American Journal of Case Reports最新文献_第5页

Management of Pharyngeal Perforation with Cervical Spine Injury Following Blunt Trauma on Electric Vehicle Accident. 电动汽车钝器伤后颈椎咽穿孔的处理。

IF 1

American Journal of Case Reports Pub Date : 2025-05-29 DOI: 10.12659/AJCR.947274

Yinkui Wang, Dengfeng Wang, Tinglao Chen, Xiaoli Zhu

{"title":"Management of Pharyngeal Perforation with Cervical Spine Injury Following Blunt Trauma on Electric Vehicle Accident.","authors":"Yinkui Wang, Dengfeng Wang, Tinglao Chen, Xiaoli Zhu","doi":"10.12659/AJCR.947274","DOIUrl":"10.12659/AJCR.947274","url":null,"abstract":"BACKGROUND Cases of pharyngeal perforation (PP) associated with cervical spine injury following blunt trauma are extremely rare. CASE REPORT A 58-year-old woman was hit by a car while riding an electric bicycle. She presented with neck pain and dyspnea on admission to the hospital. The CT scan showed suspected fractures of the 5th and 6th cervical vertebrae without evidence of cervical emphysema. Serial blood tests revealed a rapidly decreasing hemoglobin level. An urgent surgical exploration of the neck was performed. Intraoperative findings included complete tears of the anterior and posterior longitudinal ligaments of the cervical spine, rupture of the 5th and 6th cervical intervertebral discs, and a longitudinal laceration of the posterior pharyngeal wall. The patient underwent surgical management, which included PP repair and cervical spine infusion via an anterior cervical approach. The buccopharyngeal fascia was sutured to the prevertebral fascia to seal the connection between the PP and the prevertebral space. The patient recovered well after surgery. The 3-month postoperative follow-up showed a stable cervical spine and good healing of the PP. CONCLUSIONS We present the first case of PP associated with severe cervical spine injury following blunt trauma. Direct laryngoscopy is essential to establish the presence of PP and to assess the size and location of the injury. In this rare case, suturing the buccopharyngeal fascia and prevertebral fascia to isolate the PP and spinal implant was effective in preventing implant infection and surgical failure potentially caused by salivary leakage.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947274"},"PeriodicalIF":1.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175187","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}

引用次数: 0

Rare Abdominal Pain Onset in Guillain-Barré Syndrome: A Case Report of Acute Motor Sensory Axonal Neuropathy. 格林-巴勒综合征罕见腹痛：急性运动感觉轴索神经病1例报告。

IF 1

American Journal of Case Reports Pub Date : 2025-05-28 DOI: 10.12659/AJCR.946737

Muhammad Aidil Idham Sharom, Julina Md Noor, Mohd Fazrul Mokhtar

{"title":"Rare Abdominal Pain Onset in Guillain-Barré Syndrome: A Case Report of Acute Motor Sensory Axonal Neuropathy.","authors":"Muhammad Aidil Idham Sharom, Julina Md Noor, Mohd Fazrul Mokhtar","doi":"10.12659/AJCR.946737","DOIUrl":"10.12659/AJCR.946737","url":null,"abstract":"BACKGROUND Guillain-Barre syndrome (GBS) typically presents with ascending weakness and sensory disturbances. However, initial symptoms like abdominal pain are rare and can make diagnosis more challenging, as this is not a common feature of GBS. This diagnostic delay can be particularly significant in severe GBS subtypes like acute motor and sensory axonal neuropathy (AMSAN), with only a few reported cases presenting in this atypical manner. CASE REPORT A 42-year-old man experienced 3 days of persistent abdominal pain that progressively disrupted his normal activities. Soon after, he developed weakness and loss of sensation, beginning in his lower limbs and eventually spreading to the upper limbs. His condition rapidly deteriorated, resulting in respiratory failure that required intubation. Upon examination, muscle weakness and sensory loss were noted, leading to a diagnosis of AMSAN. This was confirmed by nerve conduction studies, MRI, and cerebrospinal fluid analysis. The patient initially received intravenous immunoglobulin (IVIG) but showed minimal improvement after 8 days. He then underwent plasma exchange, consisting of 5 treatment cycles. After 64 days in the hospital, including 39 days in the intensive care unit (ICU), he was discharged and able to walk with assistance. CONCLUSIONS This case highlights the importance of recognizing the atypical presentations of GBS, particularly the AMSAN subtype. The patient's initial presentation of severe abdominal pain, followed by rapid neurological deterioration, underscores the need for clinicians to maintain a high index of suspicion for GBS even when symptoms diverge from the classic ascending paralysis.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946737"},"PeriodicalIF":1.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162760","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}

引用次数: 0

Comparative Analysis of Pure VWF and VWF/FVIII Complex in Orthopedic Surgery for Type 2B von Willebrand Disease. 单纯VWF与VWF/FVIII复合物在2B型血管性血友病骨科手术中的比较分析。

IF 1

American Journal of Case Reports Pub Date : 2025-05-28 DOI: 10.12659/AJCR.947187

Pierre Chamouni, Virginie Barbay, Paul Billoir, Veronique Le Cam Duchez

{"title":"Comparative Analysis of Pure VWF and VWF/FVIII Complex in Orthopedic Surgery for Type 2B von Willebrand Disease.","authors":"Pierre Chamouni, Virginie Barbay, Paul Billoir, Veronique Le Cam Duchez","doi":"10.12659/AJCR.947187","DOIUrl":"10.12659/AJCR.947187","url":null,"abstract":"BACKGROUND This report describes a 55-year-old man with hypertension, hypercholesterolemia, type 2B von Willebrand disease (VWD2B), and thrombocytopenia requiring 2 surgical total hip replacements managed with pure von Willebrand factor (VWF) concentrate (Wilfactin®) and VWF/Factor VIII (FVIII) complex concentrate (Voncento®). VWD2B is a rare, autosomal-dominant, inherited disorder of primary hemostasis caused by VWF alterations that increase its affinity for the GP1b receptor on circulating platelets. In some families, thrombocytopenia of varying severity is observed. This can worsen the hemorrhagic phenotype and require adapted management. Specific laboratory tests and genetic studies are used to confirm the diagnosis of VWD2B, particularly before surgery in which VWF concentrates may be required. CASE REPORT This patient underwent 2 hip replacement interventions, 3.5 months apart, performed by the same surgical team. Hemorrhage prevention was achieved using Wilfactin® for the first hip replacement procedure and required 9 injections of Wilfactin® (352.9 IU/kg). For the second hip replacement, which took place 3.5 months after, we used Voncento® to prevent bleeding and required 8 injections of Voncento® (282.3 IU/kg). Both treatments were effective in terms of bleeding prevention. No thrombotic event was reported. The hospital stay duration was identical for both interventions. CONCLUSIONS Here, we report a real-life comparison of Wilfactin® and Voncento® in the same patient and in the same peri-operative management conditions. This study confirms the efficacy and safety of these VWF concentrates in preventing bleeding without thrombotic risks and highlights the benefits of close laboratory monitoring to personalize treatment and optimize management.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947187"},"PeriodicalIF":1.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175186","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}

引用次数: 0

Diagnosis and Management of Autoimmune Hepatitis After Hepatitis A in a Young Woman. 1例年轻女性甲型肝炎后自身免疫性肝炎的诊断和治疗

IF 1

American Journal of Case Reports Pub Date : 2025-05-27 DOI: 10.12659/AJCR.946795

Siddharth Patel, Cory Dixon, Niti Chokshi, Susana Giraldo, Mrudula Thiriveedi, Virginia Dailey

{"title":"Diagnosis and Management of Autoimmune Hepatitis After Hepatitis A in a Young Woman.","authors":"Siddharth Patel, Cory Dixon, Niti Chokshi, Susana Giraldo, Mrudula Thiriveedi, Virginia Dailey","doi":"10.12659/AJCR.946795","DOIUrl":"10.12659/AJCR.946795","url":null,"abstract":"BACKGROUND Hepatitis A (Hep A) is a common cause of viral hepatitis in developing nations. Autoimmune hepatitis is characterized by subacute to chronic liver inflammation, which can lead to liver cirrhosis if untreated. Both conditions remain uncommon in the United States. Development of autoimmune hepatitis following viral Hep A is extremely rare. However, viral infections, including Hep A, have been implicated in triggering autoimmune diseases through immune system activation, molecular mimicry, and inflammatory cytokine surges. Early recognition of this phenomenon is crucial for timely intervention and improved outcomes. CASE REPORT A 32-year-old Hispanic woman with a history of Hep A presented to the emergency room with chief concerns of intermittent epigastric abdominal pain and jaundice for 2 weeks. Physical exam revealed scleral icterus with right upper-quadrant tenderness. Although abdominal imaging was concerning for gallbladder wall thickening, the degree of hyperbilirubinemia (10 mg/dL) and ALT (2100 U/L) elevation were out of proportion to that commonly seen with cholecystitis. The patient's condition deteriorated despite supportive treatment. Further investigations detected IgG against Hep A, positive anti-nuclear antibodies, and anti-smooth muscle antibodies. The liver biopsy confirmed autoimmune hepatitis. The patient showed rapid clinical improvement after initiation of intravenous steroids and was ultimately discharged home. CONCLUSIONS Autoimmune hepatitis developing after acute Hep A is rare. High clinical suspicion and prompt treatment with systemic steroids are key for rapid clinical improvement and preventing complications. Recognizing viral infections as potential autoimmune triggers may help guide earlier diagnosis and intervention.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946795"},"PeriodicalIF":1.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152161","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}

引用次数: 0

A 61-Year-Old Man with Perforation of the Left Ventricle and Pericardium 3 Days After Insertion of a Cardiac Pacemaker Lead. 1例61岁男性左心室和心包膜穿孔，植入心脏起搏器导联3天后。

IF 1

American Journal of Case Reports Pub Date : 2025-05-27 DOI: 10.12659/AJCR.947341

Shanqing Bao, Ke Yang, Yuanhong Li, Tenglong Wang, Chengxin Zhang

{"title":"A 61-Year-Old Man with Perforation of the Left Ventricle and Pericardium 3 Days After Insertion of a Cardiac Pacemaker Lead.","authors":"Shanqing Bao, Ke Yang, Yuanhong Li, Tenglong Wang, Chengxin Zhang","doi":"10.12659/AJCR.947341","DOIUrl":"10.12659/AJCR.947341","url":null,"abstract":"BACKGROUND The use of implantable cardiac devices, including permanent pacemakers, has become routine, and reported complications are rare. However, in some cases, a cardiac pacemaker lead can perforate the ventricular or atrial wall. However, patients can present with nonspecific and heterogeneous clinical manifestations, leading to potential delays in diagnosis. We present a case of a 61-year-old man with perforation of the left ventricle and pericardium diagnosed 3 days after the insertion of a cardiac pacemaker lead. CASE REPORT A 61-year-old man with symptomatic second-degree type II sinoatrial block underwent uneventful dual-chamber permanent pacemaker implantation. On the evening of the third day following the pacemaker implantation procedure, the patient presented with persistent chest pain and was admitted to the hospital. Emergency chest computed tomography demonstrated that the right ventricular pacemaker lead had penetrated the left ventricle and pericardium. The patient underwent surgery on the fourth day of admission, and the pacing lead was secured to the left ventricular myocardium via a small incision in the left intercostal space. The surgical procedure was completed successfully, and the patient was discharged on the third postoperative day, without any complications. CONCLUSIONS Cardiac perforation due to the lead is a rare but potentially fatal complication of pacemaker implantation. We present a patient who presented with a left ventricular and pericardium perforation 3 days after pacemaker implantation. This clinical case underscores the necessity for screening for perforation in patients treated with cardiac implantable electronic devices prior to discharge.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947341"},"PeriodicalIF":1.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162804","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}

引用次数: 0

A 4-Week-Old Female Infant with Type 3 von Willebrand Disease Presenting with Nosebleeds and Uncontrolled Bleeding Following Surgical Frenectomy: A Clinical Case. 一例4周大的3型血管性血友病女婴在系带切除术后出现鼻出血和无法控制的出血：一例临床病例。

IF 1

American Journal of Case Reports Pub Date : 2025-05-26 DOI: 10.12659/AJCR.946625

Aleksandra Zima, Teresa Iwaniec, Joanna Zdziarska, Tomasz Sacha, Zbigniew Żuber

{"title":"A 4-Week-Old Female Infant with Type 3 von Willebrand Disease Presenting with Nosebleeds and Uncontrolled Bleeding Following Surgical Frenectomy: A Clinical Case.","authors":"Aleksandra Zima, Teresa Iwaniec, Joanna Zdziarska, Tomasz Sacha, Zbigniew Żuber","doi":"10.12659/AJCR.946625","DOIUrl":"10.12659/AJCR.946625","url":null,"abstract":"BACKGROUND Congenital von Willebrand disease can be autosomal recessive or dominant and is classified into types 1, 2, and 3, based on laboratory findings. Severe von Willebrand factor deficiency (type 3 von Willebrand disease) is a rare, congenital deficiency of plasma coagulation factor, the symptoms of which can manifest as early as during the first weeks of a child's life. This report describes the case of a 4-week-old female infant with congenital von Willebrand disease presenting with nosebleeds and uncontrolled bleeding following surgical frenectomy. CASE REPORT A 4-week-old female newborn experienced prolonged bleeding episodes, repeated nosebleeds, and gastrointestinal bleeding following the procedure of inferior labial frenulum cutting (frenectomy). During hematology diagnostics at the neonatal ward, the cause of the described manifestations was identified. In the tested parameters of the coagulation system, the activity of von Willebrand factor in the patient was <1% (below detectable levels). In addition, a secondary decrease in the child's serum FVIII activity (2.1%) was observed. We confirmed type 3 von Willebrand disease. CONCLUSIONS Although type 3 of the disease is an extremely rare disorder within the coagulation cascade, it is important to be aware of the symptoms that can signal a bleeding diathesis, also in children in the first weeks of life. In every patient, regardless of age, in the presence of bleeding and abnormalities in the results of hemostasis system tests, plasma coagulation disorders should be investigated.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946625"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152158","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}

引用次数: 0

Neurological and Cardiac Adverse Events in Cervical Cancer Treatment: A Case of Postoperative Sintilimab-Induced Encephalitis and Myocarditis. 宫颈癌治疗中的神经系统和心脏不良事件：术后辛替利单抗引起的脑炎和心肌炎1例。

IF 1

American Journal of Case Reports Pub Date : 2025-05-26 DOI: 10.12659/AJCR.947730

Haiyu Guo, Huanlei Wu, Jun Li, Ruichao Li

{"title":"Neurological and Cardiac Adverse Events in Cervical Cancer Treatment: A Case of Postoperative Sintilimab-Induced Encephalitis and Myocarditis.","authors":"Haiyu Guo, Huanlei Wu, Jun Li, Ruichao Li","doi":"10.12659/AJCR.947730","DOIUrl":"10.12659/AJCR.947730","url":null,"abstract":"BACKGROUND Immune checkpoint inhibitors (ICIs) have shown considerable promise in enhancing patient outcomes and improving survival rates, offering a new frontier in cancer treatment. As a result, their use in clinical practice has become more widespread. However, the adverse effects associated with ICIs can compromise treatment efficacy. Among these, immune-related neurological adverse events are relatively uncommon, with an incidence rate of approximately 17%. Central nervous system (CNS) symptoms, although less frequent (around 6%), are particularly concerning due to their higher risk compared to peripheral nervous system involvement. Additionally, in recent years, the incidence of cardiac toxicity has been increasing, often indicated by elevated cardiac biomarkers, but most cases are asymptomatic. CASE REPORT This report presents a case of a middle-aged woman with cervical cancer who developed both encephalitis and myocarditis during postoperative consolidation therapy with an immune checkpoint inhibitor. A thorough evaluation, including laboratory tests, imaging studies, and an assessment of the patient's medical history and clinical presentation, excluded infection and paraneoplastic encephalitis as potential causes. She was treated with high-dose corticosteroids and intravenous immunoglobulin (IVIG), resulting in gradual resolution of her central nervous system symptoms and normalization of cardiac biomarkers. CONCLUSIONS Although the incidences of immune-related encephalitis and myocarditis are generally low, they can be very severe. With the increasing use of ICIs in clinical practice, the incidence of immune-related neurological symptoms may rise. This highlights the need for increased vigilance in clinical applications, including early preventive measures and prompt diagnosis and treatment to mitigate the adverse effects of these therapies, thereby maximizing patient benefits.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947730"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144019","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}

引用次数: 0

A Rare Case of Severe Pernicious Anemia with Neuropsychiatric Implications. 一例罕见的伴有神经精神疾病的严重恶性贫血。

IF 1

American Journal of Case Reports Pub Date : 2025-05-25 DOI: 10.12659/AJCR.946911

Stanley Kim, Jade Punzalan, BreeAnna Carlson

{"title":"A Rare Case of Severe Pernicious Anemia with Neuropsychiatric Implications.","authors":"Stanley Kim, Jade Punzalan, BreeAnna Carlson","doi":"10.12659/AJCR.946911","DOIUrl":"10.12659/AJCR.946911","url":null,"abstract":"BACKGROUND Pernicious anemia (PA) is caused by a deficiency in intrinsic factor (IF), which is necessary for vitamin B12 (cobalamin) absorption, resulting in vitamin B12 deficiency and subsequent megaloblastic anemia. Diagnosis of PA relies on the detection of circulating antibodies to IF. In addition to anemia, patients can develop neuropsychiatric conditions, such as subacute combined degeneration of the spinal cord or psychosis. We present the case of a patient with a history of schizophrenia who exhibited unusually severe manifestations of pernicious anemia, including life-threatening anemia, multiple hypersegmented neutrophils, and significantly elevated methylmalonic acid (MMA) levels. CASE REPORT A 51-year-old Hispanic woman with a history of schizophrenia was admitted with severe weakness, shortness of breath, and diarrhea. The hemoglobin (Hb) level was 2.5 g/dL and mean corpuscular volume (MCV) was 133 fL. A diagnosis of pernicious anemia was made by a low vitamin B12 level, high levels of methylmalonic acid (MMA) and homocysteine, and positive IF-blocking antibodies. Her anemia did not improve initially, even after 3 units of blood were transfused. She had no signs of bleeding. It was thought that hemoconcentration due to severe dehydration falsely raised her initial Hb levels, which were corrected by hydration. A peripheral blood smear showed many hypersegmented neutrophils. With parenteral cyanocobalamin therapy, her anemia and schizophrenia symptoms improved. The hypersegmented neutrophils disappeared by 2 weeks. CONCLUSIONS This is an extreme case of pernicious anemia with life-threatening anemia. The hypersegmented neutrophils disappeared in 2 weeks with vitamin B12 therapy. The symptoms of schizophrenia also improved.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946911"},"PeriodicalIF":1.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143968","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}

引用次数: 0

Recurrent Angiomatous Meningioma in a Young Adult: A Case Report. 青年血管瘤性脑膜瘤复发1例报告。

IF 1

American Journal of Case Reports Pub Date : 2025-05-24 DOI: 10.12659/AJCR.947185

Viktorija Loginova, Raimonds Mikijanskis, Daira Krišāne, Inese Briede, Ilze Štrumfa, Arturs Balodis

{"title":"Recurrent Angiomatous Meningioma in a Young Adult: A Case Report.","authors":"Viktorija Loginova, Raimonds Mikijanskis, Daira Krišāne, Inese Briede, Ilze Štrumfa, Arturs Balodis","doi":"10.12659/AJCR.947185","DOIUrl":"10.12659/AJCR.947185","url":null,"abstract":"BACKGROUND Meningiomas stand as the predominant primary intracranial tumors, encompassing a broad spectrum of histological variations. Within this spectrum, angiomatous meningiomas are notable for their significant vascularity within the tumor structure and rarity, making up only 2.1% of all meningiomas. These tumors typically present with slow-onset symptoms, commonly manifesting as seizures and compression-related effects. This report describes a 27-year-old man presenting with seizures and a diagnosis of angiomatous meningioma with postoperative recurrence, emphasizing the challenges in imaging, diagnosis, and disease management. CASE REPORT A 27-year-old man presented with a generalized seizure and unconsciousness. He had a history of exposure to chemicals from road construction and logging and smoked for 7 pack years. Initial CT scan revealed a 2.8-cm irregular tumor on the convex surface of his right frontal lobe. Craniotomy and resection of the lesion revealed angiomatous meningioma (central nervous system [CNS] World Health Organization [WHO] grade I). Six months later, control MRI showed recurrence at the excision site (2.4×2.0×1.4 cm). Re-craniotomy confirmed atypical meningioma (CNS WHO grade 2), and the patient received postoperative radiotherapy (56 Gy). CONCLUSIONS This case report highlights the importance of MRI in diagnosing angiomatous meningioma, a rare subtype comprising only 2.1% of all meningiomas. Although the tumor was initially resected successfully, its rapid recurrence as a WHO grade 2 atypical meningioma within 6 months underscores the surgical challenges and high recurrence risk associated with its vascular nature. These findings emphasize the need for careful postoperative monitoring and management.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947185"},"PeriodicalIF":1.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136435","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}

引用次数: 0

Allergic Reactions to Tetracaine-Phenylephrine in Neonatal Lingual Frenotomy: Clinical Insights. 新生儿舌切开术对丁卡因-苯肾上腺素的过敏反应：临床观察。

IF 1

American Journal of Case Reports Pub Date : 2025-05-23 DOI: 10.12659/AJCR.947325

Adriana Cátia Mazzoni, Amanda Rafaelly Honório Mandetta, Barbara Curi, Sandra Gouveia Spinola, Lara Jansiski Motta, Ana Luiza Cabrera Martimbianco, Ana Paula Taboada Sobral, Cinthya Cosme Gutierrez Duran, Sandra Kalil Bussadori

{"title":"Allergic Reactions to Tetracaine-Phenylephrine in Neonatal Lingual Frenotomy: Clinical Insights.","authors":"Adriana Cátia Mazzoni, Amanda Rafaelly Honório Mandetta, Barbara Curi, Sandra Gouveia Spinola, Lara Jansiski Motta, Ana Luiza Cabrera Martimbianco, Ana Paula Taboada Sobral, Cinthya Cosme Gutierrez Duran, Sandra Kalil Bussadori","doi":"10.12659/AJCR.947325","DOIUrl":"10.12659/AJCR.947325","url":null,"abstract":"BACKGROUND Infants born with a short lingual frenulum, a condition known as ankyloglossia or tongue-tie, can experience breastfeeding difficulties and often require surgical frenotomy to restore functional mobility. Topical anesthesia is commonly used to minimize discomfort during the procedure, and adverse reactions are rare. This case report describes a 48-day-old female infant who experienced an allergic reaction to topical anesthesia with tetracaine and phenylephrine during frenotomy. CASE REPORT A 48-day-old infant with ankyloglossia and breastfeeding difficulties was referred for specialized dental evaluation. Laser frenotomy was indicated and performed under topical anesthesia with tetracaine and phenylephrine, followed by infiltrative anesthesia with lidocaine. During the application of the topical anesthetic, the patient developed lip edema and vesicles, which led to a diagnosis of ophthalmic anesthetic-induced angioedema. The procedure was completed without further complications, and the patient showed progressive improvement of the allergic condition postoperatively. CONCLUSIONS This case report highlights a rare complication of topical anesthesia with tetracaine and phenylephrine during frenotomy in a 48-day-old infant with breastfeeding difficulties. The observed allergic reaction emphasizes the importance of caution when using medications outside their intended scope and underscores the need for careful monitoring of adverse effects during procedures.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947325"},"PeriodicalIF":1.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128860","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}

引用次数: 0