Images in medicine
‘Cascade Sign’ revealing a Behçet's disease
‘Signo de la cascada’ que revela un Behçet
Mariem Essouri Dr, Zeineb Teyeb
, Souha Khfifi, Imen Mariem Abbassi, Naziha Khammassi
Corresponding author
Internal Medicine Departement, Razi's Hospital, Faculty of Medicine of Tunis, University of Tunis Al Manar, Tunis, Tunisia
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"souha.khfifi@etudiant-fmt.utm.tn" ] ] 3 => array:4 [ "preGrado" => "MD" "nombre" => "Imen Mariem" "apellidos" => "Abbassi" "email" => array:1 [ 0 => "imenmariem.abbassi@fmt.utm.tn" ] ] 4 => array:4 [ "preGrado" => "PHD" "nombre" => "Naziha" "apellidos" => "Khammassi" "email" => array:1 [ 0 => "naziha.khammassi@fmt.utm.tn" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Internal Medicine Departement, Razi's Hospital, Faculty of Medicine of Tunis, University of Tunis Al Manar, Tunis, Tunisia" "identificador" => "af0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "‘Signo de la cascada’ que revela un Behçet" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "f0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1566 "Ancho" => 2835 "Tamanyo" => 351062 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "al0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Sagittal view of brain RMI showing with bilateral T2 and flair hyperintensity of the mesencephalon.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="p0005" class="elsevierStylePara elsevierViewall">A 16-year-old patient with no previous medical history, presenting with a progressive neurological disorder characterized by balance disturbance and binocular diplopia. Physical examination showed dysarthria, pyramidal syndrome, action tremor, and pseudo-folliculitis.</p><p id="p0010" class="elsevierStylePara elsevierViewall">The cerebral magnetic resonance imaging (MRI) showed a bilateral asymmetrical high T2 signal of the posterior arms of the internal capsules associated with bilateral T2 and flair hyperintensity of the mesencephalon (<a class="elsevierStyleCrossRef" href="#f0005">figure 1</a>). The high signal involvement of the mesencephalic junction is defined as a waterfall or cascade sign (<a class="elsevierStyleCrossRef" href="#f0010">figure 2</a>).</p><elsevierMultimedia ident="f0005"></elsevierMultimedia><elsevierMultimedia ident="f0010"></elsevierMultimedia><p id="p0015" class="elsevierStylePara elsevierViewall">Cerebrospinal fluid was inflammatory with an aseptic lymphocytosis (238 cells/mm<span class="elsevierStyleSup">3</span>) and matched oligoclonal bands.</p><p id="p0020" class="elsevierStylePara elsevierViewall">Medical history was reconducted. The patient confirmed recurrent aphthous that she neglected. Behçet's disease was diagnosed according to EULAR criteria (oral recurrent aphthous, skin, and neurological involvement).</p><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0005">Funding</span><p id="p0025" class="elsevierStylePara elsevierViewall">This research received no specific funding.</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0010">Ethical consideration</span><p id="p0030" class="elsevierStylePara elsevierViewall">Patient gave the consent to be part of the research.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "s0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "s0010" "titulo" => "Ethical consideration" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2024-07-10" "fechaAceptado" => "2024-07-11" "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "f0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1566 "Ancho" => 2835 "Tamanyo" => 351062 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "al0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Sagittal view of brain RMI showing with bilateral T2 and flair hyperintensity of the mesencephalon.</p>" ] ] 1 => array:8 [ "identificador" => "f0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1524 "Ancho" => 1362 "Tamanyo" => 158360 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "al0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Coronal brain RMI T2 high signal involvement of the thalamus: Cascade sign.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/26039249/0000000700000004/v1_202410240709/S2603924924000375/v1_202410240709/en/main.assets" "Apartado" => array:4 [ "identificador" => "80822" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imagen en medicina" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/26039249/0000000700000004/v1_202410240709/S2603924924000375/v1_202410240709/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2603924924000375?idApp=UINPBA00004N" ]
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