The American journal of emergency medicine
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Risk of cerebrovascular disease is increased in patients with HIV infection; however, cerebral venous sinus thrombosis is not commonly reported in this condition. We report a case of young man with intracranial hemorrhage whose radiologic investigations revealed thrombosis of the left transverse and sigmoid sinuses extending into the left internal jugular vein. ⋯ He was started on anticoagulant therapy, after which he showed gradual recovery. This case highlights a rarely encountered presentation of HIV infection as cerebral venous sinus thrombosis.
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Fetal loss in symptomatic first-trimester pregnancy with documented yolk sac intrauterine pregnancy.
The possibility of spontaneous miscarriage is a common concern among pregnant women in the emergency department (ED). ⋯ Seventy percent of women diagnosed with a yolk sac IUP in the ED carried their pregnancy to at least 20 weeks. The remaining women (30%) experienced fetal loss. Vaginal bleeding (with or without pain) increased the rate of fetal loss compared with women with pain only. These data will assist the emergency physician in counseling women with symptomatic first-trimester pregnancies.
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Case Reports
Rapid revascularization reverses cerebral and myocardial ischemia arising from aortic dissection.
Thrombolytic therapy is relatively contraindicated in aortic dissection (AD)–related cerebral and myocardial ischemia for high risk of bleeding. We report a 52-year-old woman experiencing acute cerebral and myocardial ischemia arising from AD. ⋯ Emergent surgery completely reversed her neurologic deficit and myocardial injury. We suggest that carotid duplex could be a useful tool to detect AD-related stroke before thrombolytic therapy and would not delay the timing for treatment.
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Acute phosphate toxicity following rectal administration of phosphate-containing preparations was documented earlier. However, acute phosphate toxicity due to inhalation of monoammonium phosphate (MAP) is rarely reported. ⋯ In view of the easy accessibility of fire extinguishers and its likely use for suicidal or homicidal purposes, physicians and practitioners working in emergency departments should be aware of this entity. Early recognition, removal of phosphate by hemodialysis, and supportive care have prevented this case from acute phosphate nephropathy and further complications.