Leptospirosis is an acute infectious disease that manifests as a biphasic sickness with an initial leptospiraemic and a subsequent immunological phase. It is caused by a spirochete belonging to the genus Leptospira. Leptospirosis seldom manifests clinically as a primary neurological impairment. We report a case of a middle -aged man who was initially diagnosed with leptospirosis and subsequently complicated by development of cerebral venous sinus thrombosis. This intriguing case study emphasises the importance of identifying uncommon leptospirosis symptoms in endemic regions such as Malaysia.

Background: Brain ischaemia and infarction are the leading factors in morbidity and mortality of traumatic brain injury. This study aimed to determine the perfusion status of pericontusional hypodense areas in traumatic cerebral contusion Methods: Ten patients involved in motor vehicle accidents were enrolled in this study, and contusions were diagnosed from plain computed tomography scans of the brain. Subsequent computed tomography perfusion (CTP) was performed to analyse the perfusion of pericontusional hypodense areas, which were divided into 4 regions of interest (ROI). Results: Most ischaemic perfusion was found in ROI 6 (affecting 60% of patients), although the mean of the perfusion parameters were normal. A significant positive correlation was found between the perfusion status in the pericontusional area nearest to the skull vault (ROI 3) and its distance/thickness to the skull vault (r = 0.698, P = 0.025). Two adjacent pericontusional hypodense areas (ROI 4 and ROI 5) showed a significant positive correlation with each other (r = 0.667, P = 0.035) in terms of perfusion status. The presence of a hypodense pericontusional area is suggestive of oedema and perfusion disturbances. Conclusion: CTP is a useful, fast, and appropriate method in evaluating perfusion of pericontusional hypodensity area that may help the treating physician to provide an appropriate treatment to the patient.