1/8. Spinal epidural haematoma as a result of warfarin/fluconazole drug interaction.This is the first reported case in the emergency medicine literature of a drug interaction between warfarin and fluconazole. We present a case of spinal epidural haematoma and summarize four other case reports reported elsewhere from 1988 to 1996. We admonish emergency physicians to be aware of this dangerous drug combination. warfarin and fluconazole are frequently encountered drugs in the emergency department and thus any interaction between these drugs is of considerable importance.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/8. Minor head injury.The evaluation and treatment of minor head injuries are reviewed, with particular emphasis on those problems of head injury commonly seen by family physicians. Clinical history, physical examination, and radiologic studies that are of value in diagnosing minor head injuries are highlighted.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/8. Acute epidural hematoma of the cervical spine: an unusual cause of neck pain.Cervical spinal epidural hematoma is an unusual neurosurgical disorder that usually requires emergent surgical decompressive therapy. We report the case of an 85-year-old woman with acute, severe neck and shoulder pain with progressive neurologic deficits. A computed tomography scan of the neck revealed an acute cervical spinal epidural hematoma. This case involves an unusual cause of neck pain in an elderly patient with no history of trauma. It is incumbent on the emergency physician to recognize this disorder and arrange emergent neurosurgical consultation to ensure an optimal outcome. Further, the differential diagnosis of neck pain and progressive neurologic findings should include this entity.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/8. Dangerous sequelae of epidural anesthesia in geriatrics.These three cases demonstrate: (1) an epidural hematoma (case three); (2) a probable anterior spinal artery occlusion (case two); and (3) a low cord damage of obscure nature (case one). Three serious neurological sequelae after epidural anesthesia among the operated patients of one physician seems alarming. The three occurred within two years. These are published to direct attention to potential risks from epidural anesthesia in older patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/8. multiple trauma in the achondroplastic dwarf: an emergency medicine physician perspective case report and literature review.Although uncommon, the achondroplastic dwarf (AD) may become the victim of multiple trauma, presenting special challenges for the emergency department (ED) physician. Traditional management of airway, breathing, circulation, and neurological disability is altered by the unique anatomic features of achondroplasia. Despite facial abnormalities observed in the AD, orotracheal and nasotracheal intubation are usually accomplished without particular difficulty; however, abnormalities of the base of the skull and cervical spine make hyperextension of the neck especially hazardous in these patients. The lungs are functionally normal, although vital capacity is decreased and thoracic case abnormalities and abdominal obesity impair lung expansion. Vascular access in the AD is difficult. Peripheral access is difficult because of excessive subcutaneous fat, whereas central venous access is complicated by neck, chest wall, and spinal abnormalities that obscure commonly used anatomic landmarks. Major neurological syndromes observed in ADs are hydrocephalus, cervical medullary compression, and thoracolumbar stenosis. The ED physician should recognize these syndromes, their potential to produce neurological disability, and their unique implications for trauma.- - - - - - - - - - ranking = 6keywords = physician (Clic here for more details about this article) |
6/8. Spinal epidural hematoma with subarachnoid hemorrhage caused by acupuncture.Unintentional acupuncture needling of the thoracic spinal canal produced a spinal epidural hematoma and subarachnoid hemorrhage. This case demonstrates that patients are sometimes reluctant to disclose folk medical treatments to Western physicians, and the proper diagnosis may depend upon the prowess of the neuroradiologist.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/8. Spontaneous cervicothoracic epidural hematoma following prolonged valsalva secondary to trumpet playing.Spontaneous spinal epidural hematoma is an uncommon clinical entity. patients with this disease may present with devastating neurological deficits that can mimic other diseases. Emergency physicians should be familiar with this condition to assure appropriate therapy in a timely manner. A typical case of spontaneous spinal epidural hematoma is presented with review of appropriate differential diagnosis and management.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/8. Bacterial meningitis and lumbar epidural hematoma due to lumbar acupunctures: a case report.A 48-year-old female expressed signs of meningeal irritation after having received several lumbar acupunctures within one week for back pain. Bacterial meningitis was diagnosed from cerebrospinal fluid examinations. Magnetic resonance image (MRI) of spine at admission demonstrated a fusiform lesion with characters of subacute hematoma in the epidural space of the first and second lumbar level. She received antibiotics treatment only and recovered from her central nervous system infection completely. The epidural lesion disappeared spontaneously in the MRI follow up three weeks later. We report the diagnosis and follow-up of epidural hematoma of the lumbar spine by MRI which aided the medical physician to treat meningitis attentively.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |