Acute massive posterior stroke with tonsillar herniation in a scuba diver.

IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL

Oxford Medical Case Reports Pub Date : 2024-08-26 eCollection Date: 2024-08-01 DOI:10.1093/omcr/omae094

Gufran Algaly, Sara M I Ahmed, Amro Abdelrahman, Mohamad Abdelgadir Elgassim, Ayesha Parveen

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引用次数: 0

Abstract

A transient female passenger in her 40s presented to the emergency department (ED) exhibiting drowsiness post-scuba diving. Despite normal initial vitals, she reported dizziness, sleepiness, and occipital headache. A computed tomography (CT) scan showed a severe posterior circulation acute infarction affecting various brain regions, resulting in significant mass effects and complications like 4th ventricle compression, cerebellar tonsillar herniation, and hydrocephalus. Extensive diagnostic tests, blood workup, and stroke evaluations revealed normal findings, except for an incidental patent foramen ovale (PFO). Collaboration with neurosurgery led to her transfer for life-saving extraventricular drain (EVD) insertion and posterior fossa decompression. Treatment included right-side EVD insertion, suboccipital craniectomy, and foramen magnum decompression. Postoperatively, she was extubated the next day, alert, without focal neurological deficits. Upon EVD removal, a repeat CT head scan showed regression of mass effect. She was discharged home safely after 16 days, fully ambulating.

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一名潜水员急性大面积后脑中风并伴有扁桃体疝。

急诊科（ED）收治了一名 40 多岁的临时女性乘客，她在潜水后出现嗜睡症状。尽管最初的生命体征正常，但她报告说头晕、嗜睡和枕部头痛。计算机断层扫描（CT）显示，严重的后循环急性脑梗塞波及多个脑区，导致明显的肿块效应和并发症，如第四脑室受压、小脑扁桃体疝和脑积水。广泛的诊断测试、血液检查和中风评估显示结果正常，只是偶然发现了卵圆孔未闭（PFO）。与神经外科合作后，她转院接受了脑室外引流管（EVD）插入术和后窝减压术，从而挽救了生命。治疗包括右侧 EVD 插管、枕下颅骨切除术和枕骨大孔减压术。术后第二天她就能拔管，神志清醒，无局灶性神经功能缺损。移除 EVD 后，重复头部 CT 扫描显示肿块效应消失。16 天后，她安全出院回家，可以完全行走。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oxford Medical Case Reports MEDICINE, GENERAL & INTERNAL-

CiteScore

0.90

自引率

0.00%

发文量

125

审稿时长

19 weeks

期刊介绍： Oxford Medical Case Reports (OMCR) is an open access, peer-reviewed online journal publishing original and educationally valuable case reports that expand the field of medicine. The journal covers all medical specialities including cardiology, rheumatology, nephrology, oncology, neurology, and reproduction, comprising a comprehensive resource for physicians in all fields and at all stages of training. Oxford Medical Case Reports deposits all articles in PubMed Central (PMC). Physicians and researchers can find your work through PubMed , helping you reach the widest possible audience. The journal is also indexed in the Web of Science Core Collection . Oxford Medical Case Reports publishes case reports under the following categories: Allergy Audiovestibular medicine Cardiology and cardiovascular systems Critical care medicine Dermatology Emergency medicine Endocrinology and metabolism Gastroenterology and hepatology Geriatrics and gerontology Haematology Immunology Infectious diseases and tropical medicine Medical disorders in pregnancy Medical ophthalmology Nephrology Neurology Oncology Paediatrics Pain Palliative medicine Pharmacology and pharmacy Psychiatry Radiology, nuclear medicine, and medical imaging Respiratory disorders Rheumatology Sexual and reproductive health Sports Medicine Substance abuse.