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Total 172 results found since Jan 2013.

Stroke: management and prevention
Acute stroke treatment requires clear protocols to rapidly triage patients – using appropriate investigations – for mechanical thrombectomy and intravenous thrombolysis. Computed tomography (CT) excludes haemorrhage, CT angiography locates the occluded vessel, and CT perfusion and perfusion magnetic resonance imaging identify viable tissue. An organized approach to str oke care in a specialist environment reduces disability and saves lives. Adoption of a ‘care bundle’ approach, including the active management of pyrexia and hyperglycaemia, and early screening for swallowing difficulties, is beneficial.
Source: Medicine - July 25, 2023 Category: Internal Medicine Authors: Gina Hadley, Ivie I. Gbinigie, Joyce S. Balami, Alastair M. Buchan Tags: Acute neurology Source Type: research

Differential Diagnosis of New Giant T-Wave Inversions
To the Editor The electrocardiogram (ECG) presented by Dr Cai and colleagues is indeed a great challenge. Two days after a fall, an older patient was admitted to the hospital with a hip fracture that was treated by external fixation and skin traction. On hospital day 2, the patient suddenly lost consciousness. An ECG immediately performed showed giant negative T waves (>20 mm) in the precordial leads and a QTc prolongation of 535 milliseconds. Cardiac troponin was elevated. Findings of computed tomography and magnetic resonance imaging (performed because of neurologic deficits) showed bilateral multifocal subacute ische...
Source: JAMA Internal Medicine - July 10, 2023 Category: Internal Medicine Source Type: research

Assessment of dizziness in neurology
Dizziness and vertigo are common symptoms. In acute vertigo, expert clinical assessment is critically important in discerning stroke from non-stroke causes because the results of stroke-protocol brain magnetic resonance imaging, including diffusion-weighted imaging, can be falsely negative in the first 24 hours. It follows that acute medical services must have access to clinicians expert in assessing acute vertigo. Expertise in clinical examination and interpretation of the findings requires appropriate training, but here we outline the basic diagnostic and therapeutic approach to patients with dizziness.
Source: Medicine - June 27, 2023 Category: Internal Medicine Authors: Louisa Murdin, Barry M. Seemungal, Adolfo M. Bronstein Tags: Clinical assessment in neurology Source Type: research

Acute dysphagia: A rare initial symptom of lateral medullary syndrome: A case report
CONCLUSION: The diagnosis of LMS was queried owing to the presentation of the single most important common symptom, with no other characteristic manifestations of LMS.PMID:36582892 | PMC:PMC9793181 | DOI:10.1016/j.amsu.2022.104851
Source: Annals of Medicine - December 30, 2022 Category: Internal Medicine Authors: Farhan Ali Amraha Zubair Fatima Nazir Kashif Ali Sobia Mansoor Source Type: research

Diffuse low-grade glioma misdiagnosed as acute cerebral infarction: A case report
We report a case of DLGG detected by computed tomography and magnetic resonance imaging (MRI). Patient concerns: A 58-year-old man suddenly phantom smells for half an hour and was previously healthy. Diagnoses: Computed tomography findings showed a leaf-shaped slightly hypodense shadow in the right temporal lobe with no obvious mass effect and an unclear boundary. MRI findings showed diffuse and slightly longer T1-weighted imaging (T1WI)/T2-weighted imaging (T2WI)signal in the right temporal lobe and hippocampus, slight hyperintensity on diffusion-weighted imaging, diffuse swelling in the right temporal lobe ...
Source: Medicine - September 2, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intramedullary spinal cord abscess associated with right-to-left shunt via right superior vena cava draining into left atrium: A case report
We report the first case of ISCA associated with RSVC-LA RL shunt. Patient concerns: A 36-year-old man developed progressive paraparesis, dysuria, and spontaneous pain in the lumbar region and lower extremities. Spinal magnetic resonance imaging revealed an intramedullary lesion extended from Th12 to L2 with ring-shaped gadolinium enhancement. Cerebrospinal fluid (CSF) study exhibited a marked pleocytosis, and CSF culture grew Streptococcus intermedius. Cardiovascular computed tomography angiography identified RSVC-LA RL shunt, which caused transient acute cardiac syndrome due to air embolus. Diagnoses: The p...
Source: Medicine - July 1, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

54-Year-Old Woman With Altered Mental Status and Abdominal Pain
A 54-year-old woman was transferred to our medical center with altered mental status, abdominal pain, and hypotension. Her medical history included type 2 diabetes mellitus, hypertension, hyperlipidemia, active tobacco use, prior cholecystectomy, and a recent stroke. One month earlier, she presented to an outside facility with right-sided facial weakness and numbness. Brain magnetic resonance imaging (MRI) at that time revealed multiple small lacunar-type infarcts. Computed tomography (CT) angiography of the head and neck, 48-hour Holter monitoring, and transesophageal echocardiography did not reveal an embolic source.
Source: Mayo Clinic Proceedings - June 29, 2022 Category: Internal Medicine Authors: Caroline L. Matchett, Nikita Rafie, Jacob C. Jentzer Tags: Residents ’ Clinic Source Type: research

Endovascular Coil Embolization for Recurrent Bow Hunter's Stroke
Intern Med. 2022 May 14. doi: 10.2169/internalmedicine.8906-21. Online ahead of print.ABSTRACTBow hunter's stroke is a rare cause of vertebrobasilar infarction. There is no consensus regarding the optimal treatment. We herein report a case of bow hunter's stroke successfully treated by endovascular treatment. A 70-year-old man presented with central vertigo. Magnetic resonance imaging (MRI) showed posterior circulation infarcts. Dynamic angiography revealed thrombus formation and hypoperfusion of the right vertebral artery upon head rotation to the left. Endovascular parent artery occlusion of the right vertebral artery wa...
Source: Internal Medicine - May 15, 2022 Category: Internal Medicine Authors: Fumiya Kutsuna Yoichi Morofuji Eri Shiozaki Daiki Uchida Masahiro Tokuda Hiroshi Iwanaga Tomonori Ono Ichiro Kawahara Wataru Haraguchi Keisuke Tsutsumi Source Type: research