An altered level of consciousness followed by a crying spell during blood donation

Author(s):  
Ankur Goyal ◽  
Ashish Maheshwari ◽  
Mohit Varshney ◽  
Meenu Bajpai
2002 ◽  
Vol 1 (2) ◽  
pp. 60-63
Author(s):  
B Edmunds ◽  
◽  
P J Francis ◽  

Direct ophthalmoscopy is an essential part of the full systemic examination. However, the technique is challenging and time-consuming. In the acute medical setting therefore, it is advisable for the physician to identify the subgroup of patients in whom examination of the fundus is most likely to be helpful. Ophthalmoscopy should be performed where papilloedema is suspected, in those with an altered level of consciousness or other focal neurology, those with an unknown systemic disorder, and those complaining of visual disturbance.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Phillip M. Grenz ◽  
Robert N. Ray Jr. ◽  
Olivia A. Hardy ◽  
Andrew L. Koons ◽  
Kenneth D. Katz ◽  
...  

Methemoglobinemia results from increased amounts of oxidized hemoglobin in the blood with an ensuing change in oxygen dissociation curve and lack of oxygen delivery to tissue. A previously well, male toddler was brought to the Pediatric Emergency Department (PED) by Emergency Medical Services (EMS) with abrupt onset of altered mental status and cyanosis after a suspected ingestion of “Rush” nail polish remover. He was quickly diagnosed with methemoglobinemia by both clinical presentation and chocolate-colored blood appearance. He emergently received intravenous (IV) methylene blue (MB) with immediate and sustained improvement requiring no further doses. Though inhalation of nitrites and subsequent methemoglobinemia is frequently reported in adolescents, we were unable to find any cases in the literature detailing ingestion of this product and the resulting clinical manifestations. Our objective with this report is to describe a rare case of a toddler with an accidental ingestion of “Rush” nail polish remover, a nitrite compound. Our patient presented to the PED with abrupt onset of altered level of consciousness, hypotension, and cyanosis resulting from acquired methemoglobinemia. This case report demonstrates the importance of emergency clinicians being able to make clinical judgements and decisions based on the history and physical exam when methemoglobinemia is suspected.


2020 ◽  
Vol 8 (5) ◽  
pp. 104-110
Author(s):  
Saadi JS AlJadir

Pituitary Apoplexy (PA) is an acute critical endocrine condition that is infrequently encountered in daily medical practice. Its life-threatening condition that mandates prompt diagnosis and urgent treatment and may be neurosurgical intervention. Majority of cases are attributed to ischemic infarction or hemorrhage of the pituitary gland usually in the vicinity of pituitary adenoma, and in most cases could be the initial manifestation of these tumors! In reviewing the literatures there is conflicting evidence of which are the predominant, non-functional, or functional adenomas, some reports were showed that prolactin-secreting are at highest risk. There are recognizable risk factors that might precipitate this endocrine emergency like hypertension, medications, major surgery, head injury, radiation, or dynamic testing, but in majority of cases at presentation no identifiable risk factor could be detected. The typical clinical scenario includes persistent worsening headache, vomiting, and altered level of consciousness, visual defect or loss with extreme hormonal derangements which are shown by hemodynamic instability, adrenal crises with variable hormonal deficiencies.


2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Qalab Abbas ◽  
Qurat ul Ain Merchant ◽  
Bushra Nasir ◽  
Anwar ul Haque ◽  
Basit Salam ◽  
...  

Intracerebral hemorrhage (ICH) in children is a rare but disabling disease that accounts for almost half cases of stroke. We report our experience of ICH in children. Retrospective review of medical records of children (1 month-16 years) admitted in Pediatric Intensive Care Unit between January 2007 and December 2014 was done. Data collected included age, gender, presentation, examination findings, neuroimaging done (CT, MRI, and angiography) management (conservative/intervention), and outcome. Results are presented as frequency and percentages. Of the total 50 patients, 58% were male and 26% were <1 year. On presentation 44% had vomiting, 42% had seizures, and GCS < 8 while 40% had altered level of consciousness. Single bleed was present in 88%, 94% had supratentorial bleed, and 32% had intraventricular extension. 72% had bleed volume of <30 mL and 8% had >60 mL. CT scan was done in 98% patients and MRI in 34%, while 6% underwent conventional angiography. 60% patients were managed conservatively, 36% underwent neurosurgical intervention, and 6% underwent radiological vascular intervention. Hematologic causes were identified in 52% patients and vascular malformations in 14% and in 26% no cause could be identified. 26% of patients expired.


2021 ◽  
pp. 722-730
Author(s):  
Angela M. Parsons ◽  
Joseph F. Drazkowski

Correctly diagnosing seizures and seizurelike events is important for numerous reasons, including safety issues, social consequences, and therapy. Patients with transient neurologic events of unknown cause are commonly admitted to hospitals, and an estimated 10% of the people in the United States have a seizure in their lifetime. These facts highlight the importance of diagnostic accuracy. History taking is imperfect, but it is still a cornerstone in making the proper diagnosis of transient neurologic events. Focused, supporting diagnostic tests may add accuracy in arriving at the proper diagnosis, but even with a good history, diagnostic testing, and physical examination findings, the diagnosis may be inaccurate. Self-reports of seizure frequency are notoriously inaccurate and often miss more than 50% of focal-onset seizures, especially if the seizures begin in the dominant hemisphere (largely because the effects of the event cause an altered level of consciousness).


2013 ◽  
Vol 2013 (sep24 2) ◽  
pp. bcr2013010823-bcr2013010823
Author(s):  
A. M. Ajlan ◽  
H. Al-Jehani ◽  
C. Torres ◽  
J. Marcoux

2019 ◽  
Vol 55 (02) ◽  
pp. 098-109
Author(s):  
Alka Shukla ◽  
Mayank Gangwar ◽  
Sonam Rastogi ◽  
Gopal Nath

AbstractViral encephalitis is inflammation of brain that manifests as neurological complication of viral infections. There are quite a good number of viruses, for example, human herpes virus, Japanese encephalitis, and enteroviruses that can result in such a dreadful condition. Geographical location, age, gender, immune status, and climatic conditions also contribute to the establishment of this disease in an individual. Clinical signs and symptoms include fever, headache, altered level of consciousness, changed mental status, body ache, seizures, nausea, and vomiting. Effective management of this disease relies on timely diagnosis that in turn depends on apt and suitable investigation techniques. Traditional investigations have thinned out these days owing to the fact that advanced molecular technologies have been introduced to the diagnostic field. Treatment of viral encephalitis mainly involves symptomatic relieve from fever, malaise, myalgia along with measures to reduce viral load in the patient. This review mentions about all the possible aspects of viral encephalitis starting from etiology to the management and preventive measures that include immunization and vector control.


2018 ◽  
Vol 15 (02/03) ◽  
pp. 074-077
Author(s):  
Jennyfer Paulla Galdino Chaves ◽  
Pedro Henrique Mezadri ◽  
Thiago Suzuki ◽  
Carlos Alexandre Twardowsky ◽  
Tatiana Von Hertwig Fernandes Oliveira

AbstractThe present report is about a 25-year-old woman who had a motorcycle accident with brain trauma injury. Although she was admitted at another institution disoriented but alert, she progressively evolved to an altered level of consciousness and required orotracheal intubation. She was then transferred to our hospital sedated, and the admission head computed tomography showed signs of posterior fossa ischemia. The angiography demonstrated a vertebral artery dissection with subsequent embolization to the basilar artery, which provoked its complete occlusion. After drug withdrawal, the patient recovered level of consciousness but was aphasic and did not exhibit purpose movements apart from eye blinking, as expected in patients with locked-in syndrome.


Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Ross Puffer ◽  
Luz Cumba-Garcia ◽  
Benjamin T Himes ◽  
David O Okonkwo ◽  
Ian F Parney

Abstract INTRODUCTION Extracellular vesicles (EVs) are membrane-bound particles released by the majority of human cells, including cells within the central nervous system. They may represent a diagnostic or prognostic target obtainable in peripheral blood of neurotrauma patients. We have isolated micro RNA sequences contained within EVs of 15 patients with traumatic brain injury (TBI) and compared them to miRNA sequences from 5 healthy controls. METHODS Extracellular vesicles were isolated from 15 TBI subjects, including 6 mild TBI (Glasgow Coma Scale (GCS) 13-15), 3 moderate TBI (GCS 9-12), and 6 severe TBI (GCS 3-8), as well as 5 healthy control. EVs were analyzed using nanoparticle tracking analysis. Samples underwent RNA isolation and extraction, followed by miRNA sequencing and analysis. RESULTS TBI patients presenting with an altered level of consciousness (GCS = 14) had a significantly higher mean extracellular vesicle size compared to subjects with normal GCS (mean + /− sem = 108.3 nm + /− 7.7 nm vs 89.2 nm + /− 6.7 nm; P < .04). GFAP ELISA of the samples demonstrated significantly higher GFAP concentration in subjects with altered level of consciousness (GCS = 14) as compared to those with normal GCS (mean + /− sem GFAP concentration 2204.2 pg/mL + /− 1067.2 pg/mL vs. 207.8 pg/mL + /− 270.8 pg/mL, P = .05). We identified 9 miRNA sequences that were found in a significantly higher proportion in patients with altered consciousness compared to controls, as well as 2 miRNA sequences that were significantly downregulated in subjects with altered consciousness as compared to controls. CONCLUSION EVs may contain brain specific biomarkers that are released in greater quantities after TBI. These molecules can be isolated from plasma and sequenced. Further analysis will better elucidate the final pathways affected by these up and downregulated miRNA sequences. Analysis of EVs in subjects with TBI may allow for the identification of novel diagnostic and potentially prognostic biomarkers.


Sign in / Sign up

Export Citation Format

Share Document