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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

The challenge of coprescription of antiplatelet therapy and oral anticoagulants
The coexistence of symptomatic carotid artery stenosis and nonvalvular atrial fibrillation (NVAF) in the recently reported 85year old man [1] bears out the findings of the study which documented a 24.3% prevalence of high-grade (50% or more) carotid artery stenosis among 103 consecutive NVAF patients (mean age 69) who presented with stroke [2]. Among these patients with high-grade stenosis 66.7% had stenosis ipsilateral to the cerebral infarct [2]. Given the fact that patients with symptomatic carotid artery stenosis are at high risk of stroke recurrence and/or worsening neurological disability during the first 14days foll...
Source: The American Journal of Emergency Medicine - May 22, 2017 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Cerebral hyperperfusion syndrome: a rare postoperative complication of carotid endarterectomy
Acute neurological deficits are common presentations to the emergency department. Cerebral hyperperfusion syndrome, a rare phenomenon which can occur within one month following carotid surgical revascularization, may be challenging for the emergency physician to diagnose in the setting of an acute neurological presentation. Carotid arterial disease contributes 15-20% of ischemic cerebrovascular accidents and surgical revascularization is the commonest intervention for preventing stroke in patients with significant carotid disease.
Source: The American Journal of Emergency Medicine - March 5, 2016 Category: Emergency Medicine Authors: Mina Guirgis, Kishore Sieunarine Source Type: research

Cerebral hyperperfusion syndrome: A rare postoperative complication of carotid endarterectomy
Acute neurological deficits are common presentations to the emergency department. Cerebral hyperperfusion syndrome, a rare phenomenon which can occur within one month following carotid surgical revascularization, may be challenging for the emergency physician to diagnose in the setting of an acute neurological presentation. Carotid arterial disease contributes 15 –20% of ischemic cerebrovascular accidents and surgical revascularization is the commonest intervention for preventing stroke in patients with significant carotid disease.
Source: The American Journal of Emergency Medicine - March 4, 2016 Category: Emergency Medicine Authors: Mina Guirgis, Kishore Sieunarine Tags: Case Report Source Type: research