Introduction: Hippotherapy has recently emerged as a horse-based rehabilitative therapy to improve balance, coordination, and strength in patients with a wide range of medical conditions. Although several studies have demonstrated its effectiveness in restoring balance and gait in patients who have suffered cerebrovascular accidents (CVA), few studies have reported on adverse events associated with the treatment.
Case presentation: This case report describes a female post-stroke patient who fell from a horse during a hippotherapy session. She suffered a closed right zygomaticomaxillary complex fracture and ruptured globe injury. The patient's orbital injuries were surgically repaired, yet ultimately left her with no light perception in the affected eye and required enucleation.
Conclusion: Ocular and orbital injuries following hippotherapy are potentially blinding yet preventable. As such, practitioners should weigh the risks and benefits of hippotherapy, particularly in patients with unstable gait, and advise that additional safety precautions are taken to avoid these devastating injuries.
Introduction: Adenocarcinoma of the colon can metastasize to multiple organs but very rarely metastasizes to the axilla.
Case: We present a case of a 56-year-old male with metastatic colon adenocarcinoma that metastasized to the rectum and then the axilla. Three years after initial diagnosis and treatment of right colon mucinous adenocarcinoma a metastatic mass was found in the rectum. The mass was successfully resected, but within a year of finding the rectal mass, metastatic disease to the axilla was discovered.
Conclusion: This case provides valuable teaching points about routes of metastasis and the importance of continued clinical follow-up in patients diagnosed with adenocarcinoma of the colon.
Ischemic stroke represents a leading cause of death worldwide and the leading cause of disability in the United States. Greater than 8% of all deaths are attributed to ischemic stroke. This rate is consistent with the heightened burden of cardiovascular disease deaths. Treatments for acute ischemic stroke remain limited to tissue plasminogen activator and mechanical thrombolysis, both of which require significant medical expertise and can only be applied to a select number of patients based on time of presentation, imaging, and absence of contraindications. Over 1,000 compounds that were successful in treating ischemic stroke in animal models have failed to correlate to success in clinical trials. The search for alternative treatments is ongoing, drawing greater attention to the importance of preclinical models that more accurately represent the clinical population through incorporation of common risk factors. This work reviews the contribution of these commonly observed risk factors in the clinical population highlighting both the pathophysiology as well as current clinical diagnosis and treatment standards. We also highlight future potential therapeutic targets, areas requiring further investigation, and recent changes in best-practice clinical care.
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