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Central venous sinus thrombosis presenting with generalized tonic-clonic seizures in a patient with no known risk factors
We present a case of a previously healthy woman with a new onset seizure, whose only other complaint was weakness despite a normal neurological examination. Her head computed tomography (CT) showed an intraparenchymal hemorrhage of the left frontal lobe and signs of infarction of the right frontal lobe.
Source: The American Journal of Emergency Medicine - October 9, 2016 Category: Emergency Medicine Authors: Patricia Khatib, Omar Mostafa, Erin L. Simon Tags: Case Reports Source Type: research

Intracerebral hemorrhage in a middle-aged cocaine user despite normal blood pressures
We report the case of a 40-year-old woman who did not declare at admission her 4-year history of intranasal cocaine hydrochloride and developed an intracerebral subcortical spontaneous hemorrhage. She documented a normal blood pressure, and computer tomography angiography did not show vascular abnormalities and excluded the presence of arterial aneurisms.
Source: The American Journal of Emergency Medicine - September 2, 2016 Category: Emergency Medicine Authors: Antonio Siniscalchi, Walter Lentidoro, Ermanno Pisanil, Giovamabattista De Sarro, Luca Gallelli Tags: Case Report Source Type: research

Intracerebral hemorrhage in a middle aged cocaine user despite normal blood pressures
We report the case of a 40-year-old woman with a not declared at admission with a 4 year history of intranasal cocaine hydrochloride who developed an intracerebral subcortical spontaneous hemorragie. She documented a normal blood pressure and a CT angiography did not shown vascular abnormalities and excluded the presence of arterial aneurisms.
Source: The American Journal of Emergency Medicine - September 2, 2016 Category: Emergency Medicine Authors: Antonio Siniscalchi, Walter Lentidoro, Ermanno Pisanil, Giovamabattista De Sarro, Luca Gallelli Tags: Case Report Source Type: research

Differentiating contrast staining after acute ischemic stroke from hemorrhagic transformation during emergency evaluation
A hyperdense lesion observed in a computed tomographic (CT) image of the brain is usually suspected to be a hemorrhage during an emergency evaluation. Other rare differential diagnoses include contrast-induced encephalopathy (CIN) and acute cerebral infarction with contrast staining (CS). Recent contrast administration is a common risk factor for both CIN and CS. The former has been associated with favorable neurologic outcomes, whereas CS might have complications, such as hemorrhagic transformation (HT).
Source: The American Journal of Emergency Medicine - May 17, 2016 Category: Emergency Medicine Authors: Sing-Kong Ho, Jen-Kuang Lee, Yen-Jun Lai, Tzu-Chiao Lin, Cheng-Wei Liu Tags: Case Report Source Type: research

The Utility of Bolus IV Nicardipine for Hypertensive Emergencies in the Emergency Department
We describe the first two documented cases of use of nicardipine administered as an IV bolus dose in the emergency department for hypertensive emergencies involving acute ischemic stroke and hemorrhagic stroke.
Source: The American Journal of Emergency Medicine - March 21, 2016 Category: Emergency Medicine Authors: Stephanie N. Komura, Nadia I. Awad Tags: Case Report Source Type: research

The utility of bolus intravenous nicardipine for hypertensive emergencies in the ED
We describe the first 2 documented cases of use of nicardipine administered as an IV bolus dose in the emergency department (ED) for hypertensive emergencies involving acute ischemic stroke and hemorrhagic stroke.
Source: The American Journal of Emergency Medicine - March 20, 2016 Category: Emergency Medicine Authors: Stephanie N. Komura, Nadia I. Awad Tags: Case Report Source Type: research

Admission serum lactate predicts mortality in aneurysmal subarachnoid hemorrhage
Aneurysmal SAH is the most devastating form of hemorrhagic stroke. Primary predictors of mortality are based on initial clinical presentation. Initial serum lactic acid levels have been shown to predict mortality and disease severity. Initial serum lactate may be an objective predictor or mortality.
Source: The American Journal of Emergency Medicine - December 30, 2015 Category: Emergency Medicine Authors: Imo P. Aisiku, Peng Roc Chen, Hanh Truong, Daniel R. Monsivais, Jonathan Edlow Tags: Original Contribution Source Type: research

Intraparenchymal hemorrhage after heroin use
Heroin-associated stroke is a rare complication of use. Various proposed mechanisms of heroin-associated ischemic stroke have been proposed, including the following: cardioembolism in the setting of infective endocarditis, hypoxic ischemic brain injury in the setting of hypoxemia and hypotension, and infective arteritis or vasculitis from drug adulterants. A previously healthy 28-year-old woman presented to the emergency department with altered mental status and normal vitals after she was found wandering outside her apartment.
Source: The American Journal of Emergency Medicine - January 16, 2015 Category: Emergency Medicine Authors: Neha Kumar, Mary Colleen Bhalla, Jennifer A. Frey, Alison Southern Tags: Case Report Source Type: research

Acute Vertebrobasilar Ischemic Stroke Due To Electric Injury
Electrical injuries are most commonly due to household accidents. Various factors determine the severity of electric injury, including type of current, amperage, voltage, tissue resistance, pathway of current and duration of contact with the body. Various types of neurological damage due to electrical injury have been described in literature. It may manifest as peripheral nerve injury, spinal cord damage, seizures, cerebellar ataxia, hypoxic encephalopathy and intracerebral hemorrhage. Acute ischemic stroke is an infrequent complication of electrical injury.
Source: The American Journal of Emergency Medicine - January 6, 2015 Category: Emergency Medicine Authors: Rajendra Singh Jain, Sunil Kumar, Desai Tushar Suresh, Rakesh Agarwal Tags: Case Report Source Type: research

Approach to the diagnosis and treatment of acute subarachnoid hemorrhage in a patient with sickle cell disease
We report a case of subarachnoid hemorrhage in a 38-year-old patient with sickle cell anemia. This case highlights the limitations of noncontrast computed tomography in the diagnosis of subarachnoid hemorrhage in patients with sickle cell disease as well as the special needs of this patient population in addressing the treatment of stroke.
Source: The American Journal of Emergency Medicine - August 29, 2014 Category: Emergency Medicine Authors: Matthew Lyon, Justin Jeter, Richard Lottenberg Tags: Case Report Source Type: research

Spontaneous splenic rupture after thrombolysis for ischemic stroke
We present the first case of an atraumatic pathological splenic rupture following alteplase thrombolysis for ischemic stroke.
Source: The American Journal of Emergency Medicine - August 26, 2014 Category: Emergency Medicine Authors: Rachid Sirbou, Cindy Tissier, Yannick Bejot, Marc Freysz Tags: Case Report Source Type: research

Acute psychosis presenting as a sole manifestation of left atrial myxoma: a new paradigm
Atrial myxomas are the most common benign cardiac tumors. Neurological manifestations associated with left atrial myxoma are seen infrequently in the form of embolic stroke of intracranial hemorrhage. Psychiatric manifestations are however exceedingly rare. We hereby present a case who presented with acute psychosis as a sole manifestation of an underlying left atrial myxoma.
Source: The American Journal of Emergency Medicine - May 12, 2014 Category: Emergency Medicine Authors: Rajendra Singh Jain, Kadam Nagpal, Rahul Jain, Swayam Prakash, Rahul Handa Tags: Case Report Source Type: research

Good outcome after intravenous thrombolysis for acute stroke in a patient under treatment with dabigatran
We describe an unusual case of treatment IV rt-PA for acute ischemic stroke in a patient receiving dabigatran for AF.
Source: The American Journal of Emergency Medicine - April 18, 2014 Category: Emergency Medicine Authors: Cátia Diogo, Josiana Duarte, Sofia Sobral, Paula Pestana, Hipólito Nzwalo, Henrique Rita, José Sousa e Costa Tags: Case Report Source Type: research

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