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Acute neurology in the emergency department
A 66-year-old woman presented with sudden onset tearing interscapular pain 1 h after gentle neck exercises. Over the next 3 h, she developed flaccid left arm and leg paralysis and a left Horner's syndrome. Her initial CT scan revealed no evidence of cerebral ischaemia or aortic/carotid dissection but did reveal what was thought to be a calcified arteriovenous malformation in the right frontal lobe. Thrombolysis for a presumed acute stroke was considered but not initiated. By 5 h, the patient had lost light touch sensation and proprioception of her left side, and additionally she developed grade 3/5 right-sid...
Source: Emergency Medicine Journal - December 22, 2013 Category: Emergency Medicine Authors: Mertes, S. C. Tags: Eye Diseases, Spinal cord injury, Pain (neurology), Spinal cord, Stroke, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Trauma Images in emergency medicine Source Type: research

A Serious Diagnosis Lacking Common Symptoms
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research