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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

Ischaemic stroke after ST-elevation myocardial infarction
Clinical introduction A 67-year-old Hispanic man presented with 5-h history of typical chest pain and an ECG consistent with inferior ST-elevation myocardial infarction (STEMI). Coronary angiography revealed an occluded proximal right coronary artery, and a percutaneous intervention with drug eluting stent was performed. He was started on aspirin and clopidogrel. Two weeks later, he was admitted with loss of consciousness, tonic-clonic seizure and urinary incontinence. On physical examination, he was unresponsive to tactile stimuli. Cardiac examination revealed a prominent left ventricular heave. Neurological examination s...
Source: Heart - December 11, 2015 Category: Cardiology Authors: Al-Ansari, Y., Otalvaro, L., Damluji, A. A. Tags: Drugs: cardiovascular system, Echocardiography, Image challenges, Acute coronary syndromes, Clinical diagnostic tests Source Type: research

Bilateral Frontal Cerebral Infarctions Presenting as Ascending Weakness: Case Report (P1.023)
CONCLUSIONS: To our knowledge there are only a few case reports describing bilateral frontal cerebral infarctions due to a single A2 segment of the anterior cerebral artery. Bilateral cerebral infarctions should be considered in patients with symmetric weakness, especially in those with vascular risk factors who do not have features consistent with an alternative etiology. Reflexes are an important feature in distinguishing between central and peripheral lesions and should be closely monitored in these patients. Timely diagnosis will enable early delivery of thrombolytic therapy to these patients improving outcomes.Disclos...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Mijalski, C., Khan, M., Silver, B. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

Spinal Cord Infarction as the Initial Presentation of Systemic Lupus Erythematosus (P2.077)
CONCLUSIONS:Aggressive therapy with high dose corticosteroids and intravenous cyclophosphamide followed by oral therapy may be a successful therapeutic approach to spinal cord infarcts secondary to systemic lupus erythematosus. Study Supported by: N/ADisclosure: Dr. Michael has nothing to disclose. Dr. Hayat has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Michael, A., Hayat, G. Tags: Neurological Consequences of Autoimmune Disease Source Type: research

Sudden bilateral anterior cerebral infarction: unusual stroke associated with unusual vascular anomalies
We describe a 38-year-old male smoker and heavy alcohol user, who awoke with sudden onset of weakness of both lower limbs, and bladder and bowel incontinence. He had consumed excessive amounts of alcohol the previous night. There was no significant past medical history including other vascular risk factors and cardiovascular disease. On admission, he was mute and abulic. The frontal release signs including the forced grasping and the snout reflex were present. Routine full blood count and biochemical analysis were normal. MRI of the brain showed bilateral, nearly symmetrical ACA infarction (figure 1A–C). Time-of-flig...
Source: Postgraduate Medical Journal - January 21, 2013 Category: Journals (General) Authors: Krishnan, M., Kumar, S., Ali, S., Iyer, R. S. Tags: Urology, Open access, Drugs: cardiovascular system, Echocardiography, Stroke, Venous thromboembolism, Radiology, Physiotherapy, Sports and exercise medicine, Clinical diagnostic tests, Radiology (diagnostics) Images in medicine Source Type: research