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Paradoxical brain embolism shadowing massive pulmonary embolism
Patent foramen ovale is frequently observed in the general population. In case of massive pulmonary embolism, the sudden increase in the right heart cavity's pressure may cause a right-to-left shunting across this foramen, which could be associated with conflicting outcomes. Herein, we report a case of reversible cardiac arrest preceded by seizures, and followed by hemodynamic stability without any vasopressor. A brain CT-scan showed a limited ischemic stroke. Initial echocardiographic assessment revealed an acute cor pulmonale and a right-to-left intracardiac shunt across a large patent foramen ovale, suggesting the diagn...
Source: The American Journal of Emergency Medicine - May 15, 2018 Category: Emergency Medicine Authors: Fran çois Bagate, Alexandre Bedet, Armand Mekontso Dessap, Guillaume Carteaux Source Type: research

Pre-procedure Change in Arterial Occlusion in Acute Ischemic Stroke Patients undergoing Endovascular Treatment by CT Angiography
The American Heart Association/American Stroke Association guidelines strongly recommend a noninvasive intracranial vascular study such as CT angiogram in acute stroke patient if endovascular treatment is contemplated.
Source: The American Journal of Emergency Medicine - February 4, 2015 Category: Emergency Medicine Authors: Adnan I. Qureshi, Mushtaq H. Qureshi, Farhan Siddiq, Daraspreet Kainth, Ameer E. Hassan, Alberto Maud Tags: Original Contribution Source Type: research

Preprocedure change in arterial occlusion in acute ischemic stroke patients undergoing endovascular treatment by computed tomographic angiography
The American Heart Association/American Stroke Association guidelines strongly recommend a noninvasive intracranial vascular study such as computed tomographic (CT) angiogram in acute stroke patient if endovascular treatment is contemplated.
Source: The American Journal of Emergency Medicine - February 4, 2015 Category: Emergency Medicine Authors: Adnan I. Qureshi, Mushtaq H. Qureshi, Farhan Siddiq, Daraspreet Kainth, Ameer E. Hassan, Alberto Maud Tags: Original Contribution Source Type: research

Acute pediatric stroke—what’s the hurry? A case for emergency physician-performed echocardiography
We describe a case of acute ischemic stroke for which emergent, physician-sonographer–performed transthoracic echocardiography (TTE) changed his outcome. The patient in this case presented with left-sided hemiparesis, with subsequent CT Angiography (CTA) imaging and follow-on neurosurgical embolectomy for a proximal middle cerebral artery occlusion after which showed early recovery of muscular deficit.
Source: The American Journal of Emergency Medicine - April 18, 2014 Category: Emergency Medicine Authors: Christopher D. Thom, Scott E. Sparks Tags: Case Report Source Type: research

Painless aortic dissection: thrombolytic and antithrombotic vigilance
We thank Huang et al for their interesting article on identification of painless aortic dissection (AD) before thrombolytic treatment for acute ischemic stroke. We would like to emphasize the importance of being vigilant to AD before initiating any contraindicated therapy. We recently had an 84-year-old man with history of atrial fibrillation and transient ischemic attack who presented to the emergency department with acute shortness of breath without chest pain. The symptom contributed to atrial fibrillation with rapid ventricular response. Chest x-ray showed increased soft tissue prominence of the aortic arch suspicious ...
Source: The American Journal of Emergency Medicine - May 20, 2013 Category: Emergency Medicine Authors: Promporn Suksaranjit, Kunatum Prasidthrathsint, Wonngarm Kittanamongkolchai, Supawat Ratanapo, Narat Srivali, Daych Chongnarungsin Tags: Correspondence Source Type: research

Identification of painless aortic dissection before thrombolytic treatment for acute ischemic stroke
We reported a 57-year-old man with acute right hemisphere watershed ischemic stroke caused by painless type A aortic dissection was diagnosed in time with computed tomographic (CT) angiography. The possible detrimental impact which may have been incurred by thrombolytic therapy was avoided. We suggest that cerebral CT angiography, covering from the aortic arch to intracranial arteries, should be performed in acute ischemic stroke patients, particularly in those with watershed CT perfusion deficits, to exclude the possibility of aortic dissection before thrombolytic treatment.
Source: The American Journal of Emergency Medicine - February 11, 2013 Category: Emergency Medicine Authors: Chen-Hsiung Huang, Hui-Chun Huang, Kang-Hsu Lin, Wei-Kung Chen, Chon-Haw Tsai Tags: Case Reports Source Type: research