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https://www.readbyqxmd.com/read/28214641/posterior-reversible-encephalopathy-syndrome-causing-vision-loss-following-endoscopic-endonasal-resection-of-pituitary-adenoma-a-case-report
#1
Nicolas W Villelli, Daniel M Prevedello, Daniel S Ikeda, Alaa S Montaser, Bradley A Otto, Ricardo L Carrau
BACKGROUND: Posterior Reversible Encephalopathy Syndrome (PRES) is characterized by headache, altered mental status, visual changes, and seizure combined with brain imaging consistent with cerebral edema without infarction. To the best of our knowledge, we report the first case of PRES following an endoscopic endonasal resection of a pituitary macroadenoma. CASE DESCRIPTION: A 59-year-old female was diagnosed with a pituitary macroadenoma, for which she underwent endoscopic endonasal extracapsular resection...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28202821/-pres-posterior-reversible-encephalopathy-syndrome
#2
Kouichirou Okamoto, Kunio Motohashi, Hidemoto Fujiwara, Tomohiko Ishihara, Itaru Ninomiya, Osamu Onodera, Yukihiko Fujii
Posterior reversible encephalopathy syndrome (PRES) is suggested in patients with acute neurological symptoms in the appropriate clinical context, including acute hypertension, blood pressure fluctuations, renal failure, blood transfusion, immunosuppression, autoimmune disorders, and eclampsia. PRES is a clinical syndrome, and refers to a disorder with reversible subcortical vasogenic brain edema caused by endothelial dysfunction, predominantly involving the bilateral parieto-occipital regions. Although the clinical course and prognosis are favorable in most cases, intracranial hemorrhage and/or restricted diffusion similar to acute infarction could be seen in some lesions on brain magnetic resonance imaging (MRI)...
February 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28187799/management-of-intracerebral-hemorrhage
#3
A M Thabet, M Kottapally, J Claude Hemphill
Intracerebral hemorrhage (ICH) is a potentially devastating neurologic injury representing 10-15% of stroke cases in the USA each year. Numerous risk factors, including age, hypertension, male gender, coagulopathy, genetic susceptibility, and ethnic descent, have been identified. Timely identification, workup, and management of this condition remain a challenge for clinicians as numerous factors can present obstacles to achieving good functional outcomes. Several large clinical trials have been conducted over the prior decade regarding medical and surgical interventions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28185296/a-report-of-cerebral-malaria-treated-with-automated-red-blood-cell-exchange
#4
Waseem Q Anani, Gerald P Smith, Mehraboon Irani, Kathleen E Puca
BACKGROUND: Adjunctive automated whole blood or red blood cell exchange (RBCEx) can rapidly decrease malarial hyperparasitemia. Several case reports and series suggest improvement in clinical symptomatology; however, recent Centers of Disease Control and Prevention (CDC) recommendations concluded that RBCEx has no efficacy as an adjunctive therapy. We present a case of mental status changes secondary to cerebral malaria treated with automated RBCEx resulting in rapid and dramatic neurologic improvement...
February 10, 2017: Transfusion
https://www.readbyqxmd.com/read/28179699/referral-pattern-of-emergencies-in-obstetrics-implications-for-defining-scope-of-services-and-policy
#5
Rahat Najam Qureshi, Rozina Sikandar, Zahra Hoodbhoy, Raffat Bano, Nigar Jabeen
OBJECTIVE: To analyse referral pattern of high-risk obstetric cases from secondary to tertiary care hospitals and to assess their maternal and neonatal outcomes. METHODS: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised all referred obstetric cases from secondary-level hospitals to tertiary-level care within and outside the Hospital between January 2011 and December 2014. Day and time of referral, reason for referral as well as maternal and neonatal outcomes were collected...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28178408/epidemiology-risk-factors-and-clinical-features-of-intracerebral-hemorrhage-an-update
#6
REVIEW
Sang Joon An, Tae Jung Kim, Byung-Woo Yoon
Intracerebral hemorrhage (ICH) is the second most common subtype of stroke and a critical disease usually leading to severe disability or death. ICH is more common in Asians, advanced age, male sex, and low- and middle-income countries. The case fatality rate of ICH is high (40% at 1 month and 54% at 1 year), and only 12% to 39% of survivors can achieve long-term functional independence. Risk factors of ICH are hypertension, current smoking, excessive alcohol consumption, hypocholesterolemia, and drugs. Old age, male sex, Asian ethnicity, chronic kidney disease, cerebral amyloid angiopathy (CAA), and cerebral microbleeds (CMBs) increase the risk of ICH...
January 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28166084/unexpected-complication-of-cocaine-associated-anti-neutrophil-cytoplasmic-antibody-vasculitis-related-to-persistent-in-hospital-cocaine-use
#7
Travis D Olives, Rebecca L Kornas, Russell Fujisawa, Jon B Cole
INTRODUCTION: Levamisole-adulterated cocaine has been implicated in anti-neutrophil cytoplasmic antibody (ANCA) vasculitis. We present a case of spontaneous intraperitoneal hemorrhage, an unexpectedly severe complication of cocaine-related ANCA vasculitis, developing late during hospitalization. CASE REPORT: An adult male with a history of hepatitis C, distant cocaine use, and limited health care presented to a local emergency department (ED) with volume overload, renal failure, hyperkalemia and non-anion gap metabolic acidosis...
February 3, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28164632/cushing-s-syndrome-presenting-with-hyponatremia
#8
Hayrullah Yazar, Necattin Firat, Ahmet Nalbant
We present a case of Cushing's syndrome that presented with hyponatremia. A 64-year-old obese woman presented to the hospital emergency service complaining of a high fever, hypertension, and generalized oedema. During the examination, the patient suddenly became confused and lost consciousness. She was admitted to the intensive care unit. In addition, blood was drawn to measure the cortisol and ACTH levels, and urine samples were sent for analysis. Adenoctomy was performed through unilateral surgical treatment...
July 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28160338/h1-antihistamine-refractory-chronic-spontaneous-urticaria-it-s-worse-than-we-thought-first-results-of-the-multicenter-real-life-aware-study
#9
Marcus Maurer, Petra Staubach, Ulrike Raap, Grit Richter-Huhn, Andrea Bauer, Franziska Ruëff, Thilo Jakob, Amir S Yazdi, Vera Mahler, Nicola Wagner, Undine Lippert, Uwe Hillen, Andreas Schwinn, Mario Pawlak, Norbert Behnke, Kamel Chaouche, Nadine Chapman-Rothe
BACKGROUND: Most data on chronic spontaneous urticaria (CSU) originate from highly selected patient populations treated at specialized centers. Little is known about CSU patient characteristics and the burden of CSU in routine clinical practice. AWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) is an ongoing global study designed to assess chronic urticaria in the real-life setting. OBJECTIVE: To describe the baseline characteristics of the first 1,539 German AWARE patients with H1-antihistamine-refractory CSU...
February 4, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28157742/stroke-epidemiology-and-risk-factor-management
#10
Amy Guzik, Cheryl Bushnell
PURPOSE OF REVIEW: Death from stroke has decreased over the past decade, with stroke now the fifth leading cause of death in the United States. In addition, the incidence of new and recurrent stroke is declining, likely because of the increased use of specific prevention medications, such as statins and antihypertensives. Despite these positive trends in incidence and mortality, many strokes remain preventable. The major modifiable risk factors are hypertension, diabetes mellitus, tobacco smoking, and hyperlipidemia, as well as lifestyle factors, such as obesity, poor diet/nutrition, and physical inactivity...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28134404/-takotsubo-cardiomyopathy-recurrence-in-patient-with-chronic-kidney-disease-case-report-and-literature-review
#11
Francesco Caccetta, Maurizio Caroppo, Fernando Musio, Anna Mudoni, Antonella Accogli, Maria Dolores Zacheo, Domenica Burzo, Rolando Mangia, Michele Accogli, Vitale Nuzzo
Takotsubo cardiomyopathy (CT) is a syndrome characterized by an acute and transient left ventricular dysfunction, electrocardiographic abnormalities suggestive of acute coronary syndrome, chest pain and/or dyspnea, left ventricular mid-apical segments akinesia and normal coronary angiography. It is mainly observed in postmenopausal women after an intense physical or mental stress. The course is usually favourable but sometimes severe complications occur. The recurrence rate is 2-10%. We present the case of a recurrence of CT in a female, 79 years old, with hypertension, diabetes, chronic kidney disease (CKD) stage 3 who was admitted to the emergency room for dyspnea and vomiting...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28122680/the-society-of-thoracic-surgeons-expert-consensus-for-the-resuscitation-of-patients-who-arrest-after-cardiac-surgery
#12
(no author information available yet)
The Society of Thoracic Surgeons Task Force on Resuscitation After Cardiac Surgery provides this professional society perspective on resuscitation in patients who arrest after cardiac surgery. This document was created using a multimodal methodology for evidence generation and includes information from existing guidelines, from the International Liaison Committee on Resuscitation, from our own structured literature reviews on issues particular to cardiac surgery, and from an international survey on resuscitation hosted by CTSNet...
January 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28104940/percutaneous-epidural-drainage-through-a-burr-hole
#13
Priscila M Falsarella, Rafael D Rocha, Rodrigo G Garcia
Intracranial extradural collection may cause an increase in intracranial pressure, requiring rapid emergency treatment to reduce morbidity and mortality. We described an alternative CT-guided percutaneous access for extradural collection drainage. We report a case of a patient with previous craniectomy for meningioma ressection who presented to the Emergency Department with symptoms of intracranial hypertension. Brains CT showed a extradural collection with subfalcine herniation. After multidisciplinary discussion a CT-guided percutaneous drainage through previous burr hole was performed...
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28099107/case-238-spontaneous-pneumothorax-secondary-to-intrapulmonary-necrobiotic-rheumatoid-nodule
#14
Ammar A Chaudhry, Maryam Gul, Abbas A Chaudhry, William Moore
History A 54-year-old white woman with a history of rheumatoid arthritis who was taking glucocorticoids and methotrexate presented to the emergency department in December with worsening shortness of breath and chest heaviness for 1 week. She reported additional symptoms of weakness, headache, and arthralgia primarily involving her bilateral hands, wrist, ankles, and feet. She denied experiencing fevers, syncope or presyncope, focal neurologic deficits, chest pain, nausea, vomiting, unintentional weight loss, or recent trauma...
February 2017: Radiology
https://www.readbyqxmd.com/read/28076672/prenatal-psychostimulant-and-antidepressant-exposure-and-risk-of-hypertensive-disorders-of-pregnancy
#15
D Jeffrey Newport, Amy L Hostetter, Sarah H Juul, Sunny M Porterfield, Bettina T Knight, Zachary N Stowe
OBJECTIVE: To investigate the association, if any, of prenatal mental illness and psychotropic exposure with the risk of hypertensive disorders of pregnancy (HDP). METHODS: A case-cohort analysis was conducted of 686 pregnant women participating in prospective, longitudinal observational studies in a tertiary referral center between January 1998 and May 2012. Risk estimates were produced using multivariate logistic regression modeling. Medication- and diagnosis-specific data were utilized to conduct post hoc confirmatory analyses of the risk estimates...
November 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28074994/-normoglycemic-diabetic-ketoacidosis-in-pregnancy-report-of-one-case
#16
Margarita Rivas M, Pamela Belmar Z, Pilar Durruty A, Lilian Sanhueza M, Gloria López S
Normoglycemic diabetic ketoacidosis should be suspected in pregnant women presenting nausea, vomiting, abdominal pain and anorexia. We report a 39 years old woman with a 32 weeks pregnancy who sought emergency care due to hyperemesis. She was hospitalized with the following diagnoses: pregnancy hypertension syndrome, gestational diabetes, morbid obesity and poor prenatal control. The evaluation of the feto-placental unit showed perception of fetal movements, non-reactive non-stress baseline record and a biophysical profile of 6/8...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28074727/-flank-pain-caused-by-a-renal-artery-dissection
#17
J C Karper, W M T Janssen, J C Breek, R Oosterhof-Berktas, J Gravendeel, T K Kremer Hovinga
BACKGROUND: A spontaneous renal artery dissection is a very rare diagnosis. The clinical presentation can vary and its course can be atypical. There are no guidelines available regarding treatment; however, the options are a conservative (medication) or interventional (radiological or surgical) approach. CASE DESCRIPTION: A 45-year-old man presented to the emergency department with hypertensive urgency after earlier episodes of flank pain. The cause appeared to be a spontaneous bilateral renal artery dissection with infarction...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28073989/patency-of-the-vein-of-labb%C3%A3-after-venous-stenting-of-the-transverse-and-sigmoid-sinuses
#18
Daniel M S Raper, Dale Ding, Ching-Jen Chen, Thomas J Buell, R Webster Crowley, Kenneth C Liu
BACKGROUND: Venous sinus stenting is an emerging treatment for patients with idiopathic intracranial hypertension and evidence of venous stenosis. Stents placed across the transverse and sigmoid sinuses often cover the vein of Labbé (VOL), a major anastomotic vein draining the cerebral hemisphere. The patency of the VOL after stenting and its clinical implications are poorly understood. METHODS: A retrospective analysis was performed of a prospectively collected database of patients undergoing venous sinus stenting...
January 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28067720/swept-source-optical-coherence-tomography-evaluation-of-chorioretinal-changes-in-hypertensive-choroidopathy-related-to-hellp-syndrome
#19
Daniel Velazquez-Villoria, Pablo Marti Rodrigo, Maria L DeNicola, Miguel A Zapata Vitori, Antonio Segura García, Jose García-Arumí
PURPOSE: To report a case of hypertensive choroidopathy with detailed chorioretinal images obtained using swept source optical coherence tomography. METHODS: We report the case of a 36-year-old pregnant woman who presented with extensive bilateral exudative retinal detachments (visual acuity of hands movement bilaterally), high blood pressure, and severe alteration of the laboratory test results resulting in the diagnosis of HELLP syndrome. The baby was delivered by emergency cesarean section and the patient was hospitalized in the intensive care unit...
January 6, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28054130/posterior-reversible-encephalopathy-syndrome
#20
REVIEW
Marlene Fischer, Erich Schmutzhard
The posterior reversible encephalopathy syndrome (PRES) is a neurological disorder of (sub)acute onset characterized by varied neurological symptoms, which may include headache, impaired visual acuity or visual field deficits, disorders of consciousness, confusion, seizures, and focal neurological deficits. In a majority of patients the clinical presentation includes elevated arterial blood pressure up to hypertensive emergencies. Neuroimaging, in particular magnetic resonance imaging, frequently shows a distinctive parieto-occipital pattern with a symmetric distribution of changes reflecting vasogenic edema...
January 4, 2017: Journal of Neurology
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