ABSTRACT
Chronic subdural haematoma (CSDH) is predominantly a disease of the elderly. Most of the existing data come from studies done several decades ago. We examined the incidence, risk factors, clinical presentation, management and outcome in elderly patients with CSDH by retrospective study of the period 1996-1999 in the three district hospitals of North Wales. 40 cases of CSDH were identified in patients >65 years, the incidence in this population being 8.2/100,000. Falls (57%) and antithrombotic therapy (33%) were the most frequent risk factors. The most common presenting features were altered mental state (52%) and focal neurological deficit (50%). 24 patients (60%) underwent surgical intervention with 4 deaths (17%). In the non-operated group mortality was 7/16 (44%). Most of the deaths in this series were due either to CSDH or to the complications of frailty and poor mobility. Surgery itself was generally successful.
Subject(s)
Hematoma, Subdural, Chronic , Aged , Aged, 80 and over , Female , Hematoma, Subdural, Chronic/diagnostic imaging , Hematoma, Subdural, Chronic/epidemiology , Hematoma, Subdural, Chronic/mortality , Humans , Incidence , Male , Retrospective Studies , Risk Factors , Tomography, X-Ray Computed , Wales/epidemiologyABSTRACT
A 76 year old woman presented with a quadriparesis associated with hyperkalaemia. She had a 10 month history of treatment with oral diclofenac sodium. On admission she had hyperkalaemic metabolic acidosis with a normal anion gap and mild renal impairment. Her weakness resolved after withdrawal of diclofenac and medical correction of her hyperkalaemia. Non-steroidal anti-inflammatory drugs are known to cause hyperkalaemic acidosis and should be used with caution, especially in the presence of renal impairment.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Diclofenac/adverse effects , Hyperkalemia/chemically induced , Quadriplegia/chemically induced , Aged , Female , HumansABSTRACT
Medication-induced oesophageal injury is one of the least recognised side-effects of oral medication and, in contrast to other oesophageal pathologies, is rarely considered in the differential diagnosis of chest pain. We describe a case of medication-induced oesophageal injury with a rare complication in which the diagnosis was not considered until the characteristic features were demonstrated at endoscopy.