scholarly journals Detection of Senile Scleral Plaque after Head Trauma

1970 ◽  
Vol 12 (4) ◽  
pp. 229-230
Author(s):  
Sarah Guigui ◽  
Tova Lifshitz ◽  
Amjad Baidousi ◽  
Ronit Yagev ◽  
Jaime Levy
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Elderly Patients ◽  
Emergency Room ◽  
Head Trauma ◽  
Late Onset ◽  
Computed Tomography Scan ◽  
Routine Examination ◽  
Prognostic Implications ◽  
Tomography Scan

Senile scleral plaques are late onset ocular calcifications, and are usually detected incidentally on orbital computed tomography scan following trauma. This report is of 4 elderly patients with senile scleral plaques who were admitted to the emergency room following trauma to the head. A head/orbital computed tomography scan was performed as part of the routine examination. In all 4 patients, computed tomography scan revealed a clear retina and no scleral perforation or foreign body intrusion, but bilateral radiodense areas were located anterior to the insertion of the horizontal rectus muscles. These areas were diagnosed as senile scleral plaques. Even though these ocular calcifications are benign, they have important prognostic implications, and should therefore be identified correctly and not confused with other ocular pathologies.

scholarly journals The Missing Tooth: A Curious Case of Postobstructive Pneumonia

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Ian Holmes ◽  
Kiran Gajurel ◽  
Jose Montoya
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Clinical Features ◽  
Computed Tomography Scan ◽  
Diagnostic Challenge ◽  
Impacted Tooth ◽  
Left Bronchus ◽  
Tomography Scan ◽  
Missing Tooth

Abstract Foreign body aspirations that are not recognized at the time of aspiration can lead to insidious symptoms that can present a diagnostic challenge. We report the case of a 70-year-old man presenting with postobstructive pneumonia 2 months after aspirating his own tooth during a meal. He had been mistakenly diagnosed with asthma and treated with bronchodilators before a computed tomography scan of the thorax revealed the impacted tooth in his left bronchus. We review the clinical features and microbiology of postobstructive pneumonia and discuss the rationale of its treatment.

Patients with Blunt Head Trauma on Anticoagulation and Antiplatelet Medications: Can They be Safely Discharged after a Normal Initial Cranial Computed Tomography Scan?

2014 ◽  
Vol 80 (6) ◽  
pp. 610-613 ◽  
Author(s):  
Salvatore Docimo ◽  
Aleksandr Demin ◽  
Fausto Vinces
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Head Trauma ◽  
International Normalized Ratio ◽  
Cranial Computed Tomography ◽  
Mechanism Of Injury ◽  
Computed Tomography Scan ◽  
Cranial Ct ◽  
Blunt Head Trauma ◽  
Tomography Scan

The literature reports delayed intracranial hemorrhage (ICH) after blunt trauma in patients taking preinjury anticoagulant and antiplatelet (AC/AP) medications. We sought to evaluate the incidence of delayed ICH at our institution and hypothesize that patients taking AC/AP medications who are found to have a negative first computed tomography (CT) scan will not require a second CT scan. A total of 303 patients were retrospectively reviewed. Age, gender, mechanism of injury, international normalized ratio (INR), initial and secondary cranial CT findings, and outcomes were recorded. One hundred sixty-eight (55.4%) were found to be taking AP/AC medications. Ninety-six (57%) were male and 72 (43%) female. Aspirin use was 42.8 per cent (72 of 168), clopidogrel next (39 of 168 [23.0%]), and warfarin least (18 of 168 [10.7%]). One hundred sixty-six (98.8%) presented with significant findings on the first CT scan. Fourteen (87.5%) of the 16 patients with an INR 2.0 or higher presented with an ICH on the first CT. Ninety percent of patients with an INR 1.5 or higher presented with positive findings on the first CT scan. One hundred per cent of patients with an INR 3.0 or higher presented with an ICH on the first CT scan. The incidence of a delayed ICH was two of 168 (1.19%). Of those two patients with a delayed ICH, 100 per cent were taking warfarin and had an INR greater than 2.0. The incidence of delayed ICH was 1.19 per cent. The protocol requiring a second CT scan for all patients on AC/AP medications after a negative first CT scan should be questioned. For patients with blunt head trauma taking warfarin or a warfarin–aspirin combination, a repeat cranial CT scan after a negative initial CT is acceptable. For patients taking clopidogrel, a period of observation may be warranted.

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