ABSTRACT
Tension pneumocephalus is the presence of air within the cranial vault compressing the ventricles and the brain parenchyma. High altitudes can exacerbate this problem, especially when a dural defect exists and air is forced into the cranial cavity with no way to escape. This case demonstrates a rare presentation of thoracic trauma causing tension pneumocephalus due to emergent air evacuation.
ABSTRACT
Pulmonary arteriovenous malformations (PAVMs) are a rare cause of pulmonary symptoms, including dyspnoea on exertion, hypoxemia and haemoptysis. PAVMs are an aetiology that is often overlooked by physicians when developing a differential diagnosis for pulmonary symptoms and unidentified lung masses. However, it is an important differential diagnosis to have as PAVMs can have serious sequelae including strokes, brain abscess and life-threatening bleeding. We present a case of an impressive PAVM presenting with chest pain, chronic cough, feelings of anxiety, mild resting hypoxemia and exertional hypoxemia. Of note, on previous chest X-ray, 8 years prior to presentation, an incidental mass was found during a shoulder repair presurgical workup but not further evaluated.
Subject(s)
Pulmonary Artery/abnormalities , Pulmonary Veins/abnormalities , Adult , Arteriovenous Fistula/diagnostic imaging , Computed Tomography Angiography , Dyspnea/etiology , Exercise Test/methods , Humans , Male , Physical Exertion/physiology , Pulmonary Artery/diagnostic imaging , Pulmonary Veins/diagnostic imagingSubject(s)
Bronchopulmonary Dysplasia/complications , Bronchopulmonary Dysplasia/diagnostic imaging , Granuloma/pathology , Adult , Bronchopulmonary Dysplasia/pathology , Female , Humans , Pulmonary Emphysema/diagnostic imaging , Pulmonary Emphysema/etiology , Respiration, Artificial/adverse effects , Respiratory Distress Syndrome, Newborn/complications , Respiratory Distress Syndrome, Newborn/therapy , Tomography, X-Ray Computed/methodsABSTRACT
The development of vaccines ushered in the most profound advancement in 20th century medicine, and have widely been regarded as the one of the most important scientific discovery in the history of mankind. However, vaccines are not without risk; reactions can range from injection site reactions to life-threatening anaphylaxis. Among the more serious vaccine-related sequela is myocarditis. Although myocarditis has been reported following many different vaccines, the smallpox vaccine has the strongest association. We report a case of a 36-year-old active duty service member presenting with progressive dyspnoea, substernal chest pain and lower extremity swelling 5 weeks after receiving the vaccinia vaccination. The aetiology of his acute decompensated heart failure was determined to be from myocarditis. Although the majority of cases of myocarditis resolve completely, some patients develop chronic heart failure and even death. Vaccine-associated myocarditis should always be on the differential for patients that exhibit cardiopulmonary symptoms after recent vaccinations.
Subject(s)
Military Personnel , Myocarditis/diagnosis , Smallpox Vaccine/adverse effects , Vaccination/adverse effects , Adult , Diagnosis, Differential , Humans , Magnetic Resonance Imaging, Cine , Male , Myocarditis/chemically induced , Myocarditis/diagnostic imagingABSTRACT
Renal infarction is a rare occurrence accounting for 0.007% of patients seen in the emergency department for renal insufficiency or hypertension. Dysfibrinogenemia is also rare, and the combination of renal artery infarct in the setting of congenital dysfibrinogenemia has not been described in the literature. Our patient, with a remote history of congenital dysfibrinogenemia with no known haemorrhagic or thrombotic complications, presented with acute flank pain and was subsequently diagnosed with an acute renal arterial infarction. He was treated with subcutaneous enoxaparin and then transitioned to lifelong anticoagulation with rivaroxaban therapy.
Subject(s)
Afibrinogenemia/diagnosis , Flank Pain/diagnostic imaging , Infarction/pathology , Kidney/blood supply , Renal Artery/pathology , Adult , Afibrinogenemia/complications , Afibrinogenemia/drug therapy , Anticoagulants/therapeutic use , Computed Tomography Angiography , Diagnosis, Differential , Enoxaparin/administration & dosage , Enoxaparin/therapeutic use , Factor Xa Inhibitors/therapeutic use , Flank Pain/diagnosis , Flank Pain/etiology , Humans , Infarction/drug therapy , Infarction/etiology , Injections, Subcutaneous , Kidney/pathology , Male , Rare Diseases , Renal Artery/diagnostic imaging , Rivaroxaban/therapeutic use , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The compounds fac-(κ(3)-PDP)Mo(CO)(3) {1; PDP = 2-[[2-(1-(pyridin-2-ylmethyl)pyrrolidin-2-yl)pyrrolidin-1-yl]methyl]pyridine}, [(cis-ß-PDP)Mo(NO)(CO)]PF(6) ([cis-ß-3]PF(6)), [(cis-α-PDP)Mo(NO)(CO)]PF(6) ([cis-α-3]PF(6)), [(cis-α-PDP)Mo(NO)Br]PF(6) ([4]PF(6)), [(trans-PDP)Cu](BF(4))(2)·CH(3)CN ([5](BF(4))(2)·CH(3)CN), and [(trans-PDP)Cu](OSO(2)CF(3))(2) ([5](OSO(2)CF(3))(2)) have been synthesized and structurally characterized by single-crystal X-ray diffraction. These are the first reported complexes of PDP on metal centers other than iron(II). The observed configurations indicate a broader range of accessible PDP topologies than has been reported. The {(cis-α-PDP)Mo(NO)}(+) fragment is found to be less π-basic than the dearomatizing {Tp(MeIm)Mo(NO)} fragment [Tp = hydridotris(1-pyrazolyl)borato; MeIm = 1-methylimidazole].
