Background and Clinical Significance: Hypoplasia of the internal carotid artery (ICA) is a rare vascular anomaly, with an estimated incidence of less than 0.01%. This condition can result in reduced blood flow to the anterior circulation, often compensated by collateral circulation. Radiological imaging, particularly computed tomography angiography (CTA), digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and ultrasound, plays a crucial role in diagnosing this condition, revealing structural abnormalities in the arterial system. Case Presentation: This case is about a 75-year-old woman who lived her entire life unaware of ICAH until a basilar artery aneurysm ruptured, leading to a large, centrally localized SAH. Further diagnostic workup, including CTA and DSA, confirmed left ICA hypoplasia, with the artery terminating as the ophthalmic artery, along with a developmental anomaly of the left middle cerebral artery from posterior circulation territory. Due to the high risk associated with surgical and endovascular intervention, conservative management was pursued, and the patient’s condition stabilized, though she continued to have significant neurological deficits. Conclusions: This case report supports the hypothesis that ICAH may be associated with aneurysm formation. This case demonstrates that if ICAH is not diagnosed early, it can lead to severe complications with permanent neurological deficits. Additionally, it highlights the critical importance of advanced imaging techniques, such as CTA and DSA, in diagnosing complex vascular conditions.

Tuberculous meningoencephalitis is a rare manifestation of Mycobacterium tuberculosis (Mtb), with the most severe form and highest mortality. It can cause multiple complications, and treatment is difficult, as drugs cannot properly diffuse through the haemato-encephalitic barrier. We reported the case of a 17-year-old female patient who was admitted to the emergency room department with a fever for previous two weeks (up to 39 °C), dizziness, difficulty walking, and weight loss. Magnetic resonance imaging indicated possible meningoencephalitis, and a CT scan of the lungs visualised miliary infiltrates in both lungs. After repeated tests, Mtb DNA was found in the bronchial wash, cerebrospinal fluid, faeces, and urine via an Xpert/Rif Ultra test. Treatment was started with isoniazid, rifampicin, ethambutol, pyrazinamide, and corticosteroids as well. Although treatment was initiated within the first few days in the hospital, a reduction in glucocorticoid dosage worsened the patient’s neurological state, making treatment even more challenging. Prolonged use of glucocorticoids led to an improvement in the stage of the condition. Further, over time, the patient’s condition improved. Pulmonary infiltrations were not found after 2.5 months of starting therapy. Conclusions: Timely treatment is crucial for improving the prognosis of patients with miliary tuberculosis and tuberculous meningoencephalitis. Prompt recognition of symptoms and accurate diagnosis are essential to initiate effective treatment strategies. In this patient’s case, prolonged use of corticosteroids reduced neurologic complications, and ongoing treatment gradually improved the patient’s condition.

Background: optic nerve glioblastoma is an uncommon pathology. The optic chiasm, optic tract, or optic nerves are possible places from which the tumor can originate. Most of the neuroimaging findings are nonspecific. To confirm the diagnosis, a biopsy is required. A delay to the treatment plan for optic nerve glioblastoma results in poor patient survival rates. Case report: a 68-year-old woman with an uncomplicated medical history presented with exophthalmos, deteriorating eyesight, and partial loss of vision. Using radiological data together with postoperative histopathological and histochemical analysis, optic nerve glioblastoma, IDH-wildtype, with optic chiasm involvement was diagnosed. Conclusion: optic nerve glioblastoma is a rare and aggressive form of cancer that affects the optic nerve, leading to significant vision impairment and potentially life-threatening complications. Treatment options are restricted and difficult because of the location and nature of the condition; surgery, radiation therapy, and chemotherapy are frequently needed as part of a multidisciplinary approach.