Sweet Nothings

2020 ◽  
pp. 259-262
Author(s):  
Pat Croskerry
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Potential Benefit ◽  
Community Hospital ◽  
Correct Diagnosis ◽  
Young Female ◽  
Computed Tomography Scan ◽  
Routine Blood ◽  
History Of ◽  
Tomography Scan

In this case, a young female presents to a community hospital complaining of headache. She has a history of migraine and reports that this headache feels typical. Routine blood work is drawn, and treatment is begun for her headache. However, before it is initiated, she has a seizure and is rendered comatose. A diagnosis of subarachnoid hemorrhage is made. She is intubated and transferred to another hospital for a computed tomography scan of her head. In the meantime, her blood work is returned, which reveals the cause of her seizure and her correct diagnosis. The case illustrates the potential benefit of medical caveats (cognitive forcing strategies).

scholarly journals Are RNA-Based Tests Sufficient for COVID-19 Diagnosis? An Inspiration of Three Asymptomatic Cases

2021 ◽  
Vol 30 ◽  
pp. 096368972098545
Author(s):  
Tao Hu ◽  
Xiao Liu ◽  
Qinan Yin ◽  
Xingting Duan ◽  
Li Yan
Keyword(s):  
Computed Tomography ◽  
Nucleic Acid ◽  
Virus Infection ◽  
Severe Acute Respiratory Syndrome ◽  
The Other ◽  
Computed Tomography Scan ◽  
Health Authorities ◽  
History Of ◽  
Tomography Scan ◽  
Nucleic Acid Tests

In this work, we discovered a new phenomenon—asymptomatic COVID-19 infection, or covert case, during the pandemic. All the 3 patients had a history of exposure, with no symptoms, and no abnormalities were found in computed tomography scan or lab tests. Except for case 2, the other patients’ severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) nucleic acid tests were negative. But their anti-SARS-COV-2 nucleocapsid antibody showed a dynamic trend, consistent with the process of virus infection and clearance. A growing number of asymptomatic or covert cases need more attention. Lack of surveillance may lead to another outbreak. We hope to demonstrate our cases to attract the attention of governments or health authorities that covert cases should be the focus as well.

scholarly journals Fulminant amoebic colitis in the era of computed tomography scan: A case report and review of the literature

2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Suman Mewa Kinoo ◽  
Vikesh V. Ramkelawon ◽  
Jaynund Maharajh ◽  
Bugwan Singh
Keyword(s):  
Computed Tomography ◽  
Bowel Wall ◽  
Abdominal Distension ◽  
Review Of The Literature ◽  
Computed Tomography Scan ◽  
Fulminant Colitis ◽  
Bowel Necrosis ◽  
Amoebic Colitis ◽  
History Of ◽  
Tomography Scan

Amoebic colitis, caused by ingestion of water or food contaminated with the protozoan Entamoeba histolytica, can progress to a fulminant colitis. Computed tomography (CT) findings reported in the literature on this type of colitis are sparse. We present a 59-year-old male patient with a one-week history of progressive abdominal pain, abdominal distension and associated watery and bloody diarrhoea. A CT scan revealed deep ulcerations with submucosal and intramural tracking of contrast. Colonoscopy and biopsy confirmed a diagnosis of Amoebic colitis. The patient required a laparotomy and demised. Deep ulcerations with submucosal and intramural tracking of contrast on CT are diagnostic of fulminant amoebic colitis. Although not demonstrated at CT in this case, discontinuous bowel necrosis, omental wrapping (seen at laparotomy in our case) and neovascularisation of the bowel wall may be other features to look out for.

scholarly journals A successfully treated primary tracheal synovial sarcoma

2020 ◽  
pp. 201010582094853
Author(s):  
Mohamed Faisal Abdul Hamid ◽  
Sopian Wahab ◽  
Nik Nuratiqah Nik Abeed ◽  
Ng Boon Hau ◽  
Andrea Ban Yu-Lin
Keyword(s):  
Computed Tomography ◽  
Airway Obstruction ◽  
Synovial Sarcoma ◽  
Successful Treatment ◽  
Initial Evaluation ◽  
Computed Tomography Scan ◽  
History Of ◽  
Rare Malignancy ◽  
Tomography Scan

Primary tracheal synovial sarcoma is a rare malignancy and is usually found incidentally. Tumours can present with cough, dyspnoea, stridor and intermittent haemoptysis. The diagnosis is challenging because it is rare, and the symptoms may mimic other diseases of airway obstruction. A previously well 53-year-old man presented with an eight-month history of cough. He had a history of minimal haemoptysis a few months prior to presentation. Spirometry showed an obstructive pattern, and a computed tomography scan of the thorax revealed an intraluminal tracheal mass. This case highlights that a thorough initial evaluation, including spirometry, leads to an earlier diagnosis and successful treatment of this rare sarcoma.

scholarly journals Volumetric analysis of the initial index computed tomography scan can predict the natural history of acute uncomplicated type B dissections

2015 ◽  
Vol 62 (4) ◽  
pp. 893-899 ◽  
Author(s):  
Kedar S. Lavingia ◽  
Sebastion Larion ◽  
Sadaf S. Ahanchi ◽  
Chad P. Ammar ◽  
Mohit Bhasin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Natural History ◽  
Volumetric Analysis ◽  
Type B ◽  
Computed Tomography Scan ◽  
History Of ◽  
Tomography Scan

scholarly journals Computed tomography grading schemes used to predict cerebral vasospasm after aneurysmal subarachnoid hemorrhage: a historical review

2006 ◽  
Vol 21 (3) ◽  
pp. 1-8 ◽  
Author(s):  
Paul Klimo ◽  
Richard H. Schmidt
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Historical Review ◽  
Science Research ◽  
Computed Tomography Scan ◽  
Major Area ◽  
Volumetric Quantification ◽  
Tomography Scan

✓The elucidation of predictive factors of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is a major area of both clinical and basic science research. It is becoming clear that many factors contribute to this phenomenon. The most consistent predictor of vasospasm has been the amount of SAH seen on the postictal computed tomography scan. Over the last 30 years, it has become clear that the greater the amount of blood within the basal cisterns, the greater the risk of vasospasm. To evaluate this risk, various grading schemes have been proposed, from simple to elaborate, the most widely known being the Fisher scale. Most recently, volumetric quantification and clearance models have provided the most detailed analysis. Intraventricular hemorrhage, although not supported as strongly as cisternal SAH, has also been shown to be a risk factor for vasospasm.

scholarly journals The Relationship Between Delayed Infarcts and Angiographic Vasospasm After Aneurysmal Subarachnoid Hemorrhage

Neurosurgery ◽  
2013 ◽  
Vol 72 (5) ◽  
pp. 702-708 ◽  
Author(s):  
Robert J. Brown ◽  
Abhay Kumar ◽  
Rajat Dhar ◽  
Tomoko R. Sampson ◽  
Michael N. Diringer
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Infarct Volume ◽  
Delayed Cerebral Ischemia ◽  
Computed Tomography Scan ◽  
Angiographic Vasospasm ◽  
Arterial Vasospasm ◽  
The Relationship ◽  
Tomography Scan

Abstract BACKGROUND: Delayed cerebral ischemia is common after aneurysmal subarachnoid hemorrhage (aSAH) and is a major contributor to poor outcome. Yet, although generally attributed to arterial vasospasm, neurological deterioration may also occur in the absence of vasospasm. OBJECTIVE: To determine the relationship between delayed infarction and angiographic vasospasm and compare the characteristics of infarcts related to vasospasm vs those unrelated. METHODS: A retrospective review of patients with aSAH admitted from July 2007 through June 2011. Patients were included if they were admitted within 48 hours of SAH, had a computed tomography scan both 24 to 48 hours following aneurysm treatment and ≥7 days after SAH, and had a catheter angiogram to evaluate for vasospasm. Delayed infarcts seen on late computed tomography but not postprocedurally were attributed to vasospasm if there was moderate or severe vasospasm in the corresponding vascular territory on angiography. Infarct volume was measured by perimeter tracing. RESULTS: Of 276 aSAH survivors, 134 had all imaging requisite for inclusion. Fifty-four (34%) had moderate or severe vasospasm, of whom 17 (31%) had delayed infarcts, compared with only 3 (4%) of 80 patients without vasospasm (P < .001). There were a total of 29 delayed infarcts in these 20 patients; 21 were in a territory with angiographic vasospasm, but 8 (28%) were not. Infarct volume did not differ between vasospasm-related (18 ± 25 mL) and vasospasm-unrelated (11 ± 12 mL) infarcts (P = .54), but infarcts in the absence of vasospasm were more likely watershed (50% vs 10%, P = .03). CONCLUSION: Delayed infarcts following aSAH can occur in territories without angiographic vasospasm and are more likely watershed in distribution.

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