thebluntdissection

pulling apart cases from the ED...

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a perplexing paradox…

June 21, 2016 By Christopher Partyka Leave a Comment

The case.

a 70 year old female is bought to your ED at 10pm via ambulance with a dense right-sided hemiparesis following a witnessed collapse at home only 30 minutes earlier. [Read more…]

Filed Under: #FOAM, Interesting, Neurology, Radiology, Respiratory Tagged With: ischaemic stroke, massive PE, massive pulmonary embolism, MCA stroke, paradoxical embolism, patent foramen ovale, PFO, pulmonary embolism, thrombolysis

a splitting headache…

March 23, 2015 By Christopher Partyka Leave a Comment

the case.

39 year old female presents to your Emergency Department with a four day history of a gradually worsening headache. Whilst she has a past history of migraines, this headache is much more severe and of different character to any migraine she has had previously. [Read more…]

Filed Under: #FOAM, Interesting, Neurology, Radiology Tagged With: anticoagulation, cerebral venous thrombosis, CT venogram, CVT, delta sign, dural sinus thrombosis, empty delta sign, headache, sagittal sinus thrombosis, secondary headache, stroke unit, thrombolysis

pupils predict pathology…

March 16, 2014 By Christopher Partyka Leave a Comment

the case.

A 34 year old male is bought to your ED with reduced level of consciousness. He was at a restaurant having dinner with family & friends when he excused himself to use the bathroom. They found him 15 minutes later slumped near the toilet – unconscious and barely breathing. [Read more…]

Filed Under: #FOAM, Neurology, Radiology Tagged With: coma, pin point pupils, pontine, Pontine haemorrhage, primary pontine haemorrhage

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