A spontaneous cervical epidural hematoma mimicking a stroke - A case report.

Conclusion: tPA treatment is frequently used as first-line therapy for acute ischemic stroke. Therefore, physicians should be aware of the potential for the SCEH in patients presenting with hemiparesis, as tPA administration may increase cervical hematoma leading to clinical deterioration. With this case, we intended to warn about SCEH as a rare but possible entity, since its early recognition and prompt clinical intervention may improve neurological outcomes. PMID: 32637210 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research

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Written by Meyers, edits by SmithA 50-ish year old man was working construction when he suddenly collapsed. Coworkers started CPR within 1 minute of collapse. EMS arrived within 10 minutes and continued CPR and ACLS, noting alternating asystole and sinus bradycardia during rhythm checks. He received various ACLS medications and arrived at the ED with a perfusing rhythm.Initial vitals included heart rate around 100 bpm and BP 174/96. Here is his initial ECG, very soon after ROSC:What do you think?Sinus tachycardia.  There is incomplete RBBB (QRS duration less than 120 ms).  There is diffuse STD, maximal in V4-V5 a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Sickle cell disease (SCD) is a medical condition in which chronic pain is common and negatively impacts psychosocial function and quality of life. Although the brain mechanisms underlying chronic pain are well studied in other painful conditions, the brain mechanisms underlying chronic pain and the associated psychosocial comorbidities are not well established in SCD. A growing literature demonstrates the effect of treatment of chronic pain, including pharmacological and nonpharmacological treatments, on brain function. The present systematic review aimed to (1) determine the effects of chronic pain and psychosocial comorb...
Source: Pain - Category: Anesthesiology Tags: Systematic Reviews and Meta-Analyses Source Type: research
ConclusionHemiplegic spontaneous cervical EDH occurs very rarely. It is often misdiagnosed as ischemic stroke and is likely to be administered with thrombolytic agents, making the patient's symptoms worse. Early diagnosis and rapid management of cervical EDH increase the likelihood of complete recovery of the patient's symptoms. Therefore, if there are unilateral weakness and neck pain without cranial nerve dysfunction and there is no evidence of stroke in the brain imaging, spinal EDH should be considered.
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
AbstractPurpose of ReviewThis review details the frequency of and ways in which migraine can be both an ischemic stroke/transient ischemic attack mimic (false positive) and chameleon (false negative). We additionally seek to clarify the complex relationships between migraine and cerebrovascular diseases with regard to diagnostic error.Recent FindingsNearly 2% of all patients evaluated emergently for possible stroke have an ultimate diagnosis of migraine; approximately 18% of all stroke mimic patients treated with intravenous thrombolysis have a final diagnosis of migraine. Though the treatment of a patient with migraine wi...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
Conditions:   Stroke, Ischemic;   Pain, Postoperative;   Substance Abuse;   Subarachnoid Hemorrhage Interventions:   Drug: Placebo;   Drug: NP10679 Sponsors:   Neurop Inc.;   National Institute of Neurological Disorders and Stroke (NINDS);   Pharmaron Active, not recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionPreclinical models suggest a key role for enhanced SD susceptibility and microembolization to explain both the occurrence of migraine attacks and the increased stroke risk in migraineurs. Therapeutic targeting of SD and microembolic events, or potential causes thereof, will be promising for treatment of aura and may also prevent ischemic infarction in vulnerable brains.
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
Conclusions: Acute cholecystitis and stroke are closely associated, and anti-thromboembolic drugs may cause hemorrhagic cholecystitis. Stroke patients tend to have atherosclerotic risk factors resulting in ischemic injury of the gallbladder. Furthermore, severe hemiparesis, a fasting state, dehydration, or bacteremia, which are occasionally exhibited by stroke patients, are known risk factors for acalculous cholecystitis. Stroke patients, especially patients with aphasia and consciousness disturbance, require immediate abdominal examination, if acute cholecystitis is suspected.
Source: Neurology India - Category: Neurology Authors: Source Type: research
vaara M Abstract A stroke affecting the somatosensory pathway can trigger central post-stroke pain syndrome (CPSP). The symptoms often include hyperalgesia, which has also been described in rodents after the direct damage of the thalamus. Previous studies have shown that hemorrhagic stroke or ischemia caused by vasoconstriction in the thalamus induces increased pain sensitivity. We investigated whether inducing secondary damage in the thalamus by a cortical stroke causes similar pain hypersensitivity as has previously been reported with direct ischemic injury. We induced a focal cortical ischemia-reperfusion injur...
Source: Cell Transplantation - Category: Cytology Authors: Tags: Cell Transplant Source Type: research
Conclusions: Acupuncture therapy seems effective for motor function, pain relief and activities of daily living in stroke patients with mild SHS, when it is used in combination with rehabilitation. The low certainty of evidence downgrades our confidence in making recommendations to clinical practice. Introduction Shoulder-hand syndrome (SHS) is a common condition among people who have had a stroke, with its reported prevalence ranging from 12% to 49% (1, 2). The main symptoms of SHS include pain, hyperalgesia, joint swelling and limitations in range of motion (ROM) (3). Post-stroke SHS is also named type I complex ...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
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