Hemorrhagic cardioembolic stroke secondary to a left ventricular thrombus: a therapeutic dilemma

Cardiogenic embolism is a major cause of stroke and often leads to significant morbidity and mortality. Despite the recent advances in our understanding of the pathophysiology of stroke and its risk factors, diagnosis and therapy; some case scenarios still present a real challenge for the treating physicians. We report a case of a 50 year old male patient presenting with multi-territory cerebral infarctions due to a left ventricular mobile thrombus complicated with hemorrhagic transformation at the time of presentation. Gradual introduction of anticoagulation coupled with a multidisciplinary team approach advocating careful daily clinical assessment of the patient and regular echocardiographic and neuroimaging studies have resulted in a better management and achievement of therapeutic goals

case of Crimean-Congo hemorrhagic fever in Oman

In the summer of June 2011, the first case of Crimean-Congo hemorrhagic fever [CCHF] was observed in Oman since the last fifteen years. The first blood sample using reverse transcriptase polymerase chain reaction [PCR] test were sent looking for CCHF, tick-borne encephalitis, dengue, Japanese encephalitis, Chikungunya and West Nile. All resulted as negative. The repeated serology for CCHF came strongly positive after five days from the initial negative test, and accordingly patient started on ribavirin and he responded to it. His condition improved dramatically