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Severe Symptoms, but a Truly Treatable Disease
​BY NOURA MAHDI; DARRON LEWIS; JEREMY OSBORNE; & AHMED RAZIUDDIN, MDA 73-year-old man was brought to the emergency department from his nursing home for rectal bleeding and anemia. The patient mentioned he had had episodes of bright red rectal bleeding and constipation for a few months. A colonoscopy had been done prior to the visit, which revealed a large intestine tumor and biopsy confirming adenocarcinoma. He was awaiting an appointment with his surgeon.The patient reported bloody rectal leakage, and a CBC done at the nursing home showed a hemoglobin level of 7.2. He also complained of dyspnea but denied any other ...
Source: The Case Files - March 20, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Severe Cerebral Vasospasm and Childhood Arterial Ischemic Stroke After Intrathecal Cytarabine
We report on 2 patients who developed widespread cerebral vasospasm and arterial ischemic strokes (AIS) after application of intrathecal (IT) cytarabine. In a 3-year-old child with acute lymphoblastic leukemia (ALL), left leg weakness, hyperreflexia, and clonus were noted 4 days after her first dose of IT cytarabine during the induction phase of her chemotherapy. Cerebral MRI revealed multiple acute cerebral ischemic infarcts and widespread cerebral vasospasm. A 5-year-old girl complained of right arm and leg pain and began limping 11 days after IT cytarabine. Symptoms progressed to right dense hemiplegia, left gaze deviat...
Source: PEDIATRICS - February 1, 2016 Category: Pediatrics Authors: Tibussek, D., Natesirinilkul, R., Sun, L. R., Wasserman, B. A., Brandao, L. R., deVeber, G. Tags: Hematology/Oncology, Cancer/Neoplastic, Neurology, Neurologic Disorders Case Report Source Type: research

Cerebral microbleeding in varicella-zoster viral meningitis: An early sign of vasculopathy?
A 75-year-old man undergoing chemotherapy for prostate cancer for 3 months presented with headache after having blisters in his left ear canal and auricle. His body temperature at presentation was 38°C. Neurologic examination revealed nuchal stiffness and left peripheral facial palsy. We also noted leukocytopenia (2,000/µL) and elevated serum C-reactive protein (8.51 mg/dL). CSF analysis showed no erythrocytes, elevated leukocytes (640/µL; 3% monocytes, 97% neutrophils), an increased protein level (473 mg/dL), and slightly decreased glucose level (51 mg/dL, serum glucose 120 mg/dL). Brain MRI and magnetic r...
Source: Neurology - March 3, 2014 Category: Neurology Authors: Ohtomo, R., Shirota, Y., Iwata, A., Shimizu, J., Tsuji, S. Tags: MRI, Other cerebrovascular disease/ Stroke, Vasculitis, Viral infections CLINICAL/SCIENTIFIC NOTES Source Type: research

Cerebral Vasoconstriction Triggered By Sympathomimetic Drugs During Intra-atrerial Chemotherapy
In this report, we highlight the potential risk of reversible cerebral vasoconstriction in children administered vasoactive drugs and discuss its relevance during treatment of retinoblastoma by intraarterial chemotherapy.
Source: Pediatric Neurology - January 21, 2013 Category: Neurology Authors: Todd Abruzzo, Mario Patino, James Leach, Ralph Rahme, James Geller Tags: Case Reports Source Type: research