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On Hoofs and Zebras – Struma Ovarii
A 75-year-old mother of ten suffering from a urinary tract infection developed macrohematuria and therefore an abdominal ultrasound was performed, followed by a CT scan when an unexpected large pelvic mass was discovered. Past history included hypertension, paroxysmal atrial fibrillation, and remote history of minor stroke (on candesartan, dabigatran, bisoprolol); bilateral chronic lymphedema; and hysterectomy due to prolapse at the age of 40. Imaging revealed nephrolithiasis and a prominent left adnexal mass suspected as ovarian cancer.
Source: The American Journal of Medicine - July 20, 2023 Category: General Medicine Authors: Ami Schattner, Ina Dubin, Livnat Uliel, Daniela Dick-Necula Tags: Clinical Communication to the Editor Source Type: research

Paroxysmal AV Block
A 69 year old woman with a history of congestive heart failure and stroke presented to the emergency room with sudden onset lightheadedness leading to a fall at the grocery store and sustaining head trauma. On physical examination, she was alert and in mild distress. Her HR was 72 beats per minute and blood pressure was 196/70. A 12 lead electrocardiogram (ECG) showed normal sinus rhythm, first degree atrioventricular (AV) block and right bundle branch block. She was admitted for management of subdural hematoma which was noted on CT scan.
Source: The American Journal of Medicine - December 7, 2022 Category: General Medicine Authors: Tharian S. Cherian, Amit Thosani Tags: ECG image of the month Source Type: research

Potential Role of 2-Phase Cardiac CT in Patients With Embolic Stroke of Undetermined Source
Recent trials failed to demonstrate that anticoagulation was superior to antiplatelet agents in preventing recurrent stroke after embolic stroke of undetermined source (ESUS), which may be as a result of the heterogeneity of etiology. We thus investigated whether the use of 2-phase cardiac computed tomography (CT) could help to evaluate the etiology in patients with ESUS.
Source: The American Journal of Medicine - December 19, 2019 Category: General Medicine Authors: Shenqiang Yan, Ying Zhou, Quan Han, Yi Chen, Min Lou Tags: Brief Observation Source Type: research

Hemorrhagic Brain Metastases as a Diagnosis of Exclusion: A Diagnostic Dilemma
We have read with great interest the study published in The American Journal of Medicine by Juan et  al.1 The authors presented a patient with symptoms of left hemiparesis and left facial palsy for whom computed tomography of the brain showed a single hemorrhagic lesion in the right basal ganglia. They also reported that the patient had a medical history of adenocarcinoma of the lung and hyperten sion. They presented a diagnostic dilemma, with hemorrhagic stroke or hemorrhagic brain metastasis as the cause of the hemorrhagic lesion.
Source: The American Journal of Medicine - February 15, 2018 Category: General Medicine Authors: Athanasios Konstantelias, Sofia Mourgela Tags: Letter Source Type: research

Intracranial Calcification Due to Hypoparathyroidism
A 70-year-old Japanese man with a history of idiopathic hypoparathyroidism presented to the Emergency Department of our hospital owing to weakness in his right leg. Although his primary care doctor had prescribed activated vitamin D analogues, his serum calcium level was slightly low at 8.0  mg/dL. Owing to suspicions of stroke, he underwent radiographic imaging of the head. Computed tomography revealed bilateral and symmetrical calcifications in the basal ganglia, cerebellum, and at the gray-white junction in the axial image and the sagittal image (Figure).
Source: The American Journal of Medicine - January 16, 2018 Category: General Medicine Authors: Ko Harada, Tatsuya Fujikawa Tags: Clinical Communication to the Editor Source Type: research

Acute Stroke Imaging: What Clinicians Need to Know
Abstract: Advances in technology and software applications have contributed to new imaging modalities and strategies in the evaluation of patients with suspected acute cerebral infarction. Routine computed tomography (CT) and magnetic resonance imaging (MRI) have been the standard studies in stroke imaging, which have been complemented by CT and MR angiography, diffusion-weighted MR imaging, and cerebral perfusion studies, while conventional angiography is typically reserved for intra-arterial therapy. The purpose of this article is to review the variety of imaging studies available in the acute stroke setting, and to dis...
Source: The American Journal of Medicine - March 15, 2013 Category: Journals (General) Authors: Rihan Khan, Kambiz Nael, William Erly Tags: Reviews Source Type: research