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Source: The American Journal of Emergency Medicine
Condition: Stroke

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Total 254 results found since Jan 2013.

A rare case of thyrotoxicosis and bilateral internal carotid artery dissections
Cervical artery dissection is a rare but important diagnosis to consider in young patients presenting with stroke. Multiple etiologies of cervical artery dissections have been previously reported, but the association with thyrotoxicosis is extremely rare. A previously healthy 43-year-old female presented to the emergency department with new symptoms related to thyrotoxicosis and bilateral internal carotid artery dissections. Her atrial fibrillation and hypertension resolved by treating the underlying hyperthyroidism with methimazole and propranolol.
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Thomas Winter, Eyal Kraut, Kristjan Thompson Source Type: research

The significance of repetitive yawning in the emergency patient - A warning of imminent death or disability
Premortem yawning is absent from almost all major medical textbooks but has been associated for more than 2000  years with impending death from acute infections and hemorrhage and was commonly known during the Bubonic Plague pandemic [1,2]. Medical reports of premortem yawning identify multiple causes of shock including vasovagal reflex, severe hypoxia/anemia/hypoglycemia, stroke, and intracranial hyperten sion [3-5].
Source: The American Journal of Emergency Medicine - July 2, 2020 Category: Emergency Medicine Authors: Joan E. Rothenberg Tags: Correspondence Source Type: research

A unique presentation of Colovesical fistula
A colovesical fistula (CVF) is a pathological connection between the colon and the urinary bladder. Although they are uncommon, consequences can severely affect quality of life and mortality. Diverticula are the most common cause of CVF. This case details a patient's CVF diagnosis in the emergency department with unremitting gastrointestinal and urinary symptoms.A 78-year-old male patient with recent hospitalization for stroke and left carotid endarterectomy complicated by urinary retention treated with a Foley catheter presented to the Emergency Department with a chief complaint of hematuria and unremitting diarrhea.
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Michael Li, Jennifer Sadowski, Elizabeth M. Evans, Marna Greenberg Source Type: research

Mucormycosis with orbital compartment syndrome in a patient with COVID-19
AbstractDuring the current pandemic of COVID-19, a myriad of manifestations and complications has emerged and are being reported on. We are discovering patients with COVID-19 are at increased risk of acute cardiac injury, arrythmias, thromboembolic complications (pulmonary embolism and acute stroke), and secondary infection to name a few. I describe a novel case of COVID-19 in a previously healthy 33-year-old female who presented for altered mental status and proptosis. She was ultimately diagnosed with mucormycosis and orbital compartment syndrome, in addition to COVID-19.
Source: The American Journal of Emergency Medicine - September 15, 2020 Category: Emergency Medicine Authors: Amanda Werthman-Ehrenreich Source Type: research

Factors associated with hospitalization for ischemic stroke and TIA following an emergency department headache visit
Misdiagnosis of cerebrovascular disease among Emergency Department (ED) patients with headache has been reported. We hypothesized that markers of substandard diagnostic processes would be associated with subsequently ischemic cerebrovascular events among patients discharged from the ED with a headache diagnosis even after adjusting for demographic variables and medical history.
Source: The American Journal of Emergency Medicine - November 6, 2020 Category: Emergency Medicine Authors: Ava L. Liberman, Jenny Lu, Cuiling Wang, Natalie T. Cheng, Khadean Moncrieffe, Richard B. Lipton Source Type: research

Comments on “Inter-facility transfer for patients with acute large vessel occlusion stroke receiving mechanical thrombectomy.”
We read the recently-published article by Schevin et al. [1] with great interest. We commended the authors for looking into the work flow in Emergency Departments (ED) in patients with acute ischemia from large vessel occlusion (AIS-LVO) to assess where the longest delays to thrombectomy might occur. Unfortunately, this study is significantly underpowered to comment on patient outcomes. In this retrospective study of 95 patients undergoing mechanical thrombectomy (MT), the authors showed that patients' total ED length of stay and successful MT were not associated with good neurological outcome, defined as 90-day modified R...
Source: The American Journal of Emergency Medicine - November 25, 2020 Category: Emergency Medicine Authors: Quincy K. Tran, Nicholas Morris Source Type: research

Case series: Hyperdense basilar artery identified on unenhanced head CT in three cases of pediatric basilar artery occlusion
Acute basilar artery occlusion (BAO) is an easily missed, potentially devastating type of ischemic stroke. Children with BAO can present with a range of clinical symptoms, from headache, dizziness, nausea and/or vomiting [1-3] to profound alterations of consciousness, including locked-in syndrome and coma [2]. Typically in children with BAO, only an unenhanced head Computed Tomography (CT) is initially performed. When an obvious finding is not identified, such as intracranial hemorrhage, the unenhanced CT is rarely carefully further scrutinized by emergency physicians.
Source: The American Journal of Emergency Medicine - November 26, 2020 Category: Emergency Medicine Authors: Jennifer K. Potter, Jonathan D. Clemente, Andrew W. Asimos Source Type: research

Inter- ED transfer for patents with acute large vessel stroke: Efficiency vs thoroughness tradeoff
We thank the authors for their interest and agree that timely intervention for patients with large vessel occlusion (LVO) is associated with improved outcomes. Given the clear importance of timely treatment, the primary exposure we were interested in was the time spent at transferring EDs for patients who were transferred and ultimately received mechanical thrombectomy for LVO.
Source: The American Journal of Emergency Medicine - December 3, 2020 Category: Emergency Medicine Authors: MichaelJ. Ward, Michael Froehler, William L. Scheving, Kimberly Hart, Candace D. McNaughton Source Type: research

External validation of prehospital stroke scales for emergent large vessel occlusion
It is suggested that a prehospital scale should be utilized to identify patients with emergent large vessel occlusion (ELVO). We aimed to perform external validation of nine ELVO scales.
Source: The American Journal of Emergency Medicine - December 11, 2020 Category: Emergency Medicine Authors: Yu-Chen Chiu, Ming-Ju Hsieh, Yen-Heng Lin, Sung-Chun Tang, Jen-Tang Sun, Wen-Chu Chiang, Li-Kai Tsai, Chung-Wei Lee, Yu-Ching Lee, Jiann-Shing Jeng Source Type: research

Thyrotoxicosis and bilateral internal carotid artery dissections
Cervical artery dissection is a rare but important diagnosis to consider in young patients presenting with stroke. Multiple etiologies of cervical artery dissections have been previously reported, but the association with thyrotoxicosis is extremely rare. A previously healthy 43-year-old female presented to the emergency department with new symptoms related to thyrotoxicosis and bilateral internal carotid artery dissections. Her atrial fibrillation and hypertension resolved by treating the underlying hyperthyroidism with methimazole and propranolol.
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Thomas Winter, Eyal Kraut, Kristjan Thompson Tags: Case Report Source Type: research

Priapism in a patient with coronavirus disease 2019 (COVID-19)
Thromboembolic complications related to SARS-CoV-2 have been extensively reported. They include deep vein thrombosis, pulmonary embolism, ischemic stroke, and acute coronary syndrome. Penile thrombosis has not been reported as a thrombotic complication of SARS-CoV-2 infection with hypercoagulability.Here we describe a case of priapism as a thromboembolic complication in a patient with COVID-19 who recovered from acute respiratory distress syndrome (ARDS). We discuss the underlying pathophysiological mechanisms mainly related to an hypercoagulability state.
Source: The American Journal of Emergency Medicine - June 17, 2020 Category: Emergency Medicine Authors: Myriam Lamamri, Ala Chebbi, Jordan Mamane, Sofia Abbad, Milena Munuzzolini, Florence Sarfati, St éphane Legriel Tags: Case Report Source Type: research

Rapid and severe neurologic deterioration due to influenza associated encephalopathy in a healthy child
We present the clinical details of a previously well child with two days of mild viral symptoms who progressed from playful and active to severe neurologic injury over the course of eight hours.
Source: The American Journal of Emergency Medicine - January 2, 2021 Category: Emergency Medicine Authors: Dominic DiPrinzio, Taylor Roth, Jay D. Fisher Source Type: research

Idarucizumab (PRADAXA ®) as a sole reversal agent in an unstable hemorrhagic shock patient on an unknown anticoagulant with elevated protime/international normalized ratio (PT/INR).
We present a case of an 85-year-old female with an unknown medication history, shortness of breath and severe anemia due to an upper gastrointestinal bleed. Laboratory abnormalities were significant for INR 6.43 and serum creatinine 2.21  mg/dL.
Source: The American Journal of Emergency Medicine - February 5, 2021 Category: Emergency Medicine Authors: Sara Kutner, Nicholas Scaturo, Brett Williams Source Type: research

Symptomatic intracranial hemorrhage in patients with admission hyperglycemia and diabetes after mechanical thrombectomy: A systematic review and meta-analysis
Symptomatic intracranial hemorrhage (sICH) is a severe complication of revascularization therapy. We aimed to investigate the association of admission hyperglycemia and sICH after mechanical thrombectomy in patients with acute ischemic stroke.
Source: The American Journal of Emergency Medicine - February 22, 2021 Category: Emergency Medicine Authors: Lin Zang, Dan Zhang, Yanyan Yao, Yujie Wang Source Type: research