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Late-onset myocardial infarction and autoimmune haemolytic anaemia in a COVID-19 patient without respiratory symptoms, concomitant with a paradoxical increase in inflammatory markers: a case report
ConclusionsBoth complications occurred quite late after COVID-19 diagnosis and were probably precipitated by systemic inflammation, as indicated by a significant delayed increase in inflammatory markers, including interleukin-6 (IL-6).
Source: Journal of Medical Case Reports - December 18, 2020 Category: General Medicine Source Type: research

Treatment of pseudobulbar affect (PBA) in a patient with a history of traumatic brain injury, partial brain resection, and brainstem stroke: a case report
ConclusionsThis case provides anecdotal evidence for the efficacy of dextromethorphan/quinidine in the treatment of pseudobulbar affect with remarkably swift and complete cessation of symptoms. As a secondary point, it is worth noting that our  patient had experienced two devastating neurological traumas, both in anatomical areas that have been implicated in the corticopontine–cerebellar circuit thought to be responsible for pseudobulbar affect. However, only the second trauma, an acute left pontine infarction, produced symptoms of emo tional disinhibition. The authors hope that reporting this case will provide both con...
Source: Journal of Medical Case Reports - December 4, 2020 Category: General Medicine Source Type: research

Ultrasound imaging of carotid web with atherosclerosis plaque: a case report
ConclusionCarotid webs with atherosclerosis have no known etiological factors and are rarely reported. Thus, carotid webs could be easily confused with ulcerations on the surface of the atherosclerosis plaque. The diagnosis could be difficult and effective management remains indeterminate. Moreover, prompt recognition of this disease is key to correct treatment and management. Hence, this case report and the relevant data in the literature could contribute to the improvement of the diagnosis and treatment of this disease.
Source: Journal of Medical Case Reports - September 7, 2020 Category: General Medicine Source Type: research

Patient with rheumatoid arthritis with deep vein thrombosis presenting as a calf strain: a case report
ConclusionsVenous thromboembolism risk in rheumatoid arthritis is stated as being less recognized as an arterial complication. This is borne out by this patient ’s clinical journey, wherein his youth, fitness, athletic appearance, and onset of symptoms during exercise were said to suggest a diagnosis of a calf strain at a minor injuries unit. Ultrasonography at a different accident and emergency unit later that day ultimately was used to diagnose deep vei n thrombosis.
Source: Journal of Medical Case Reports - July 23, 2020 Category: General Medicine Source Type: research

Miller Fisher syndrome with bilateral vocal cord paralysis: a case report
ConclusionThe occurrence of acute or subacute descending paralysis with involvement of bulbar muscles and respiratory failure can often divert clinicians to a diagnosis of neuromuscular junction disorders (such as botulism or myasthenia gravis), vascular causes like stroke, or electrolyte and metabolic abnormalities. Early identification of Miller Fisher syndrome with appropriate testing is essential to prompt treatment and prevention of further, potentially fatal, deterioration.
Source: Journal of Medical Case Reports - February 17, 2020 Category: General Medicine Source Type: research

Atrial myxoma with cerebellar signs: a case report
ConclusionAlthough rare, atrial myxoma has to be considered a cause of stroke and other embolic phenomenon causing multiorgan infarctions. Early and timely diagnosis of the condition can prevent further recurrence and inappropriate anticoagulant therapy. It would be pertinent to have echocardiography done in patients who present with a stroke, arrhythmias, and other constitutional symptoms. The tumor once detected must be removed surgically as early as possible, which not only reduces serious thromboembolic complications but can be potentially curative.
Source: Journal of Medical Case Reports - February 12, 2020 Category: General Medicine Source Type: research

Successful thrombolytic therapy with recombinant tissue plasminogen activator in ischemic stroke after idarucizumab administration for reversal of dabigatran: a case report
ConclusionsIntravenous thrombolytic therapy with recombinant tissue plasminogen activator after reversal of dabigatran with idarucizumab may be safe and feasible in patients with acute ischemic stroke with lacunar infarct. Furthermore, intravenous thrombolytic therapy with recombinant tissue plasminogen activator could be used in patients in emergency settings until just before the end of the recommended time limit within which it needs to be administered because of the immediate effect of idarucizumab.
Source: Journal of Medical Case Reports - December 25, 2019 Category: General Medicine Source Type: research

Continuous intravenous low-dose diclofenac sodium to control a central fever after ischemic stroke in the intensive care unit: a case report and review of the literature
ConclusionsWe observed that a low-dose diclofenac sodium infusion was effective in treating fever without systemic side effects. This treatment may be suggested as an alternative to conventional antipyretic drugs, but additional clinical trials are required.
Source: Journal of Medical Case Reports - December 17, 2019 Category: General Medicine Source Type: research

Pneumocephalus and pneumorachis after blunt chest trauma without spinal fractures: a case report
ConclusionsThis is the first case report to describe pneumorachis and pneumocephalus following blunt trauma with pneumothorax, but no spinal or skull fractures. The mechanism that is probably involved here is a migration of air with subcutaneous emphysema and a pleural hernia into the spinal canal. However, in cases of pneumorachis or pneumocephalus, skull fractures need to be investigated as these require surgery and appropriate vaccination to prevent meningitis.
Source: Journal of Medical Case Reports - October 24, 2019 Category: General Medicine Source Type: research

Dynamic derangement in amino acid profile during and after a stroke-like episode in adult-onset mitochondrial disease: a case report
ConclusionsGrowth differentiation factor-15 can be used not only for the diagnosis of mitochondrial disease, but as an indicator of its acute exacerbation. A stroke-like episode of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes reflects a drastic derangement of multiple amino acids. The involvement of aspartic acid in the episodes should be explored in future studies.
Source: Journal of Medical Case Reports - October 20, 2019 Category: General Medicine Source Type: research

Unusual skull base metastasis from neuroendocrine tumor: a case report
ConclusionsIntracranial metastasis is rare in patients with neuroendocrine tumor, particularly in those with well-differentiated histology; skull base metastasis is even more uncommon. Management of intracranial metastasis from a rare tumor should always be discussed in a specialist multidisciplinary meeting. Surgery or radiotherapy, including stereotactic radiosurgery, should be considered in skull base metastases. Hormonal abnormalities may occur following radiotherapy to skull base metastases and should be monitored closely in the first few months post treatment.
Source: Journal of Medical Case Reports - August 29, 2019 Category: General Medicine Source Type: research

Stroke in malignancy: complexities of diagnosis and management: a case report
ConclusionsThis case highlights the importance of having a high threshold of suspicion for malignancy as a cause of stroke.
Source: Journal of Medical Case Reports - August 19, 2019 Category: General Medicine Source Type: research

Giant cabergoline-resistant prolactinoma in a man who presented with a psychotic episode during treatment: a case report
ConclusionsCombined use of cabergoline with quetiapine and mirtazapine to treat a psychotic crisis may have contributed to shrinking the tumor in our patient because these antipsychotics have action mediated by growth factors that interfere with growth of pituitary tumors.
Source: Journal of Medical Case Reports - June 15, 2019 Category: General Medicine Source Type: research

Occlusive radiation cerebral vasculopathy implies medical complexity: a case report
ConclusionLate-onset occlusive radiation vasculopathy is a potentially severe iatrogenic manifestation of radiotherapy that requires a high index of suspicion as an etiology of stroke in young population, especially those with coexistent meningioma that might be a strong indicator for occlusive radiation vasculopathy as the stroke culprit. We reviewed the available literature to better understand the pathogenesis, clinical presentation, and treatment options of occlusive radiation vasculopathy. Applying perfusion studies with acetazolamide measures the cerebrovascular reserve in patients with occlusive radiation vasculopat...
Source: Journal of Medical Case Reports - June 2, 2019 Category: General Medicine Source Type: research

Combined flow-based imaging assessment of optimal cardiac resynchronization therapy pacing vector: a  case report
ConclusionThis clinical case offers an innovative and accurate approach for acute echocardiographic optimization of left pacing vector. It shows clinical utility of combined three-dimensional full-volume color Doppler transthoracic echocardiography/echo-particle imaging velocimetry assessment to increase response to cardiac resynchronization therapy, in terms of reduction of functional mitral regurgitation, improving fluid dynamics synchrony of the left ventricle.
Source: Journal of Medical Case Reports - May 24, 2019 Category: General Medicine Source Type: research

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