Unique Features Of Polycythemia Observed On Plain Non Contrast Ct Head

S. Gayathri, A. Prasad, S. Aggarwal, B. P. Baruah
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Abstract

We present a case of Polycythemia secondary to a congenital cardiac anomaly presenting with acute neurological complications showing hyperdense venous sinuses and cerebral vasculature in association with a cerebral abscess. INTRODUCTION Neurological conditions associated with Polycythemia may warrant an emergency non contrast CT scan of the head. The unique findings associated with Polycythemia have not been well characterized in literature. We present a case of Polycythemia associated with hyperdense dural venous sinuses and cerebral vasculature hence simulating the appearance of a contrast enhanced CT on Plain CT films. CASE REPORT A 27 year old male patient presented to our emergency with history of fever and headache for the past 4 days with altered sensorium for 2 days and a brief episode of loss of consciousness two days back. Patient had a history of breathlessness on and off since three years of age. He was diagnosed as a case of heart disease but financial constraints prevented timely treatment. Examination revealed central cyanosis , rt hemiparesis and a pansystolic murmur over the epicardium. NCCT findings were suggestive of a left temporoparietal cerebral abscess associated with hyperdensity of all cerebral venous sinuses and cerebral vasculature. (patient had not been given any intravenous contrast agents ). Figure 1
非对比Ct平扫观察红细胞增多症的独特特征
我们报告一例继发于先天性心脏异常的红细胞增多症,表现为急性神经系统并发症,表现为高密度静脉窦和脑血管,并伴有脑脓肿。与红细胞增多症相关的神经系统疾病可能需要紧急进行头部非对比CT扫描。与红细胞增多症相关的独特发现尚未在文献中得到很好的描述。我们报告一例红细胞增多症合并硬膜静脉窦和脑血管高密度,因此在CT平片上模拟了增强CT的外观。病例报告一名27岁男性患者,过去4天有发热和头痛病史,2天感觉改变,2天前有短暂的意识丧失。患者自三岁起就有断断续续的呼吸困难病史。他被诊断为心脏病,但经济拮据无法及时治疗。检查显示中枢性发绀、全身偏瘫和心外膜上的全收缩期杂音。NCCT结果提示左侧颞顶叶脑脓肿伴所有脑静脉窦和脑血管高密度。(患者未静脉注射造影剂)。图1
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