Wednesday, February 20, 2013

Severe left internal carotid artery stenosis:

This patient has the right hemiplegia following a cerebrovascular accident involving the left parietal lobe. Color Doppler imaging of the carotid tree shows severe stenosis, 80 to 90%, involving the left internal carotid artery close to its origin from the common carotid artery.
The colour Doppler image below shows the internal diameter of the left internal carotid artery is less than 3 mm near its origin. This is definitely abnormal and shows severe stenosis.

spectral Doppler trace of the left common carotid artery appears relatively normal.

however, the left internal carotid artery shows a definite evidence of severe stenosis with peak systolic velocity reaching up to 224 cm/s suggesting greater than 90% stenosis at this level. The normal peak velocity of flow at the internal carotid artery should be less than an and 120 cm/s.

the video below shows the characteristic spectral waveform seen in this case. The characteristic high pitch sound of the Doppler waveform and high velocity flow at the site of left internal carotid artery stenosis can be appreciated.

For more on this topic:

Friday, February 08, 2013

A case of painful left scrotal mass

This middle aged male patient has a left scrotal mass which is tender and painful. What do you opine?
The mass showed plenty of mobile particulate matter and is located on the upper pole of the left testis.

Answer: this is a case of left scrotal abscess with the purulent collection being within the left tunica vaginalis sac. Aetiology of this left scrotal collection appears to be tuberculous in origin. This can explain the lack of significant vascularity within the left scrotum and the left testes.
See similar lesions at: