UNASSIGNED: It is well known that whereas bilateral occlusion is less common, unilateral internal carotid artery blockage happens regularly. Asymptomatic to fatal ischemic stroke can be the clinical presentation, depending on whether there is adequate collateral blood flow. Internal carotid artery occlusion is often associated with significant neurologic events, both at the time of initial occlusion and during follow-up.
UNASSIGNED: The authors describe a patient\'s experience of dizziness followed by a fall. The hyperdense position of the basilar artery near its bifurcation was identified following a computed tomography (CT) scan. Furthermore, the pons, midbrain, and medial parts of the right temporal lobe showed numerous small hypodensities suggestive of an ischemic injury. The patient had medical treatment without surgery after it was determined that they had bilateral internal carotid arteries and a blocked right vertebral artery. After taking dual anti-platelet therapy for 5 days, the patient recovered without incident and was discharged from the hospital.
UNASSIGNED: In a young patient with bilateral internal carotid arteries occlusion (BICAO), the authors highlighted the significance of prompt diagnosis of stroke-like symptoms, diagnostic possibilities, and treatment options. Options for diagnosis include brain MRI and CT head to check for ischemia and CT angiography (CTA) head and neck to assess for artery obstruction. Options for treatment include severe medical and surgical treatments, such as carotid endarterectomy, stent implantation, or balloon angioplasty, or medical management alone, such as dual anti-platelet medication and thrombolysis.
UNASSIGNED: BICAO is associated with a grave prognosis and significant cerebrovascular complications. High-quality studies are needed to establish the best treatment strategy, considering the complex and individualized nature of the condition.

BACKGROUND: Cutaneous malignant melanomas rarely occur in the eye, usually in the eyelids or the conjunctiva. Conjunctival malignant melanomas are even rarer. Most melanomas are dark in color as they are pigmented. However, amelanotic conjunctival malignant melanomas, a scarce variant of the cancer, can be challenging to diagnose accurately.
METHODS: We present two cases of white Caucasian Swedish-born women who were diagnosed with unilateral amelanotic malignant melanoma in the conjunctiva of the eye. In the first case, the patient was an 81-year-old woman who was suffering from redness and foreign body sensation in the left eye. The initial diagnosis was blepharitis. Three biopsies were taken, which showed malignant melanoma in the eyelid and the conjunctiva. Unfortunately, the eye and the rest of the orbit could not be saved, and the patient had to undergo an orbital exenteration. In the second case, the patient was a 50-year-old woman, and the tumor was localized in the temporal conjunctiva of the left eye. The initial diagnosis was pinguecula, but at the time of surgery, the physician suspected conjunctival intraepithelial neoplasia. The tumor was not completely removed, so adjuvant brachytherapy and local chemotherapy were used. The eye was preserved. No neck and/or lung metastasis was detected in either case at the time of diagnosis.
CONCLUSIONS: Conjunctival amelanotic malignant melanomas should be suspected when tumors are present in the eye and/or the eyelids. By suspecting amelanotic malignant melanoma, the delay in treatment can be shortened. Treating them as soon as possible is essential to minimize the risk of metastasis.

Aim: To describe the successful treatment of atypical occipital neuralgia (ON) using a unilateral dual-lead occipital nerve stimulator.Setting: Outpatient clinic/operating room.Patient: A 53-year-old male with atypical ON.Case description: Patient was previously diagnosed with treatment-refractory left-sided trigeminal neuralgia with atypical occipital distribution. On presentation, his symptoms were consistent with ON with distribution to the left fronto-orbital area. He received a left-sided nerve stimulator implant targeting both the greater and lesser occipital nerves.Results: Patient reported pain relief from a numerical rating scale 10/10 to 3-4/10.Conclusion: ON with referred ipsilateral trigeminal distribution should be considered when patients present with simultaneous facial and occipital pain. Further, a dual-lead unilateral stimulator approach may be a viable treatment.
Atypical, persistent inflammation to the left occipital nerve treated with a neuromodulator: a case reportAim: To describe the successful treatment of atypical headache using a one-sided nerve stimulator.Setting: Outpatient clinic/operating room.Patient: A 53-year-old male with atypical headache.Case description: Patient was previously diagnosed with left-sided chronic facial pain with pain to the back of the head. He previously failed to improve with medication and underwent Botox injections and several surgical operations targeting the nerves responsible for his pain symptoms with no improvement. He recently underwent a nerve-stimulating device trial, designed to alter the activity levels of the targeted nerve, that targeted a nerve in the back of his head. This significantly improved his pain and he ultimately presented for an official stimulator implant. Upon presentation, his symptoms were consistent with left-sided headache to the back of the head with distribution to the left eye area.Results: Patient reported significant pain relief from 10/10 to a 3-4/10, with a 10 representing the worst pain the patient has ever felt.Conclusion: Left-sided headache on the back of the head that can distribute to the left eye area should be a consistent thought for pain/headache practitioners. Further, this stimulator placement approach may be a viable treatment.

This is a rare clinical case report of a 19-year-old male patient reported in the Department of Orthodontics and Dentofacial Orthodontics, Sharad Pawar Dental College, Sawangi (Meghe), Wardha, Maharashtra, with chief complaint of asymmetry present on the lower left side of the face and forwardly placed upper front teeth. The asymmetry was due to the congenital complete absence of the left condyle and skeletal cant in the maxilla and functional occlusal plane. The true agenesis of the condyle is an extremely rare condition that requires proper diagnosis and interdisciplinary management. In this case, there was left-sided condylar agenesis with no other skeletal anomaly present, which was treated by pre-surgical orthodontics for decompensation and surgical correction of skeletal cant followed by Ramal distraction osteogenesis and advancement genioplasty. A condylar stock metal implant was placed on the left side for functional rehabilitation. The patient expressed satisfaction with the aesthetic and functional improvements, highlighting the effectiveness of the integrated orthodontic-surgical approach.

Angiokeratoma is a vascular cutaneous disorder that is generally asymptomatic and presents with multiple dark red to blue or black papules over the skin. The prevalence of angiokeratoma increases as the age increases and it is more common after third and fourth decades of life. There are different types of angiokeratoma which may be localized forms (angiokeratoma of Mibelli, angiokeratoma circumscriptum, solitary angiokeratoma, and angiokeratoma of the scrotum or vulva) or diffuse variant (angiokeratoma corporis diffusum). Here, we report a series of five rare cases of angiokeratoma of Fordyce, of which two cases had vulval involvement and one case showed lesions on unilateral scrotal wall which was unusual.

Stafne bone defect (SBD) is a rare developmental bone defect characterized by an asymptomatic focal concavity of the cortical bone, typically on the lingual aspect of the mandibular body, which generally contains salivary gland tissue. It can be detected during routine dental examinations and typically appears as an ovoid, well-defined, well-corticated, radiolucent depression in the posterior mandibular region below the inferior alveolar nerve (IAN) (in: Neville et al, Oral and maxillofacial pathology, Elsevier, Inc, St. Louis, MO, 2016).An 80-year-old male presented to our clinic for a routine dental examination. Panoramic radiography and cone-beam computed tomography (CBCT) displayed two well-defined, well-corticated, ovoid radiolucencies inferior to the IAN canal on the left mandibular molar region. The working diagnosis was SBD, and the patient was informed of the findings. Irregular margins on the superior aspect of the anterior defect were noted on CBCT imaging; therefore, follow-up with panoramic images at 6 months, 1 and 5 years was recommended.

Mature teratomas, also known as ovarian dermoid cysts, are benign embryonal tumors that develop slowly. One of the following imaging techniques is commonly employed to evaluate these cysts: transvaginal ultrasound, pelvic ultrasonography, magnetic resonance imaging, or computed tomography. The two surgical methods most frequently used for removing persistent or very large cysts are laparoscopy and laparotomy. A 42-year-old female, who is P3L1D2 with a history of previous cesarean section, presented with an abdominal mass that had been gradually increasing in size over the past five months. She also reported lower abdominal pain for the last five days. Upon further evaluation, she was diagnosed with a left ovarian dermoid cyst. The patient underwent exploratory laparotomy, during which a total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The cut section of the gross cyst specimen revealed abundant sebaceous fluid and a large tuft of hair, which was confirmed by histopathology. The patient was followed up every three months for a year. Ovarian tumors typically manifest with nonspecific symptoms. The early recognition of dermoid cysts and prompt intervention are crucial to prevent potential complications.

Puffy hand syndrome occurs in addicts who have injected drugs either intravenously, intradermally, or subcutaneously. It usually presents as bilateral reversible pitting edema of the hands; less frequently, it occurs unilaterally. The forearms and arms may also be affected. The onset of puffy hand syndrome can occur while the patient is still injecting drugs; however, it can initially appear several years after injection of the drug has been discontinued. Infection with hepatitis C is a common comorbidity. A 47-year-old man is described who had a 20-year history of injecting methylamphetamine only into his non-dominant left arm, forearm, and hand and experienced his second episode of unilateral puffy hand syndrome four years after discontinuing injecting the drug and three years after his initial episode; he also had hepatitis C infection. He presented with erythema and pitting edema of his left hand and forearm. Cellulitis was initially suspected, and he was admitted to the hospital for intravenous antibiotics; all cultures were negative for pathogens. The erythema and swelling resolved after five days of therapy. Puffy hand syndrome has been associated with various drugs; it has also been observed to occur in women during pregnancy and occasionally associated with acrocyanosis. The diagnosis is often not originally entertained by the clinician; the condition is often initially treated empirically as an infection. Serologic evaluation is typically negative for rheumatologic diseases, such as systemic lupus erythematosus and scleroderma, and cultures of the skin and blood are usually negative for pathogens. Radiologic assessment (such as roentgenograms, ultrasound to rule out venous thrombosis, computed tomography, magnetic resonance imaging, venogram, and lymphangiogram) may be performed, to exclude other conditions. Skin biopsy of the affected edematous hand occasionally demonstrates granulomatous inflammation and foreign bodies (suggestive of starch or injection additives) in the dermis. The edema for some of the patients with puffy hand syndrome was successfully treated with daily bandaging with compression stockings. The pathogenesis of puffy hand syndrome is considered to be multifactorial: damage to the veins, injury to the lymphatic system, and direct toxicity of the injectable drugs to the vascular structures.

Renal agenesis refers to the congenital absence or complete failure of development of one or both kidneys. It occurs when the kidneys fail to form during embryonic development. This case report describes the presentation of a 23-year-old male patient who experienced sporadic episodes of abdominal pain on the right side and occasional episodes of hematuria. Diagnostic investigations, including ultrasonography and magnetic resonance imaging scans, confirmed the diagnosis of right renal agenesis. The management of the patient in this case report involved close monitoring of renal function and regular follow-up visits. Initially, the patient was followed for a period of 3 months and based on the patient\'s clinical status and any associated risk factors, it was determined that a follow-up schedule of visits every 6 months is appropriate. This interval allows for ongoing assessment of renal function and facilitates early detection of any potential complications or changes in kidney health. This case highlights the importance of early diagnosis, comprehensive management, and long-term monitoring in individuals with renal agenesis.

UNASSIGNED: Unilateral twin ectopic pregnancy is extremely rare in natural pregnancy, with an incidence rate of only 1 in 200,000-2,500,000, represents a major health risk for reproductive-aged women, leading to even life-threatening complications. There is a lack of data on the prevalence of this rare disease after in-vitro fertilization-embryo transfer (IVF-ET) cycles.
UNASSIGNED: We present a case of a 51-year-old woman with rare unilateral twin ectopic pregnancy after frozen embryo transfer treated with bilateral salpingectomy, followed by a review of the literature.
UNASSIGNED: Twin ectopic pregnancy is a very rare type of pregnancy that requires a high index of suspicion to diagnose and treat early to prevent complications and maternal death.