central nervous system (CNS) diseases makes the detection of MOG-IgG antibodies important for prognosis and treatment decisions. Herein, we describe the occurrence of MOG-IgG associated disease presenting as acute disseminated encephalomyelitis (ADEM), with spinal MRI findings of centrally located long cord lesion in a 14-month old child.

Fulltext COVID-19 and Cerebral Hemorrhage: Proposed Mechanisms

Md Noh MSF

J Neuroradiol, 2021 Mar;48(2):125-126.

PMID: 32507577 DOI: 10.1016/j.neurad.2020.05.007

Fulltext Dyke-Davidoff-Masson syndrome: a case report

Abdul Rashid AM, Md Noh MSF

BMC Neurol, 2018 May 29;18(1):76.

PMID: 29843624 DOI: 10.1186/s12883-018-1079-3

BACKGROUND: Dyke-Davidoff-Masson syndrome is a rare condition of unknown frequency resulting from brain injury due to a multitude of causes; especially in early life. Characteristics include cerebral hemiatrophy/hypoplasia, contralateral hemiparesis, seizures, and compensatory osseous hypertrophy.

CASE PRESENTATION: We present a case of a 13-year-old girl who initially presented with headaches, followed by episodic complex-partial seizures; which was controlled via medication. She also had right sided hemiparesis. Computed tomography (CT) showed evidence of left parieto-temporal infarct with cerebral atrophy. Complementary magnetic resonance imaging (MRI) did not reveal additional information. Workup for young stroke was negative. Upon further evaluation by Neuroradiology, features suggesting Dyke-Davidoff-Masson syndrome were confirmed. Patient has been under Neurology follow up since.

CONCLUSIONS: Due to its rarity, Dyke-Davidoff-Masson syndrome may easily be missed by the majority of treating clinicians. Knowledge of its features on imaging enables timely and accurate diagnosis - allowing appropriate management.

Fulltext Development of pseudo-subarachnoid hemorrhage secondary to hypoxic-ischemic injury due to bleeding pulmonary arterio-venous malformation

Md Noh MSF, Abdul Rashid AM

BMC Neurol, 2018 Sep 28;18(1):157.

PMID: 30266082 DOI: 10.1186/s12883-018-1161-x

BACKGROUND: The computed tomography (CT) finding of a pseudo-subarachnoid hemorrhage (SAH) may lead the treating physician into a diagnostic dilemma. We present a case of a pseudo-SAH in a patient with post-resuscitative encephalopathy, secondary to a newly diagnosed bleeding pulmonary arterio-venous malformation (AVM).

CASE PRESENTATION: A 19-year-old female presented acutely with massive hemoptysis. Cardiopulmonary resuscitation (CPR) followed, and the patient was subsequently intubated for airway protection with intensive care unit (ICU) admission. Urgent CT angiography of the thorax showed a bleeding pulmonary AVM, with evidence of hemothorax. Non-contrasted cranial CT initially revealed cerebral edema. Day 3 post admission, repeat cranial CT showed worsening cerebral edema, with evidence of pseudo-SAH. Patient passed away the next day.

CONCLUSIONS: Pseudo-SAH, if present, carries a poor prognosis. It should be recognized as a potential CT finding in patients with severe cerebral edema, due to various causes. The diagnosis is vital, to avoid wrongful treatment institution, as well as determination of cause of death.

Fulltext Massive subdural empyema

Md Noh MSF, Bahari N

Oxf Med Case Reports, 2018 Sep;2018(9):omy065.

PMID: 30159156 DOI: 10.1093/omcr/omy065

Fulltext Beaver in the liver

Md Noh MSF, Muhammad SJSS

Pan Afr Med J, 2017 Jun 23;27:138.

PMID: 28904667 DOI: 10.11604/pamj.2017.27.138.12227

The disappearing basal ganglia sign

Md Noh MSF, Abdul Rashid AM

QJM, 2018 May 01;111(5):343.

PMID: 29228291 DOI: 10.1093/qjmed/hcx240

Fulltext Isolated non-traumatic, non-aneurysmal convexal subarachnoid hemorrhage in a patient with Evans syndrome

Abdul Rashid AM, Md Noh MSF

BMC Neurol, 2017 Aug 25;17(1):165.

PMID: 28841841 DOI: 10.1186/s12883-017-0944-9

BACKGROUND: Non-traumatic, spontaneous subarachnoid hemorrhage occurs in approximately 85% of cases where there is a ruptured saccular aneurysm. An additional 10% of cases arise from non-aneurysmal peri-mesencephalic hemorrhages.

CASE PRESENTATION: We report a rare case of a young female, with underlying Evans syndrome, who was initially thought to have non-hemorrhagic stroke, eventually diagnosed having isolated non-traumatic, non-aneurysmal convexal subarachnoid haemorrhage.

CONCLUSIONS: Spontaneous non-traumatic, non-aneurysmal convexal subarachnoid hemorrhage is a rare entity - of which there are multiple possible etiologies.

Fulltext Incremental Role of Fluorine 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Assessment of Computed Tomography-Inconspicuous Pancreatic Lesions

Ahmad Saad FF, Abdul Rashid AM, Md Noh MSF

J Pancreat Cancer, 2017;3(1):66-70.

PMID: 30631845 DOI: 10.1089/pancan.2017.0014

Background: Pancreatic malignancies encompass a heterogenous group of disorders, with poor prognosis at diagnosis. Traditionally, conventional computed tomography (CT) has been used for diagnosis, staging, and follow up. However, this technique lacks functional information; and is limited in diagnosis of occult pancreatic disease. Hybrid imaging in the form of positron emission tomography (PET)/CT provides a potential avenue for early detection and subsequent appropriate therapy. Case Presentation: A 60-year-old male, with a history of abdominal aortic aneurysm which was repaired, came with a complaint of 2 months history of back pain, radiating to the front. The pain was relieved on leaning forward, and aggravated by lying on his back. CT angiography of the abdomen was done, which revealed a concealed aortic aneurysm and a significant atrophy of the pancreatic tail. The serum cancer antigen (CA) 19-9 was elevated (50.0 U/mL, reference range 0.0-37.0 U/mL). At this juncture, the PET scan done revealed no discernible abnormalities. Patient was put on close follow-up in view of the rising trend of CA 19-9 levels. Three months following the initial scans, a repeat 18F-FDG (fluorine 18 fluorodeoxyglucose) PET/CT revealed an FDG-avid lesion at the neck of the pancreas on PET without perceptible changes on the correlated CT. A Whipple's procedure ensued, with histopathological examination findings of pancreatic adenocarcinoma. Conclusion: This article discusses the role of PET/CT in the early diagnosis of inconspicuous pancreatic lesions; which could have averted immediate medical therapy.

Fulltext Tuberculous Myelopathy Associated with Longitudinally Extensive Lesion: A Clinicoradiological Review of Reported Cases

Md Noh MSF, Bahari N, Abdul Rashid AM

J Clin Neurol, 2020 Jul;16(3):369-375.

PMID: 32657056 DOI: 10.3988/jcn.2020.16.3.369

Acute transverse myelitis is an inflammatory disorder of the spinal cord in which there is no evidence of spinal cord compression. Longitudinally extensive transverse myelitis (LETM) is a specific subtype of acute transverse myelitis that usually affects three or more vertebral levels and produces marked neurological deficits. While the most-common cause of LETM is neuromyelitis optica or neuromyelitis optica spectrum disorder, there are rare cases of other causes mimicking this condition, including tuberculosis (TB). We sought to review the clinicoradiological features of TB myelopathy associated with longitudinally extensive lesion, which may mimic LETM, in the English literature. We searched the PubMed, Google Scholar, Web of Science, and Scopus databases for relevant articles using search terms including "longitudinally extensive transverse myelitis," "tuberculosis," "TB spinal cord," and various combinations of these expressions. Full-text papers were selected without limiting the publication year. We also examined the reference lists of key papers to identify further articles that are potentially relevant. We found 10 cases in 7 papers describing TB myelopathy associated with longitudinally extensive lesion. The demographics, clinical features, relevant cerebrospinal fluid findings, and radiological findings were compiled and summarized. TB myelopathy associated with longitudinally extensive lesion is very rare, with no documented prevalence. Early and accurate diagnosis is important since the condition is potentially treatable.

A Massive Hemothorax in a Pregnant Woman: Role of Interventional Radiology

Md Noh MSF, Abdul Rashid AM, Abdul Rahim E

J Bronchology Interv Pulmonol, 2018 07;25(3):e30-e32.

PMID: 29944591 DOI: 10.1097/LBR.0000000000000456

Fulltext A case of anti-N-methyl-d-aspartate receptor encephalitis

Abdul Rashid AM, Mohamad Mokhtar E, Md Noh MSF

SAGE Open Med Case Rep, 2020;8:2050313X20926431.

PMID: 32547761 DOI: 10.1177/2050313X20926431

Anti-N-methyl-d-aspartate receptor encephalitis is characterized by the clinical manifestation of neuropsychiatric symptoms, predominantly affecting young adults, and frequently associated with neoplasms. It is the second most common cause of autoimmune and paraneoplastic encephalitis. Early diagnosis is often missed, as patients are commonly diagnosed with psychiatric illnesses and are treated with antipsychotics - which rarely gives complete resolution of symptoms. Herein, we discuss a patient with mixed clinical, imaging, electroencephalogram, and laboratory findings, with an eventual diagnosis of anti-N-methyl-d-aspartate receptor encephalitis requiring immunotherapy and operative intervention.

Tuberculous (TB) myelopathy associated with longitudinally extensive lesion: A case report

Noh MSF, Bahari N, Abdul Rashid AM

J Neuroradiol, 2021 Nov;48(6):453-455.

PMID: 31837378 DOI: 10.1016/j.neurad.2019.12.002

Fulltext Pediatric critical illness associated cerebral microhemorrhages

Abdul Rashid AM, Bahari N, Md Noh MSF

eNeurologicalSci, 2020 Mar;18:100221.

PMID: 31909229 DOI: 10.1016/j.ensci.2019.100221

Fulltext Supraclinoid direct carotid-cavernous sinus fistula

Che Ani MF, Kumar R, Md Noh MSF, Muda AS

BJR Case Rep, 2018 Mar;4(3):20170058.

PMID: 31489208 DOI: 10.1259/bjrcr.20170058

Carotid-cavernous fistulas (CCFs) are vascular shunts between the carotid arterial system with direct drainage into the cerebral venous system, mainly to the cavernous sinus. Direct CCF is a well-recognised complication following head trauma. Classically in direct or traumatic CCF, vessel wall tear occurs at the cavernous segment of the internal carotid artery, between the fixed and free segment. Tears at the supraclinoid segment are rare. We report a case of an internal carotid artery supraclinoid segment pseudoaneurysm, with a direct communication with the cavernous sinus, draining into the superior ophthalmic vein.

Fulltext Emphysematous aortitis: report of two cases and CT imaging findings

Md Noh MSF, Abdul Rashid AM, Ar A, B N, Mohammed Y, A R E

BJR Case Rep, 2017;3(3):20170006.

PMID: 30363220 DOI: 10.1259/bjrcr.20170006

Emphysematous aortitis is a rare condition that manifests through the presence of air within or surrounding the inflamed aorta. Aortic inflammation may result from either an infective or a non-infective cause. Recognition of this rare condition is important as the resultant clinical deterioration may be rapid and lead to inevitable death. Cross-sectional imaging, with its relatively wide availability, proves an important tool in the diagnosis and subsequent management of this condition. We report two such cases encountered in our centre, with particular focus on the imaging findings on CT.

Fulltext Successful febuxostat desensitization in a patient with febuxostat hypersensitivity: A Malaysian experience

Sulaiman N, Othman AZ, Shahril NS, Abdul Rashid AM, Md Noh MSF

SAGE Open Med Case Rep, 2017;5:2050313X17749080.

PMID: 29318019 DOI: 10.1177/2050313X17749080

Over the years, allopurinol has been widely used as the preferred choice of urate lowering therapy in patients with gout. However, its role in patients with renal impairment is limited; and adverse reactions are well documented. Febuxostat, a newer oral non-purine xanthine oxidase inhibitor has been proven in several trials to be more effective and tolerable compared to allopurinol and may be used in patients with renal impairment. Here, we describe a case of successful febuxostat desensitization in a patient with a history of allopurinol- and febuxostat-induced adverse cutaneous reaction, as well as the protocol utilized.

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