Chun Chau Tan, Nursyazana NAZEE MUDEEN, Munirah Osman
Blunt thoracic trauma carries a high risk of morbidity and mortality and may be life-threatening. Clinical identification of a tension pneumothorax necessitates immediate decompression. Diagnosing a diaphragmatic hernia in a trauma context is challenging and rather uncommon. Should both pathologies coexist, there is potential bowel perforation due to thoracocentesis. A traumatic chest injury can complicate patients with a congenital diaphragmatic hernia who are asymptomatic. Early identification with clinical assessment and bedside ultrasound is essential, and surgical repair is the definitive management. We report a case of traumatic left tension pneumothorax, prompting an immediate left thoracostomy and an incidental finding of an uncomplicated congenital diaphragmatic hernia.
{"title":"Traumatic Left Tension Pneumothorax with Concomitant Congenital Diaphragmatic Hernia","authors":"Chun Chau Tan, Nursyazana NAZEE MUDEEN, Munirah Osman","doi":"10.33706/jemcr.1326209","DOIUrl":"https://doi.org/10.33706/jemcr.1326209","url":null,"abstract":"Blunt thoracic trauma carries a high risk of morbidity and mortality and may be life-threatening. Clinical identification of a tension pneumothorax necessitates immediate decompression. Diagnosing a diaphragmatic hernia in a trauma context is challenging and rather uncommon. Should both pathologies coexist, there is potential bowel perforation due to thoracocentesis. A traumatic chest injury can complicate patients with a congenital diaphragmatic hernia who are asymptomatic. Early identification with clinical assessment and bedside ultrasound is essential, and surgical repair is the definitive management. We report a case of traumatic left tension pneumothorax, prompting an immediate left thoracostomy and an incidental finding of an uncomplicated congenital diaphragmatic hernia.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":"50 43","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138587971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osman Beydüz, Abdul Samet Şahi̇n, Ragıp Kadi, Muhammet Fatih Beşer
Introduction: Superior vena cava (SVC) syndrome is a rare but serious condition resulting from obstruction of the superior vena cava or its tributaries. Although often associated with malignancy, it can also occur due to central venous catheterization(1). Acute SVC syndrome following catheter removal is uncommon. Case Report: We present a 35-year-old hemodialysis patient with a history of central venous catheterization for hemodialysis one year prior. During a routine hemodialysis session, the patient developed symptoms of shortness of breath, neck swelling, and cyanosis of the lips. Physical examination revealed neck edema and prominent superficial vascular bifurcations. Without imaging studies, it was confused with cellulitis, but CT angiography later confirmed SVC thrombosis. The patient was started on anticoagulation and transferred to a tertiary hospital for further management. Conclusion: Emergency physicians should be aware of SVC syndrome, especially in hemodialysis patients with a history of central venous catheterization. Although it is often associated with malignancy, this case highlights the importance of considering SVC thrombosis even after catheter removal. Prompt diagnosis and appropriate management are essential to prevent life-threatening complications. Therefore, recognition and inclusion of SVC syndrome in the differential diagnosis is essential for timely intervention and improved patient outcomes.
{"title":"Superior Vena Cava Thrombosis in A Young Hemodialysis Patient After 1 year of Central Venous Catheter Removal: A Case Report","authors":"Osman Beydüz, Abdul Samet Şahi̇n, Ragıp Kadi, Muhammet Fatih Beşer","doi":"10.33706/jemcr.1389895","DOIUrl":"https://doi.org/10.33706/jemcr.1389895","url":null,"abstract":"Introduction: \u0000Superior vena cava (SVC) syndrome is a rare but serious condition resulting from obstruction of the superior vena cava or its tributaries. Although often associated with malignancy, it can also occur due to central venous catheterization(1). Acute SVC syndrome following catheter removal is uncommon. \u0000Case Report: \u0000We present a 35-year-old hemodialysis patient with a history of central venous catheterization for hemodialysis one year prior. During a routine hemodialysis session, the patient developed symptoms of shortness of breath, neck swelling, and cyanosis of the lips. Physical examination revealed neck edema and prominent superficial vascular bifurcations. Without imaging studies, it was confused with cellulitis, but CT angiography later confirmed SVC thrombosis. The patient was started on anticoagulation and transferred to a tertiary hospital for further management. \u0000Conclusion: \u0000Emergency physicians should be aware of SVC syndrome, especially in hemodialysis patients with a history of central venous catheterization. Although it is often associated with malignancy, this case highlights the importance of considering SVC thrombosis even after catheter removal. Prompt diagnosis and appropriate management are essential to prevent life-threatening complications. Therefore, recognition and inclusion of SVC syndrome in the differential diagnosis is essential for timely intervention and improved patient outcomes.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":"40 15","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138588483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Baycan Kuş, Necmi Baykan, Ömer Salt, Serhat Koyuncu, A. Akan
Abstract Introduction: Trapdoor fracture also known as, ‘White-eyed blowout fracture’’ is generally seen among pediatric patients with orbital floor blowout fracture. Case Report: It is presented as ‘’open door fracture’’ in adults because of the mineralized, fragile orbital bones. An 11-year-old boy was admitted to the emergency department (ED) because of falling and hitting his on the occipital region. His main complaint was diplopia. He did not have nausea or pain. No visible lesion detected on his head. When the orbital CT scan was examined carefully, a fracture of the right orbital floor and herniation of orbital soft tissue was noticed. The patient was transferred to the plastic surgery department for surgical intervention. Conclusion: Even though there is no direct trauma, or visible pathology around orbital region, emergency physiscians should keep in mind trapdoor fracture, especially in pediatric patients with head trauma.
{"title":"A RARE ENTITY IN EMERGENCY DEPARTMENT: TRAPDOOR FRACTURE","authors":"Baycan Kuş, Necmi Baykan, Ömer Salt, Serhat Koyuncu, A. Akan","doi":"10.33706/jemcr.1383140","DOIUrl":"https://doi.org/10.33706/jemcr.1383140","url":null,"abstract":"Abstract \u0000Introduction: Trapdoor fracture also known as, ‘White-eyed blowout fracture’’ is generally seen among pediatric patients with orbital floor blowout fracture. \u0000Case Report: It is presented as ‘’open door fracture’’ in adults because of the mineralized, fragile orbital bones. An 11-year-old boy was admitted to the emergency department (ED) because of falling and hitting his on the occipital region. His main complaint was diplopia. He did not have nausea or pain. No visible lesion detected on his head. When the orbital CT scan was examined carefully, a fracture of the right orbital floor and herniation of orbital soft tissue was noticed. The patient was transferred to the plastic surgery department for surgical intervention. \u0000Conclusion: Even though there is no direct trauma, or visible pathology around orbital region, emergency physiscians should keep in mind trapdoor fracture, especially in pediatric patients with head trauma.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":"15 7","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138984270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTION In electric shocks, lung tissue is a poor conductor and has low resistance. Therefore, they are not very sensitive to the development of tissue damage due to electric current. In this study, we wanted to present a rare case of lung parenchymal burn as a result of electric shock. CASE REPORT A 21-year-old male patient was brought to the emergency department by ambulance after being electrocuted with a current of 15,000 volts after contact with a high voltage line while working with a construction machine. The general condition of the patient was good and vital signs were stable. However, his pulse oxygen value was 74 and his breathing was slightly tachypneic. There were no lesions in the chest and abdomen due to electrical burns. Radiologic imaging showed bilateral diffuse tissue damage in the lung tissue. The patient was referred to a tertiary care institution with an intensive care burn unit. CONCLUSION In traumas caused by high-voltage electric shock, burns on the body surface may be insufficient to determine the severity of the trauma. A multidisciplinary approach must be provided to these patients
{"title":"LUNG PARENCHYMAL DAMAGE DUE TO HIGH VOLTAGE ELECTRIC SHOCK","authors":"Mustafa Alpaslan, Mehmet Oktay, Ercan Kiliç","doi":"10.33706/jemcr.1370569","DOIUrl":"https://doi.org/10.33706/jemcr.1370569","url":null,"abstract":"INTRODUCTION \u0000In electric shocks, lung tissue is a poor conductor and has low resistance. Therefore, they are not very sensitive to the development of tissue damage due to electric current. In this study, we wanted to present a rare case of lung parenchymal burn as a result of electric shock. \u0000CASE REPORT \u0000A 21-year-old male patient was brought to the emergency department by ambulance after being electrocuted with a current of 15,000 volts after contact with a high voltage line while working with a construction machine. The general condition of the patient was good and vital signs were stable. However, his pulse oxygen value was 74 and his breathing was slightly tachypneic. There were no lesions in the chest and abdomen due to electrical burns. Radiologic imaging showed bilateral diffuse tissue damage in the lung tissue. The patient was referred to a tertiary care institution with an intensive care burn unit. \u0000CONCLUSION \u0000In traumas caused by high-voltage electric shock, burns on the body surface may be insufficient to determine the severity of the trauma. A multidisciplinary approach must be provided to these patients","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":"19 2","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138984529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Songül Tomar Güneysu, Mehmet ali Aslaner, Okşan DERİNÖZ-GÜLERYÜZ
Sternal fractures are extremely rare in children. It often develops after high-energy chest trauma. Many methods other than ultrasonography are used in the diagnosis of sternal fractures. However, Point-of-care ultrasound (POCUS) can outperform other methods due to its ease of use, less radiation and fast results. A thirteen-year-old male patient was brought due to chest pain that started after blunt chest trauma after falling from a height. In her initial evaluation in the trauma room, the patient's respiratory and cardiovascular examinations were found to be normal. On palpation, there was local tenderness in the middle 1/3 of the sternum. No pathology was detected in E-FAST. The portable chest radiograph was normal. POCUS was performed after the patient did not respond to analgesic treatment and had local sensitivity on the sternum. A sternal fracture was detected. Suspicious cortical irregularity was detected in repeated chest X-ray and thorax CT was reported as normal. When CT was re-evaluated, a wet tree fracture was observed in the sternum body. The patient was discharged without any complications. In this article, the importance of diagnosing a sternal fracture case whose computed tomography was reported as normal with POCUS and integrating rapid, noninvasive and radiation-free ultrasonography into the physical examination will be discussed in the management of these patients.
{"title":"Detection of Sternum Fracture with POCUS Despite Normal Computed Tomography Findings: A Case Report","authors":"Songül Tomar Güneysu, Mehmet ali Aslaner, Okşan DERİNÖZ-GÜLERYÜZ","doi":"10.33706/jemcr.1311287","DOIUrl":"https://doi.org/10.33706/jemcr.1311287","url":null,"abstract":"Sternal fractures are extremely rare in children. It often develops after high-energy chest trauma. Many methods other than ultrasonography are used in the diagnosis of sternal fractures. However, Point-of-care ultrasound (POCUS) can outperform other methods due to its ease of use, less radiation and fast results. A thirteen-year-old male patient was brought due to chest pain that started after blunt chest trauma after falling from a height. In her initial evaluation in the trauma room, the patient's respiratory and cardiovascular examinations were found to be normal. On palpation, there was local tenderness in the middle 1/3 of the sternum. No pathology was detected in E-FAST. The portable chest radiograph was normal. POCUS was performed after the patient did not respond to analgesic treatment and had local sensitivity on the sternum. A sternal fracture was detected. Suspicious cortical irregularity was detected in repeated chest X-ray and thorax CT was reported as normal. When CT was re-evaluated, a wet tree fracture was observed in the sternum body. The patient was discharged without any complications. In this article, the importance of diagnosing a sternal fracture case whose computed tomography was reported as normal with POCUS and integrating rapid, noninvasive and radiation-free ultrasonography into the physical examination will be discussed in the management of these patients.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":"48 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139247290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract:
Introduction: Distal renal tubular acidosis (dRTA) is a metabolic disease characterized by hypokalemia, hyperchloremic metabolic acidosis and urine pH above 5.5. These findings may be accompanied by hypercalciuria, nephrocalcinosis, nephrolithiasis, jaundice, osteomalacia or rickets in children. Although hypokalemia is frequently seen as a laboratory finding in dRTA, weakness, which is the clinical finding of this deficiency, is rare.
Case Report: A 33-year-old female patient was brought to the emergency department (ED) with complaints of weakness, loss of strength in the extremities, and difficulty in breathing. Laboratory analyzes of the patient revealed metabolic acidosis and hypokalemia. Urea and creatinine values were normal. The patient was admitted to the internal medicine department with a preliminary diagnosis of dRTA and hypokalemic paralysis. Initially, parenteral infusion of KCl and NaHCO3 was administered in the treatment. In the follow-up of the patient, it was observed that hypokalemia and metabolic acidosis improved from the 3rd day and clinical findings improved within 36 hours following the replacement therapy.
Conclusion: dRTA, which is rare in adults, is among the secondary causes of hypokalemic paralysis. dRTA should be considered among the differential diagnoses in the presence of hypokalemia and metabolic acidosis in patients presenting with bilateral weakness.
References:
1-Ahlavat SK, Sachdev A: Hypokalaemic Paralysis. Postgrad Med J. 1999; 75(882):193-7. Doi: 10.1136/pgmj.75.882.193.
2-Batlle D, Kurtzman NA. Distal renal tubular acidosis: pathogenesis and classification. Am J Kidney Dis. 1982; 1:328-344. Doi: 10.1016/s0272-6386(82)80004-8.
3-Koç F, Bozdemir H. Hypokalemic periodic paralysis due to renal tubular acidosis. Ege Tıp Dergisi, 2004; 43 (1): 47–50.
4-De Silva HJ, Senanayake N. Hypokalemic Periodic Paralysis in Central Sri Lanka. Ceyloh Med J. 1994; 39(3):135-137.
5-Emektar E. Acute hyperkalemia in adults. Turk J Emerg Med. 2023; 23 (2), 75. Doi: 10.4103/tjem.tjem_288_22.
6- Aygencel G, Karamercan A, Akinci E, Demircan A, Akeles A. Metabolic syndrome and its association with ischemic cerebrovascular disease. Adv Ther. 2006;23(3):495-501. doi:10.1007/BF02850171
7- Latorre R, Purroy F. Parálisis periódica hipocaliémica: revisión sistemática de casos publicados [Hypokalemic periodic paralysis: a systematic review of published case reports]. Rev Neurol. 2020;71(9):317-325. doi:10.33588/rn.7109.2020377.
8-Tierney LM, McPhee SJ, Papadakis MA: CURRENT Medical Diagnosis & Treatment 39th Edition, USA: Lange Medical Books/McGraw- Hill; 2000. p866-868.
9- Alkaabi JM, Mushtaq A, Al-Maskari FN, Moussa NA, Gariballa S. Hypokalemic periodic paralysis: a case series, review of the literature and update of management. Eur J Emerg Med. 2010;17(1):45-47. doi:10.1097/mej.0b013e32832d6436
10- Goransson LG, Apeland T, Omdal R: Hypokalem
{"title":"HYPOKALEMIC PARALYSIS DUE TO DISTAL RENAL TUBULAR ACIDOSIS, CASE REPORT","authors":"Fatma Nur KARAARSLAN","doi":"10.33706/jemcr.1310866","DOIUrl":"https://doi.org/10.33706/jemcr.1310866","url":null,"abstract":"Abstract:
 Introduction: Distal renal tubular acidosis (dRTA) is a metabolic disease characterized by hypokalemia, hyperchloremic metabolic acidosis and urine pH above 5.5. These findings may be accompanied by hypercalciuria, nephrocalcinosis, nephrolithiasis, jaundice, osteomalacia or rickets in children. Although hypokalemia is frequently seen as a laboratory finding in dRTA, weakness, which is the clinical finding of this deficiency, is rare. 
 Case Report: A 33-year-old female patient was brought to the emergency department (ED) with complaints of weakness, loss of strength in the extremities, and difficulty in breathing. Laboratory analyzes of the patient revealed metabolic acidosis and hypokalemia. Urea and creatinine values were normal. The patient was admitted to the internal medicine department with a preliminary diagnosis of dRTA and hypokalemic paralysis. Initially, parenteral infusion of KCl and NaHCO3 was administered in the treatment. In the follow-up of the patient, it was observed that hypokalemia and metabolic acidosis improved from the 3rd day and clinical findings improved within 36 hours following the replacement therapy.
 Conclusion: dRTA, which is rare in adults, is among the secondary causes of hypokalemic paralysis. dRTA should be considered among the differential diagnoses in the presence of hypokalemia and metabolic acidosis in patients presenting with bilateral weakness.
 References:
 1-Ahlavat SK, Sachdev A: Hypokalaemic Paralysis. Postgrad Med J. 1999; 75(882):193-7. Doi: 10.1136/pgmj.75.882.193.
 2-Batlle D, Kurtzman NA. Distal renal tubular acidosis: pathogenesis and classification. Am J Kidney Dis. 1982; 1:328-344. Doi: 10.1016/s0272-6386(82)80004-8.
 3-Koç F, Bozdemir H. Hypokalemic periodic paralysis due to renal tubular acidosis. Ege Tıp Dergisi, 2004; 43 (1): 47–50.
 4-De Silva HJ, Senanayake N. Hypokalemic Periodic Paralysis in Central Sri Lanka. Ceyloh Med J. 1994; 39(3):135-137.
 5-Emektar E. Acute hyperkalemia in adults. Turk J Emerg Med. 2023; 23 (2), 75. Doi: 10.4103/tjem.tjem_288_22.
 6- Aygencel G, Karamercan A, Akinci E, Demircan A, Akeles A. Metabolic syndrome and its association with ischemic cerebrovascular disease. Adv Ther. 2006;23(3):495-501. doi:10.1007/BF02850171
 7- Latorre R, Purroy F. Parálisis periódica hipocaliémica: revisión sistemática de casos publicados [Hypokalemic periodic paralysis: a systematic review of published case reports]. Rev Neurol. 2020;71(9):317-325. doi:10.33588/rn.7109.2020377.
 8-Tierney LM, McPhee SJ, Papadakis MA: CURRENT Medical Diagnosis & Treatment 39th Edition, USA: Lange Medical Books/McGraw- Hill; 2000. p866-868.
 9- Alkaabi JM, Mushtaq A, Al-Maskari FN, Moussa NA, Gariballa S. Hypokalemic periodic paralysis: a case series, review of the literature and update of management. Eur J Emerg Med. 2010;17(1):45-47. doi:10.1097/mej.0b013e32832d6436
 10- Goransson LG, Apeland T, Omdal R: Hypokalem","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":"46 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136347920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Haemodialysis is an essential life-saving procedure for persons suffering from kidney failure. Haemodialysis is usually aceived by central venous catheterization. Neck hornformation is one of the most serious and seldom complications of the procedure.
Case Report: A haemodialysis catheter was placed in a 43-year-old man's right internal jugular vein after his arteriovenous fistula failed. After having the catheter removed, a neck horn developed at the puncture site. Horn resection and thrombus evacuation were the surgical treatment methods used.
Conclusion: Neck horn following an internal jugular catheter insertion might be dangerous if left untreated. The horn and thrombus are best removed surgically and treated with antibiotics.
{"title":"Neck Horn Formation After Jugular Vein Catheterization For Haemodialysis: Case Report","authors":"Mohammad ALŞALALDEH","doi":"10.33706/jemcr.1241766","DOIUrl":"https://doi.org/10.33706/jemcr.1241766","url":null,"abstract":"Background: Haemodialysis is an essential life-saving procedure for persons suffering from kidney failure. Haemodialysis is usually aceived by central venous catheterization. Neck hornformation is one of the most serious and seldom complications of the procedure.
 Case Report: A haemodialysis catheter was placed in a 43-year-old man's right internal jugular vein after his arteriovenous fistula failed. After having the catheter removed, a neck horn developed at the puncture site. Horn resection and thrombus evacuation were the surgical treatment methods used.
 Conclusion: Neck horn following an internal jugular catheter insertion might be dangerous if left untreated. The horn and thrombus are best removed surgically and treated with antibiotics.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":"22 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135935506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract
Vitreous hemorrhage associated with subarachnoid hemorrhage is known as Terson's Syndrome (TS). However, it is also seen in the literature in cases of traumatic brain injury or intracranial hemorrhage. Management of visual manifestations is necessary in patients with intracranial hemorrhage.
A vitreous hemorrhage was found in the evaluation made due to visual symptoms in a patient who presented to the emergency department with intracranial hemorrhage. In addition to clinical findings, imaging techniques have an important place in the diagnosis of TS. Vitreous hemorrhage findings can be detected with imaging studies such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI).
In this case, the diagnostic findings and the importance of diagnosis in CT and MRI examinations in a patient with TS will be discussed. The purpose of this case report is to share the imaging findings of TS.
References
1. Fahmy JA. Vitreous haemorrhage in subarachnoid haemorrhage - Terson’s syndrome: report of a case with macular degeneration as a complication. Acta Ophthalmologica 2009; 50:137–143.
2. Issiaka M, Mchachi A, Rachid R, Belhadji MEL, Mahazou I, Banao M. Terson syndrome: two case reports. International Journal of Surgery Case Reports 2022; 90:106700.
3. Czorlich P, Skevas C, Knospe V et al. Terson syndrome in subarachnoid hemorrhage, intracerebral hemorrhage, and traumatic brain injury. Neurosurg Rev 2015; 38:129–136.
4. Fountas KN, Kapsalaki EZ, Lee GP et al. Terson hemorrhage in patients suffering aneurysmal subarachnoid hemorrhage: predisposing factors and prognostic significance. JNS 2008; 109:439–444.
5. Frizzell RT, Morris R. Screening for ocular hemorrhages in patients with ruptured cerebral aneurysms: a prospective study of 99 patients. 1997; 41:6.
6. Manschot WA. Subarachnoid hemorrhage. American Journal of Ophthalmology 1954; 38:501–505.
7. Iuliano L, Fogliato G, Codenotti M. Intrasurgical imaging of subinternal limiting membrane blood diffusion in Terson syndrome. Case Reports in Ophthalmological Medicine 2014; 2014:1–3.
8. Czorlich P, Burkhardt T, Knospe V et al. Ocular ultrasound as an easy applicable tool for detection of Terson’s syndrome after aneurysmal subarachnoid hemorrhage. PLoS ONE 2014; 9:e114907.
9. Kapoor S. Terson syndrome: an often overlooked complication of subarachnoid hemorrhage. World Neurosurgery 2014; 81:e4.
摘要# x0D;玻璃体出血合并蛛网膜下腔出血称为Terson综合征(TS)。然而，在文献中也可以看到外伤性脑损伤或颅内出血的病例。对颅内出血患者的视觉表现进行处理是必要的。& # x0D;我们在对一位颅内出血患者的视觉症状进行评估时发现玻璃体出血。除了临床表现外，影像学技术在TS的诊断中也占有重要的地位，玻璃体出血的表现可以通过影像学检查如计算机断层扫描(CT)和磁共振成像(MRI)来检测。& # x0D;在本病例中，我们将讨论TS患者的CT和MRI检查的诊断结果和诊断的重要性。本病例报告的目的是分享TS的影像学表现。
& # x0D;引用# x0D;1. Fahmy农协。蛛网膜下腔出血中的玻璃体出血- Terson综合征:黄斑变性并发症1例报告。眼科学报;2009;本市50:137 - 143 # x0D;2. Issiaka M, Mchachi A, Rachid R, Belhadji MEL, Mahazou I, Banao M. Terson综合征2例报告国际外科病例报告杂志2022;90:106700强生# x0D;3.赵建军，李建军，李建军，等。Terson综合征在蛛网膜下腔出血、脑出血和外伤性脑损伤中的表现。neurosurgery Rev 2015;本市38:129 - 136 # x0D;4. Fountas KN, Kapsalaki EZ, Lee GP等。动脉瘤性蛛网膜下腔出血患者的特森出血:易感因素及预后意义。俊仕2008;本市109:439 - 444 # x0D;5. 李建平，李建平。脑动脉瘤破裂患者眼出血的筛查:一项前瞻性研究。1997;41:6强生# x0D;6. Manschot佤邦。蛛网膜下腔出血。美国眼科杂志，1954;本市38:501 - 505 # x0D;7. 刘建军，张建军，张建军，等。Terson综合征的手术内显像分析。2014年眼科病例报告;2014:1-3强生# x0D;8. 赵建军，李建军，李建军，等。眼超声作为动脉瘤性蛛网膜下腔出血后Terson综合征的一种简便易行的检测手段。PLoS ONE 2014;9: e114907强生# x0D;9. Kapoor S. Terson综合征:一种经常被忽视的蛛网膜下腔出血并发症。2014世界神经外科学;81: e4。
{"title":"An Intracranial Hemorrhage Complication : Terson Syndrome","authors":"Muhammet İkbal IŞIK, Ferhat CUCE, Mustafa TAŞAR","doi":"10.33706/jemcr.1312185","DOIUrl":"https://doi.org/10.33706/jemcr.1312185","url":null,"abstract":"Abstract
 Vitreous hemorrhage associated with subarachnoid hemorrhage is known as Terson's Syndrome (TS). However, it is also seen in the literature in cases of traumatic brain injury or intracranial hemorrhage. Management of visual manifestations is necessary in patients with intracranial hemorrhage. 
 A vitreous hemorrhage was found in the evaluation made due to visual symptoms in a patient who presented to the emergency department with intracranial hemorrhage. In addition to clinical findings, imaging techniques have an important place in the diagnosis of TS. Vitreous hemorrhage findings can be detected with imaging studies such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). 
 In this case, the diagnostic findings and the importance of diagnosis in CT and MRI examinations in a patient with TS will be discussed. The purpose of this case report is to share the imaging findings of TS.
 
 References
 1. Fahmy JA. Vitreous haemorrhage in subarachnoid haemorrhage - Terson’s syndrome: report of a case with macular degeneration as a complication. Acta Ophthalmologica 2009; 50:137–143.
 2. Issiaka M, Mchachi A, Rachid R, Belhadji MEL, Mahazou I, Banao M. Terson syndrome: two case reports. International Journal of Surgery Case Reports 2022; 90:106700.
 3. Czorlich P, Skevas C, Knospe V et al. Terson syndrome in subarachnoid hemorrhage, intracerebral hemorrhage, and traumatic brain injury. Neurosurg Rev 2015; 38:129–136.
 4. Fountas KN, Kapsalaki EZ, Lee GP et al. Terson hemorrhage in patients suffering aneurysmal subarachnoid hemorrhage: predisposing factors and prognostic significance. JNS 2008; 109:439–444.
 5. Frizzell RT, Morris R. Screening for ocular hemorrhages in patients with ruptured cerebral aneurysms: a prospective study of 99 patients. 1997; 41:6.
 6. Manschot WA. Subarachnoid hemorrhage. American Journal of Ophthalmology 1954; 38:501–505.
 7. Iuliano L, Fogliato G, Codenotti M. Intrasurgical imaging of subinternal limiting membrane blood diffusion in Terson syndrome. Case Reports in Ophthalmological Medicine 2014; 2014:1–3.
 8. Czorlich P, Burkhardt T, Knospe V et al. Ocular ultrasound as an easy applicable tool for detection of Terson’s syndrome after aneurysmal subarachnoid hemorrhage. PLoS ONE 2014; 9:e114907.
 9. Kapoor S. Terson syndrome: an often overlooked complication of subarachnoid hemorrhage. World Neurosurgery 2014; 81:e4.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136114225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT
Introduction: Juniper Tar has been utilized in traditional folk medicine to treat various ailments. Despite its historical use, documented cases are scarce regarding the potential complications associated with Juniper Tar, some of which have been fatal.
Case Report: A 62-year-old male patient with no previous medical history presented to the emergency department complaining of confusion and respiratory distress after drinking a glass of Juniper Tar approximately four hours ago. The patient, who experienced multiple seizures and cardiac arrest at the emergency department, was discharged after an 11-day intensive care unit monitoring period.
Conclusion: We present this case to raise awareness among emergency physicians about Juniper Tar, which is widely used for various purposes in folk medicine and cosmetics but can cause poisoning due to its content of essential oils, triterpenes, and phenols. This is a case of cardiac arrest and status epilepticus associated with juniper tar poisoning.
Keywords: Juniper tar; toxicity; emergency department
{"title":"Acute Systemic Toxicity Associated with Ingestion of Juniper Tar","authors":"Yasemin ÖZDAMAR, Mehmet Cihat DEMİR","doi":"10.33706/jemcr.1374559","DOIUrl":"https://doi.org/10.33706/jemcr.1374559","url":null,"abstract":"ABSTRACT
 Introduction: Juniper Tar has been utilized in traditional folk medicine to treat various ailments. Despite its historical use, documented cases are scarce regarding the potential complications associated with Juniper Tar, some of which have been fatal.
 Case Report: A 62-year-old male patient with no previous medical history presented to the emergency department complaining of confusion and respiratory distress after drinking a glass of Juniper Tar approximately four hours ago. The patient, who experienced multiple seizures and cardiac arrest at the emergency department, was discharged after an 11-day intensive care unit monitoring period. 
 Conclusion: We present this case to raise awareness among emergency physicians about Juniper Tar, which is widely used for various purposes in folk medicine and cosmetics but can cause poisoning due to its content of essential oils, triterpenes, and phenols. This is a case of cardiac arrest and status epilepticus associated with juniper tar poisoning.
 Keywords: Juniper tar; toxicity; emergency department","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136183810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Buket BADDAL, Aysegul BOSTANCI, Tutku AKSOY, Yasemin KUCUKCİLOGLU, Kaya SÜER
Herpes simplex viruses (HSVs) belong to the Herpesviridae family. Close contact is the primary mode of transmission for both HSV-1 and HSV-2, leading to a persistent lifelong infection. HSVs are widely recognized as causative agents of viral infections affecting the central nervous system, capable of presenting as both meningitis and encephalitis. Herpes simplex virus type 1 (HSV-1) is the predominant viral cause of encephalitis, accounting for the majority of cases. Here, a rare co-infection case of meningoencephalitis, associated with HSV-1 and rickettsia is described. A 42-year-old man presenting with non-remitting headache for 6 days, fever, sweating, and muscle aches was admitted to the Emergency Department. His Weil-Felix test was positive for Proteus OX2 indicating rickettsial infection. Therapy started promptly however patient’s condition deteriorated. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, and elevated protein concentration. CSF molecular analysis was positive for HSV-1. His cranial MRI indicated cytotoxic edema and gyral enhancement at the right temporal lobe. He was administered acyclovir for 14 days during hospital stay and was successfully discharged. This case report highlights that HSV-1 meningoencephalitis can co-occur with rickettsia infection in immunocompetent individuals, and co-infection with other agents should always be considered to avoid the progression of the disease.
{"title":"A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-infection in a Male Patient with Meningoencephalitis","authors":"Buket BADDAL, Aysegul BOSTANCI, Tutku AKSOY, Yasemin KUCUKCİLOGLU, Kaya SÜER","doi":"10.33706/jemcr.1325932","DOIUrl":"https://doi.org/10.33706/jemcr.1325932","url":null,"abstract":"Herpes simplex viruses (HSVs) belong to the Herpesviridae family. Close contact is the primary mode of transmission for both HSV-1 and HSV-2, leading to a persistent lifelong infection. HSVs are widely recognized as causative agents of viral infections affecting the central nervous system, capable of presenting as both meningitis and encephalitis. Herpes simplex virus type 1 (HSV-1) is the predominant viral cause of encephalitis, accounting for the majority of cases. Here, a rare co-infection case of meningoencephalitis, associated with HSV-1 and rickettsia is described. A 42-year-old man presenting with non-remitting headache for 6 days, fever, sweating, and muscle aches was admitted to the Emergency Department. His Weil-Felix test was positive for Proteus OX2 indicating rickettsial infection. Therapy started promptly however patient’s condition deteriorated. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, and elevated protein concentration. CSF molecular analysis was positive for HSV-1. His cranial MRI indicated cytotoxic edema and gyral enhancement at the right temporal lobe. He was administered acyclovir for 14 days during hospital stay and was successfully discharged. This case report highlights that HSV-1 meningoencephalitis can co-occur with rickettsia infection in immunocompetent individuals, and co-infection with other agents should always be considered to avoid the progression of the disease.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136183811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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