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Impact of CT scanner location on door to imaging time for emergency department stroke evaluation
Stroke is a potentially serious condition commonly diagnosed in the ED. Time to diagnosis can be crucial to maximizing outcome in a majority of ischemic stroke cases amenable to thrombolytic therapy.
Source: The American Journal of Emergency Medicine - August 13, 2019 Category: Emergency Medicine Authors: William Bonadio Source Type: research

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

Chemotherapy induced stroke mimic: 5-Fluorouracil encephalopathy fulfilling criteria for tissue plasminogen activator therapy
Stroke mimics, especially those involving chemotherapy related neurotoxicity, can confound the clinical diagnosis of acute stroke. Here we describe the case of a 63year-old male with a recent history of stage IIIC colon cancer who presented with confusion on the second day of modified FOLFOX6 (5-fluorouracil/oxaliplatin) chemotherapy and subsequently received alteplase, tissue plasminogen activator therapy (tPA), for presumed ischemic stroke. Magnetic resonance imaging scans after tPA administration did not reveal evidence of an infarction and the patients' neurological symptoms resolved completely after discontinuation of...
Source: The American Journal of Emergency Medicine - July 6, 2017 Category: Emergency Medicine Authors: May Thuy Nguyen, Robyn Stoianovici, Luigi Brunetti Source Type: research

Computed tomography angiography in acute stroke (revisiting the 4Ps of imaging)
Imaging in acute stroke has traditionally focussed on the 4Ps—parenchyma, pipes, perfusion, and penumbra—and has increasingly relied upon advanced techniques including magnetic resonance imaging to evaluate such patients. However, as per European Magnetic Resonance Forum estimates, the availability of magnetic resonance imaging scanners for the general population in India (0.5 per million inhabitants) is quite low as compared to Europe (11 per million) and United States (35 per million), with most of them only present in urban cities.
Source: The American Journal of Emergency Medicine - November 3, 2015 Category: Emergency Medicine Authors: Shriram Varadharajan, Jitender Saini, Ullas V. Acharya, Arun Kumar Gupta Tags: Brief Report Source Type: research

CT Angiography in acute stroke (Revisiting the 4Ps of Imaging)
Imaging in acute stroke has traditionally focussed on the 4 Ps - Parenchyma, Pipes, Perfusion and Penumbra and has increasingly relied upon advanced techniques including Magnetic Resonance Imaging (MRI) to evaluate such patients. However as per European Magnetic Resonance Forum (EMRF) estimates, the availability of MRI scanners for the general population in India (0.5 per million inhabitants) is quite low as compared to Europe (11 per million) and USA (35 per million), with the vast majority of them only present in urban cities.
Source: The American Journal of Emergency Medicine - November 3, 2015 Category: Emergency Medicine Authors: Shriram Varadharajan, Jitender Saini, Ullas VA, Arun Kumar Gupta Source Type: research

Hemichorea after multiple bee stings
We report the case of a 50-year-old man who developed involuntary movements of the left leg 24 hours after multiple bee stings, and the cause was confirmed to be a right temporal infarction on a diffusion magnetic resonance imaging scan. Thus, we concluded that the involuntary movement disorder was caused by right temporal infarction that occurred after multiple bee stings.
Source: The American Journal of Emergency Medicine - October 28, 2013 Category: Emergency Medicine Authors: Jin Young An, Ji Seon Kim, Jin Hong Min, Kyu Hong Han, Jun Ho Kang, Jung Soo Park, Hoon Kim, Suk Woo Lee Tags: Case Reports Source Type: research

Transient ischemic attack in hereditary hemorrhagic telangiectasia
We describe the case of a 53-year-old woman with a previous history of recurrent epistaxis, admitted to our unit for a transient episode of diplopia and unbalance. Cerebrovascular screening showed the presence of a right to left shunt at saline contrast transcranial Doppler, related to 3 PAVMs detected by subsequent chest computed tomographic scan. Genetic screening evidenced deletion in endoglin gene (ENG), suggesting diagnosis of HHT type 1. Secondary cerebrovascular prevention with antithrombotic therapy was early stopped for the worsening of epistaxis. Neurologic symptoms are common in HHT, and saline contrast transcra...
Source: The American Journal of Emergency Medicine - February 4, 2013 Category: Emergency Medicine Authors: Gino Gialdini, Alberto Chiti, Michelangelo Mancuso, Eva Terni, Nicola Giannini, Giovanni Orlandi Tags: Case Reports Source Type: research