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The effect of extracorporeal shock wave therapy on large neurogenic heterotopic ossification in a patient with pontine hemorrhage: A case report and literature review
We report a case of a 36-year-old man who developed HO around both hip joints 3 months after bilateral pontine hemorrhage. Interventions: Seven months after HO development, ESWT was administered to the area of HO every other day for a total of 10 sessions. Outcomes: Immediately following treatment, the ROM of both hip joints increased. Thus the patient was able to maintain a sitting posture without having to be bound to the wheelchair. In addition, the tolerable sitting time before groaning increased from less than ten minutes to almost 60 minutes by the end of all ESWT sessions. Unlike other previous reports...
Source: Medicine - October 28, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Avellis syndrome with ipsilateral prosopalgia, glossopharyngeal neuralgia, and central post-stroke pain: A case report and literature review
We reported a case of Avellis syndrome who manifested as the typical reported manifestations. The patient, what’s more, presented with ipsilateral trigeminal, glossopharyngeal neuralgia, and central poststroke pain which were described for the first time. It is of great significance for clinicians to recognize the typical as well as other manifestations which helps to make a clear diagnosis.
Source: Medicine - September 30, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intramedullary spinal cord abscess associated with right-to-left shunt via right superior vena cava draining into left atrium: A case report
We report the first case of ISCA associated with RSVC-LA RL shunt. Patient concerns: A 36-year-old man developed progressive paraparesis, dysuria, and spontaneous pain in the lumbar region and lower extremities. Spinal magnetic resonance imaging revealed an intramedullary lesion extended from Th12 to L2 with ring-shaped gadolinium enhancement. Cerebrospinal fluid (CSF) study exhibited a marked pleocytosis, and CSF culture grew Streptococcus intermedius. Cardiovascular computed tomography angiography identified RSVC-LA RL shunt, which caused transient acute cardiac syndrome due to air embolus. Diagnoses: The p...
Source: Medicine - July 1, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Acute cerebral infarction with acute myocardial infarction due to patent foramen ovale: A case report
Rationale: Patent foramen ovale (PFO) is not considered to be the main cause of stroke and is classified as the infarction of undetermined cause. The relationship between PFO and cerebral embolism is still unclear and cerebral embolism accompanied with coronary artery embolization in PFO patient is rare. In this case, we reported a patient with PFO suffered acute cerebral and myocardial infarction simultaneously, and analyzed the source of emboli and potential pathogenesis. Patient concerns: A 53-year-old female presented with chief complaints of intermittent palpitations and chest tightness for 6 years, aggravated fo...
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

How to continue lipid-lowering therapy in patients with coronary heart disease and severe liver dysfunction?: A case report of plaque regression by a combination of Chinese and Western Medicine
Rationale: Atherosclerotic cardiovascular disease (ASCVD), including coronary heart disease (CHD), atherosclerotic stroke and peripheral vascular disease, has become the most deadly chronic noncommunicable disease throughout the world in recent decades, while plaque regression could reduce the occurrence of ASCVD. Traditional Chinese Medicine (TCM) has been widely used for prevention and treatment of these diseases. In the perspective of TCM, phlegm and blood stasis are considered to be leading pathogenesis for CHD. Hence, activating blood circulation and dissipating phlegm, which is of great benefit to regress plaque, h...
Source: Medicine - October 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

A case report of left atrial myxoma-induced acute myocardial infarction and successive stroke
Rationale: Left atrial myxoma is a common primary cardiac tumor, however, due to poor image quality or atypical myxoma images, it is often misdiagnosed by echocardiograph. A case of left atrial myxoma being misdiagnosed as a thrombus, which successively caused acute myocardial infarction (AMI) and stroke, is very rare. Contrast-enhanced echocardiography can play an important role in definitive diagnosis. Patient concerns: A 44-year-old woman was diagnosed AMI because of chest pain with no significant stenosis in the coronary arteries. One month later, the patient was suddenly found unconscious, magnetic resonance imag...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Delayed-onset central poststroke pain due to degeneration of the spinothalamic tract following thalamic hemorrhage: A case report
Rationale: Recent studies have used diffusion tensor tractography (DTT) to demonstrate that central poststroke pain (CPSP) was related to spinothalamic tract (STT) injury in patients with stroke. However, few studies have been reported about delayed-onset CPSP due to degeneration of the STT following a stroke. Patient's concerns: A 57-year-old female patient presented with right hemiparesis after stroke. Two weeks after onset, she did not report any pain. At approximately 6 months after onset, she reported pain in the right arm and leg, and the pain slowly intensified with the passage of time. At 14 months after onset...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Acute diffuse and transient thyroid swelling after intravenous thrombolysis for acute ischemic stroke: A case report
Rationale: Intravenous thrombolysis is the primary therapy for acute ischemic stroke (AIS), but it has some complications, including symptomatic intracranial hemorrhage, orolingual angioedema, and extracranial bleeding. However, thyroid disorders associated with thrombolysis are very rare. Patient concerns: A 56-year-old man developed acute pain and neck swelling after thrombolysis with recombinant tissue plasminogen activator. Diagnoses: Ultrasound revealed a diffusely enlarged thyroid with linear hypoechoic areas throughout the entire gland, resembling a “cracked” appearance. Interventions: The patient was...
Source: Medicine - September 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Lateral medullary infarction with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and Klippel–Feil syndrome: A case report
Rationale: Patients with Klippel–Feil syndrome (KFS) are always anomaly associated with vertebrobasilar dysplasia. That may present commonly as infarction of brainstem, medulla, and cerebellum. In this article, we reported a rare case of lateral medullary infarction (LMI) with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and KFS, and the 2 rare conditions that are causally related. The case is being reported because of its unusual and rare presentation. Patient concerns: A 38-year-old female presented with acute unsteadiness, along with a tendency to lean to the left side while walk...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Improvement of peripheral artery disease with Sildenafil and Bosentan combined therapy in a patient with limited cutaneous systemic sclerosis: A case report
We report a case of a 48-year-old Black woman, who developed severe left limb claudication and walking limitation following a left femoropopliteal bypass occlusion in 2014. She was a heavy smoker and had a history of right middle cerebral artery ischemic stroke and bilateral Raynaud phenomenon. Diagnoses: According to the American College of Rheumatology/European League Against Rheumatism-2013 criteria, diagnosis of limited cutaneous SSc was retained with macrovascular lesions. She was referred for investigation of left limb claudication on treadmill using transcutaneous oxygen pressure measurement during exercise to argu...
Source: Medicine - June 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

The advantage of ultrasonography in the diagnosis of extracranial vertebral artery dissection: Two case reports
We reported 2 patients who complained of dizziness and pain, the findings of US confirmed the presence of extracranial vertebral artery dissection. Diagnoses: The floating membrane in lumen and intramural hematoma were found in US, consistent with vertebral artery dissection, whereas DSA revealed no typical sign of artery dissection. Interventions: In order to the definite diagnosis we persuaded the patients to undergo DSA, but there was no strong evidence on the diagnosis of vertebtal artery dissection. Outcomes: The patients were diagnosed of vertebral artery dissection by US. Lessons: US show more advantages in diag...
Source: Medicine - March 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Thalamic pain alleviated by stellate ganglion block: A case report
Rationale: Thalamic pain is a distressing and treatment-resistant type of central post-stroke pain. Although stellate ganglion block is an established intervention used in pain management, its use in the treatment of thalamic pain has never been reported. Patient concerns: A 66-year-old woman presented with a 3-year history of severe intermittent lancinating pain on the right side of the face and the right hand. The pain started from the ulnar side of the right forearm after a mild ischemic stroke in bilateral basal ganglia and left thalamus. Weeks later, the pain extended to the dorsum of the finger tips and the whole pa...
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research