A subdural haematoma without a history of trauma or vascular malformation is rare, indeed, in a young healthy individual. The following report describes a case of a 37 year old man with rare but recognised cause of subdural haematoma. His symptoms and assessment are discussed…anyone working in acute medicine, surgery or general practice might be […]
Category: Editors choice
Comments from Dr Dean Jenkins on the Editor’s choice case report of the week.
Traumatic subcutaneous haematoma causing skin necrosis
A 79 year old lady trips over and hurts her leg. She develops a large haematoma and is initially managed expectantly. She is on warfarin, however, and eventually requires debridement and a skin graft. The case describes the pitfalls in the management of seemingly benign injuries in patients who are anticoagulated and outlines the management […]
A rare cause of seizure masquerading as neoplasm
This is a concise, instructive, and very well-written report of a patient suffering from primary cerebral vasculitis. Firstly, it highlights the fact that obtaining histopathological specimens is of paramount importance for the further management of patients with cerebral mass-like lesions, and secondly, it reminds the reader that cerebral vasculitis is, as in other body regions, […]
Tracheal Fistula Associated with Bevacizumab 20 Months after Mediastinal Radiation
First of all I would like to commend the authors for providing us a pictorial evidence of bevacizumab induced loss of integrity of viscus. This article reminds me of two quotes by Sir Robert Hutchison. The first one being, “It is always well, before handing the cup of knowledge to the young, to wait until […]
Undetected acute aortic dissection in a patient referred for primary coronary angioplasty: a successful treatment of perioperative bleeding after abciximab administration
The authors should be acknowledged for presenting a very unusual case of acute aortic dissection mimicking an acute myocardial infarction. This case report can be very useful to the practising physician, since it points out several crucial diagnostic points. First, a complete physical assessment as well as ‘simple’ examination tests should always be performed at […]
Unusual Injuries: Locked bucket-handle tears of both medial and lateral menisci with simultaneous anterior cruciate and medial collateral ligaments injury
The authors present a virtually unheard of case of BILATERAL (medial and lateral meniscus) locked bucket handles tears in the same knee. The patient had a signficant injury with associated ACL and MCL involvement; nonetheless, the finding of locked bucket handle tears is very unusual and the picture is amazing. It is unfortunate that both […]
Unusual Injuries: Traumatic hand amputation while wakeboarding
We receive numerous reports of patients with unusual injuries with spectacular images and unexpected complications. Here is the first in a selection… Amputation of a limb as a result of it being caught in a loop of rope is a well recognised hazard in heavy industry (eg. the deep-sea fishing industry). This case illustrates that […]
A pause for thought: exercise-induced sinus arrest causing syncope in a young male
This case is a nice illustration of an uncommonly severe vasovagal event post exercise. Athletes can be very frustrated by these symptoms and management can be difficult, but as rightly pointed out, it is through education and reassurance that patients get the most benefit. It also emphasises the vital importance of a careful history, family […]
‘Quality and Safety in Medicine’ Series: Efficacy of administration of coagulation factor XIII with definitive surgery for multiple intractable enterocutaneous fistulae in a patient with decreased factor XIII activity
Enterocutaneous fistula is amongst the most challenging of surgical complications to manage. Here a patient with multiple comorbidities treated successfully results in a favourable outcome. Seema Biswas Editor-in-Chief Efficacy of administration of coagulation factor XIII with definitive surgery for multiple intractable enterocutaneous fistulae in a patient with decreased factor XIII activity […]
‘Quality and Safety in Medicine’ Series: Hypertensive emergency as a complication of brachial plexus block
Complications recognised early and treated promptly can avert disaster. In this case regional anaesthetic blockade exacerbates hypertension in a patient prepared for emergency surgery. The patient is treated urgently and surgery is cancelled. The authors discuss possible mechanisms where nerve blockade of baroreceptors may result in life-threatening hypertension and myocardial damage. Seema Biswas Editor-in-Chief Hypertensive […]