Transcranial magnetic stimulation is a non-invasive method for stimulating the brain and, in particular, the cerebral cortex. It uses a powerful electromagnet to generate a strong magnetic field that induces electrical current in the brain in much the same as direct stimulation with electricity. First described in 1985,1 it is being investigated for many conditions […]
Latest articles
Report of successful forequarter amputation
Medecins Sans Frontieres (MSF) surgeon David Nott provided a very public case report of successful forequarter amputation this week. http://www.msf.org.uk/surgery_by_text_message_20081203.news What made this extraordinary was that he and the patient were in Congo, he had never performed the procedure before and he received instructions on how to do it from a surgical colleague in the […]
Haemorrhagic transformation of a recent silent cerebral infarct during thrombolytic stroke treatment
This case report highlights the challenge of radiology interpretation in acute cases especially where effective treatment is time critical. Often an investigation will have an obvious abnormality that accounts for the presenting symptoms but elsewhere, in an unrelated part of the scan, another abnormality may be present. Even in experienced teams such other findings may […]
Iatrogenic vitamin K deficiency and life threatening coagulopathy
This is a reminder of an important clinical lesson that highlights the risk of vitamin K deficiency in the critically ill. The authors give a thorough account of the presentation, possible consequences and literature review in this case making it a rewarding and educational report. I note with interest the reviewer’s comments about not wanting […]
Bilateral breast metastases of a renal carcinoma
Although rare – this is only the second case report of bilateral breast metastases from renal carcinoma – it has a strong clinical message that recognising the possibility of metastases can save the patient from more radical surgery. It also reminds us all of the importance of the past medical history. In this case Ganapathi […]
What shall we do with case reports?
Case reports are popular and well-known but they have attracted criticism. They can distract the reader with the unusual. They are often not cited and mainstream journals are reluctant to publish them since they may lower impact factor. Their conclusions are rarely investigated further and may not be relevant outside the novelty of the case. […]