Journal of Medical Case Reports最新文献

{"title":"Fluorodeoxyglucose positron emission tomography-computed tomography missed tibial metastasis in head and neck cancer: a case report and review of literature.","authors":"Hamidreza Movahedi, Lena Nazemi, Saina Ghadiany, Alireza Movahedi, Farzad Dehghani Mahmoudabadi, Mohammadhossein Aghazadeh, Seyed Esmaeil Mousavi, Shaghayegh Khodabakhshian","doi":"10.1186/s13256-025-05275-2","DOIUrl":"10.1186/s13256-025-05275-2","url":null,"abstract":"<p><strong>Introduction: </strong>Head and neck squamous cell carcinoma is the seventh most common type of cancer in the world. Metastases occur in up to 40% of cases, and bones are the second most frequent site. Metastases in extremities are uncommon, with very few publications covering distal lower-limb bone metastasis.</p><p><strong>Case presentation: </strong>Here we report the case of a 47-year-old Persian man with head and neck squamous cell carcinoma managed by induction chemotherapy, surgery, and adjuvant chemoradiotherapy. During the adjuvant treatment, the patient experienced right tibial pain, with additional workup revealing a distal lower-limb bone metastasis that had remained undetected during the standard workup for head and neck squamous cell carcinoma.</p><p><strong>Discussion: </strong>In current guidelines, recommended fluorodeoxyglucose positron emission tomography-computed tomography in head and neck squamous cell carcinoma does not extend below the popliteal fossae. The undetected metastasis led to overtreatment of this patient. Systematic review of literature showed only six cases of distal lower-limb metastasis from head and neck cancer, which are eligible for discussion.</p><p><strong>Conclusion: </strong>Although rare, physicians should keep in mind that as recommended fluorodeoxyglucose positron emission tomography-computed tomography does not extend below the popliteal fossae, metastases may be missed, potentially leading to overtreatment.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"263"},"PeriodicalIF":0.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate hemothorax following subclavian central venous catheter removal: a case report.","authors":"Abenezer A Kebede, Nigatu A Gerba, Kibrom M Gebremedhin, Mahlet M Desalegn, Yididiya G Gebre, Mekbib B Endashaw, Selamawit T Muche, Feven T Demeke, Hiwot M Weldemeskel","doi":"10.1186/s13256-025-05318-8","DOIUrl":"10.1186/s13256-025-05318-8","url":null,"abstract":"<p><strong>Background: </strong>Central venous catheters play a vital role in managing critically ill patients by providing reliable access for fluid resuscitation, medication delivery, hemodialysis, and hemodynamic monitoring. While insertion-related complications such as pneumothorax and vascular injury are well described, adverse events following catheter removal are less commonly recognized in clinical practice. These post-removal complications, though rare, can be life-threatening if not promptly identified. This report presents a rare case of hemothorax occurring immediately after the removal of a subclavian central venous catheter that was previously inserted for hemodialysis in a recently established hospital in a developing country.</p><p><strong>Case presentation: </strong>A 30-year-old Ethiopian female patient with chronic kidney disease and hypertension, undergoing hemodialysis via a right subclavian venous catheter for the past 2 weeks, presented with difficulty initiating dialysis during her fourth session. upon the suspicion of catheter malfunction, the central line was removed. Then, 20 minutes later, the patient developed shortness of breath, right-sided pleuritic chest pain, and a drop in blood pressure. Physical examination revealed absent air entry over the right lung field. Chest x-ray confirmed a right hemothorax, and hemoglobin decreased from 6.5 mg/dL to 5.1 mg/dL within 4 hours. A chest drain was inserted, evacuating 700 mL of blood. Following blood transfusions, the patient's condition stabilized, and the chest tube was removed on day 8 after nearly complete hemothorax resolution. The patient was discharged on day 9 with significant improvement.</p><p><strong>Conclusion: </strong>This case highlights the potential for complications to arise not only during central venous catheter insertion but also during removal. Clinicians should ensure proper catheter positioning during insertion and implement post-removal monitoring protocols to detect rare but potentially life-threatening complications such as hemothorax.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"262"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obsessive-compulsive symptoms as a unique presentation of complex posttraumatic stress disorder in Southeast Asia: a case report.","authors":"Amanda Albert, Yoke Yong Chen","doi":"10.1186/s13256-025-05323-x","DOIUrl":"10.1186/s13256-025-05323-x","url":null,"abstract":"<p><strong>Background: </strong>Posttraumatic stress disorder is a mental health condition outlining psychological sequelae experienced after encountering a traumatic event. Complex posttraumatic stress disorder, however, is increasingly recognized as being distinct from posttraumatic stress disorder. This is due to an observed variation from what is traditionally defined as a traumatic event, as well as greater heterogeneity in its presentation. Cultural factors may also influence definitions of traumatic events and heterogeneity in presentation.</p><p><strong>Case presentation: </strong>In this case, a 27-year-old Malay male presented with a 9-year history of obsessive-compulsive symptoms of predominantly sexual content. Although initially treated as obsessive-compulsive disorder, persistent negative self-image and features of complex posttraumatic stress disorder surfaced in the course of therapy, stemming from a culturally-related punitive upbringing as well as bullying by peers. He responded markedly well to trauma-based psychotherapy and remains well at time of writing.</p><p><strong>Conclusion: </strong>A diagnosis of complex posttraumatic stress disorder should be considered in the individual who presents with mental health difficulties, particularly if the individual's symptoms are atypical to classical diagnostic criteria or the individual does not respond to conventional treatment. It is important to note the role of cultural background-this may give rise to unique presentations of complex posttraumatic stress disorder, and the triggering events may not be traditionally defined as traumatic. Cultural background may also potentially inform treatment and future prevention strategies for complex posttraumatic stress disorder.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"261"},"PeriodicalIF":0.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed traumatic subcutaneous emphysema: a case report.","authors":"Lucas Bishop, Sarah MacLaren, William Pollitt","doi":"10.1186/s13256-025-05249-4","DOIUrl":"10.1186/s13256-025-05249-4","url":null,"abstract":"<p><strong>Background: </strong>Subcutaneous emphysema is a common, usually benign, and self-limiting complication of traumatic chest wall injury. In a minority of thoracic injuries, pneumothoraces can result in extensive subcutaneous emphysema and subsequent airway obstruction if air tracks along tissue planes within the neck. Furthermore, patients may have a delay to presentation following chest-wall injury and can rapidly decline. Hence, we discuss a case of delayed traumatic subcutaneous emphysema resulting in airway compromise, without cardiorespiratory compromise from tension pneumothoraces.</p><p><strong>Case presentation: </strong>A white British female in her 70s attended the emergency department 24 h after a fall at home with the complaint of right sided chest pain and shortness of breath. On arrival, the patient appeared well, with no sign of compromise. The patient rapidly deteriorated over the course of the next 30 min. Massive crepitus swelling was identified of her upper and lower limbs, head (including palpebral closure), neck, chest, and abdomen. Vocal changes and early airway obstruction features were identified. Prompt recognition of rapidly progressive subcutaneous emphysema with airway compromise, early rapid-sequence induction, chest-drain insertion, and a multidisciplinary team approach ensured a positive outcome, with discharge home after 12 days in hospital.</p><p><strong>Conclusion: </strong>Subcutaneous emphysema itself is rarely life-threatening, though it can infrequently manifest as an obstructive airway emergency. Delayed presentations are possible, and the presence of subcutaneous emphysema indicates severe chest-wall injury. Airway protection and treatment of pneumothoraces are critical interventions for these patients.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"258"},"PeriodicalIF":0.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soft tissue metastasis in colorectal cancer: a case report.","authors":"Yosr Zenzri, Zahra Ghodhbani, Haythem Yacoub, Yoldez Houcine, Hajer Ben Mansour, Khedija Meddeb, Nadia Maamouri, Amel Mezlini","doi":"10.1186/s13256-025-05317-9","DOIUrl":"10.1186/s13256-025-05317-9","url":null,"abstract":"<p><strong>Background: </strong>Soft tissue metastases of solid tumors are rare events, especially for colorectal cancers.</p><p><strong>Case presentation: </strong>We report herein the case of a 65-year-old Arab woman with soft tissue metastases (left arm, right scapula, and right axillary masses) of a colorectal cancer 4 years after the initial surgery. The patient was treated with folinic acid-fluorouracil-irinotecan and bevacizumab as first-line treatment. One year after completion of chemotherapy, the patient remained alive.</p><p><strong>Conclusions: </strong>The key aim in reporting this case is to raise awareness among oncologists regarding potential unusual metastasis locations of colon adenocarcinoma such as skin and skeletal muscle.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"260"},"PeriodicalIF":0.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunoglobulin A vasculitis and pustular psoriasis precipitated by Tawon Liar: a case report.","authors":"Mengyi Zha, Delaney D Ding","doi":"10.1186/s13256-025-05167-5","DOIUrl":"10.1186/s13256-025-05167-5","url":null,"abstract":"<p><strong>Background: </strong>Unregulated herbal supplements can pose significant health risks due to undisclosed ingredients. Tawon Liar, an Indonesian product marketed as an \"all-natural\" remedy, claims to alleviate pain and boost immunity but lacks stringent regulatory oversight. We report a unique case of Tawon Liar-induced Immunoglobulin A (IgA) vasculitis and exacerbation of psoriasis, highlighting the potential dangers associated with misadvertised supplements.</p><p><strong>Case presentation: </strong>A 53-year-old migrant worker from Mexico with a history of psoriasis and ankylosing spondylitis, effectively managed with adalimumab, presented with new-onset rashes on his extremities. Physical examination revealed palpable purpura on the lower legs and erythematous papules and plaques with pustules on the upper extremities. Dermoscopic analysis suggested IgA vasculitis and pustular psoriasis. The patient denied recent infections, new medications, or over-the-counter drug use. However, after thorough questioning, it was revealed that he had been intermittently ingesting Tawon Liar for chronic musculoskeletal pain. The supplement, obtained from a coworker, contained undisclosed ingredients including meloxicam, ketorolac, and dexamethasone. Laboratory tests ruled out renal involvement, and biopsies were not performed due to financial constraints. The patient was advised to discontinue Tawon Liar and was treated with topical corticosteroids, leading to substantial improvement and resolution of symptoms within one week.</p><p><strong>Conclusions: </strong>This case underscores the potential dangers of herbal supplements containing hidden pharmacologic agents. It highlights the need for clinicians to diligently inquire about supplement use during patient evaluations, especially for vulnerable populations facing language barriers and limited access to healthcare. Public health authorities should enhance efforts to disseminate drug safety information across diverse languages and platforms to mitigate health risks associated with such products.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"259"},"PeriodicalIF":0.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluconazole-induced drug rash with eosinophilia and systemic symptoms syndrome: a case report.","authors":"Stanley Kim, Kevin Chen, William Stull","doi":"10.1186/s13256-025-05321-z","DOIUrl":"10.1186/s13256-025-05321-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Drug rash with eosinophilia and systemic symptoms syndrome is a severe T-cell-mediated adverse drug reaction characterized by a skin rash, fever, hematologic abnormalities, and internal organ involvement following prolonged exposure to a causative medication. Drugs associated with drug rash with eosinophilia and systemic symptoms syndrome include anticonvulsants, allopurinol, antibiotics, and nonsteroidal anti-inflammatory drugs. Fluconazole is an exceedingly rare cause of drug rash with eosinophilia and systemic symptoms syndrome, with only one previously reported case in abstract form. We present a case of a woman with pulmonary coccidioidomycosis who developed fluconazole-induced drug rash with eosinophilia and systemic symptoms syndrome, presenting with an unusual clinical feature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case presentation: &lt;/strong&gt;A 19-year-old Hispanic woman was taking fluconazole for pulmonary coccidioidomycosis. A total of 30 days after starting fluconazole, she developed a generalized skin rash. Despite this, she continued taking the medication. Then 1 week later, she experienced facial swelling and a sensation of \"throat closing.\" She also developed fever, axillary lymphadenopathy, eosinophilia, atypical lymphocytes, and hepatitis. Fluconazole was discontinued, and she was treated with intravenous methylprednisolone, which led to an overall improvement in her condition. During hospitalization, her antifungal therapy was switched to posaconazole. However, within 24 hours, she again experienced the \"throat closing\" sensation, which was relieved with an epinephrine injection. The patient was discharged on Day 6 with oral methylprednisolone. Again, 9 days after discharge, her symptoms recurred, including facial swelling and new skin rashes. She was readmitted and treated with famotidine, corticosteroids, and diphenhydramine. Her general condition and skin rashes gradually improved, with complete resolution of the rash 3 months after the initial eruption.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We present a case of a woman with pulmonary coccidioidomycosis who developed drug rash with eosinophilia and systemic symptoms syndrome induced by fluconazole. Our case meets Bocquet's diagnostic criteria and is categorized as \"definite\" drug rash with eosinophilia and systemic symptoms by the Registry of Severe Cutaneous Adverse Reactions. Drug rash with eosinophilia and systemic symptoms syndrome is a T-cell-mediated type IV hypersensitivity reaction; however, our patient also exhibited a unique symptom-a sensation of \"throat closing\"-suggestive of angioedema and a Type I hypersensitivity component. This symptom appeared while she continued fluconazole after the onset of drug rash with eosinophilia and systemic symptoms syndrome and recurred upon the initiation of posaconazole. Although both fluconazole and posaconazole belong to the triazole antifungal class, true allergic cross-reactivity medicated by IgE is rare probably due to ","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"257"},"PeriodicalIF":0.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibrosarcoma of the maxilla with maxillary sinus invasion: a case report and review of the literature.","authors":"Nazanin Mahdavi, Samira Derakhshan, Mahsa Etemadi","doi":"10.1186/s13256-025-05279-y","DOIUrl":"10.1186/s13256-025-05279-y","url":null,"abstract":"<p><strong>Background: </strong>Fibrosarcoma is a rare, invasive soft tissue sarcoma that is more common in males aged 30-60 years. It accounts for 1% of all malignancies in the human body. Treatment is radical surgical removal, radiotherapy, and chemotherapy.</p><p><strong>Case presentation: </strong>A 58-year-old Khorasani Persian male patient with a complaint of expansion, pain, and paresthesia in the left maxillary quadrant was diagnosed with infiltrative high-grade sarcoma. Tumoral cells were strongly diffuse positive for vimentin and negative for S100 and desmin, indicating high-grade adult fibrosarcoma.</p><p><strong>Conclusion: </strong>This report presents a rare case of a fibrosarcoma causing paresthesia, pain, and expansion in the maxilla with maxillary sinus invasion, which requires early diagnosis and immediate referral.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"254"},"PeriodicalIF":0.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mega solid bone cyst in iliac region from primary hyperparathyroidism: a case report.","authors":"Francesco Rosario Campo, Federico Di Sacco, Antonio D'Arienzo, Edoardo Ipponi, Fabio Cosseddu, Vanna Bottai, Sebastiano Barreca, Lorenzo Andreani, Paolo Domenico Parchi","doi":"10.1186/s13256-025-05295-y","DOIUrl":"10.1186/s13256-025-05295-y","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal bone cysts are benign, locally aggressive bone lesions that commonly affect young adults and adolescents. These cysts, which may cause pain, fractures, or deformities, are often associated with vascular or abnormal bone resorption processes. Though their etiology is not fully understood, an intriguing and rarely discussed correlation between aneurysmal bone cysts and endocrine disorders, particularly primary hyperparathyroidism, has been reported. Hyperparathyroidism, usually resulting from a parathyroid adenoma, promotes osteoclastic activity, which can lead to bone resorption and potentially the formation of aneurysmal cysts. The diagnosis of hyperparathyroidism can be challenging, especially in the absence of characteristic clinical signs.</p><p><strong>Case presentation: </strong>A 47-year-old Albanian Caucasian female individual, with a body mass index of 40, presented with coxalgia and an incidental finding of an osteolytic lesion in the right sacral wing on pelvic X-ray. Subsequent imaging, including magnetic resonance imaging and computed tomography, confirmed the presence of a large aneurysmal bone cyst. Despite its size, traditional surgical interventions were not pursued owing to the discovery of primary hyperparathyroidism, as indicated by elevated serum calcium and parathyroid hormone levels. A parathyroid ultrasound revealed an atypical adenoma in the left lower parathyroid, confirming the diagnosis of hyperparathyroidism. The patient underwent successful parathyroidectomy and left thyroid loboistectomy with a favorable outcome. Postsurgical follow-up revealed normalization of metabolic parameters and clinical resolution of symptoms, with stable dimensions of the sacral cyst.</p><p><strong>Conclusion: </strong>This case emphasizes the importance of thorough diagnostic evaluation in patients with bone lesions, particularly in those with risk factors for metabolic bone disorders. Primary hyperparathyroidism, although rare, can manifest with bone abnormalities such as aneurysmal cysts. A multidisciplinary approach, including timely diagnosis and surgical intervention, is crucial for optimal management and preventing long-term complications. Regular follow-up and monitoring of metabolic parameters are key to ensuring successful outcomes.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"256"},"PeriodicalIF":0.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awake prone positioning in a patient with respiratory impairment due to subarachnoid hemorrhage: a case report.","authors":"Giorgia Pacchiarini, Federico Geraldini, Alessandro De Cassai, Giulia Aviani Fulvio, Annalisa Boscolo, Francesco Zarantonello, Paolo Navalesi, Marina Munari","doi":"10.1186/s13256-025-05311-1","DOIUrl":"10.1186/s13256-025-05311-1","url":null,"abstract":"<p><strong>Background: </strong>Prone positioning has been shown to be an effective rescue strategy in severe acute respiratory distress syndrome and was widely used during the coronavirus disease 2019 pandemic, both in mechanically ventilated and in awake patients. Subarachnoid hemorrhage is often associated with respiratory failure. Prone positioning has been used in brain-injured patients, but concerns relating to neurological complications from intracranial hypertension still remain.</p><p><strong>Case presentation: </strong>We report the case of a 59-year-old Italian patient with subarachnoid hemorrhage who safely underwent awake prone positioning after deterioration of respiratory function.</p><p><strong>Conclusions: </strong>In this report, we show that awake pronation is possible in patients with subarachnoid hemorrhage. However, careful monitoring of Intracranial pressure and clinical examination may be the keys to successful application of this procedure.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"255"},"PeriodicalIF":0.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}