Scoliosis occurs
relatively frequently in the general population, and its frequency
depends upon the magnitude of the curve being described. Scoliosis of
greater than 25 degrees has been reported in about 1.5/1000 persons in
the United States. Most curves can be treated nonoperatively if they are
detected before they become too severe. However, 60 % of curvatures in
rapidly growing prepubertal children will progress. Therefore, scoliosis screening
is done in schools across America and several other countries. This
screening is probably not necessary until the fifth grade. Beyond that
point, boys and girls should be examined every 6 - 9 months. Generally,
curvatures less than 30 degrees will not progress after the child is
skeletally mature. Once this has been established, scoliosis screening
and monitoring can usually be stopped. However, with greater
curvatures, the curvature may progress at about 1 degree per year in
adults. In this population, monitoring should be continued.
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| A large, right-sided pneumothorax has occurred from a rupture of a subpleural bleb. |
Pneumothorax,
the presence of air within the pleural space, is considered to be one
of the most common forms of thoracic disease. It is classified as
spontaneous (not caused by trauma), traumatic, or iatrogenic (see the
images below)
Spontaneous
pneumothorax may be either primary (occurring in persons without
clinically or radiologically apparent lung disease) or secondary (in
which lung disease is present and apparent). Most individuals with
primary spontaneous pneumothorax (PSP) have unrecognized lung disease;
many observations suggest that spontaneous pneumothorax often results
from rupture of a subpleural bleb.
Traumatic
pneumothorax is caused by penetrating or blunt trauma to the chest, with
air entering the pleural space directly through the chest wall, through
visceral pleural penetration, or through alveolar rupture resulting
from sudden compression of the chest.
Iatronic
pneumothorax results from a complication of a diagnostic or therapeutic
intervention. With the increasing use of invasive diagnostic procedures,
iatrogenic pneumothorax likely will become more common, although most
cases are of little clinical significance.
Findings
Head CT with
and without contrast shows a
rim-enhancing right frontoparietal lesion with surrounding edema. There
is no significant mass effect.
Discussion
Cysticercosis begins
with ingestion of Taenia solium worm eggs from undercooked pork.
Gastrointestinal absorption leads to hematogenous dissemination and
any organ or tissue can be subsequently seeded.
The two forms
of cysticercosis from an imaging perspective are inactive and active.
Inactive disease manifests as multiple 1 cm or less
parenchymal calcifications. Organisms are no longer viable at this
stage.
Active disease
represents the imaging manfiestations of viable and degenerating
parasites and is subdivided into vesicular, colloidal, and granular
stages. The vesicular stage is represented
by multiple well-defined parenchymal cysts at the gray-white
matter junction with a possible muralnodule.
During the
colloidal stage, the cyst contentsbecome higher than CSF density. During
the granular stage, the cyst begins to collapse,
surrounding edema develops, and there is intense enhancement of the cyst
walls.
Our case is therefore an example of a single lesion of neurocysticercosis in the granular stage.
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