{"title":"Transient speech impairment: a minor stroke/TIA case escaping conventional imaging methods.","authors":"Sheharyar H Khan, Mustafa Aljanabi","doi":"10.1093/omcr/omae119","DOIUrl":"https://doi.org/10.1093/omcr/omae119","url":null,"abstract":"<p><p>This case report discusses the diagnostic challenges posed by transient ischaemic attacks (TIAs) and minor strokes presenting with atypical symptoms, focusing on a 62-year-old male presenting with isolated speech difficulties reminiscent of Broca's aphasia. Despite initial inconclusive imaging, subsequent evaluation revealed minor periventricular changes consistent with ischaemic small vessel disease and a pre-existing lacunar infarct. The resolution of symptoms within 10 days highlights the transient nature of the event. The case underscores the importance of recognising nuanced presentations of cerebrovascular events and the necessity for standardised diagnostic criteria and assessment tools for transient speech impairments resembling Broca's aphasia. Further research into the mechanisms underlying these transient events, utilising advanced imaging techniques, such as diffusion-weighted MRI (DWI), may be warranted to facilitate early recognition and appropriate management in clinical practice.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 10","pages":"omae119"},"PeriodicalIF":0.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477241","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}
Branco G M Bettinotti, Mickias B Tegegn, Victor Razuk, Som Bailey, Rowena Hann, Cesar Mendoza, Marian T Calfa, Rosario A Colombo
{"title":"A Mother's struggle: postpartum preeclampsia complicated by triple vessel spontaneous coronary artery dissection.","authors":"Branco G M Bettinotti, Mickias B Tegegn, Victor Razuk, Som Bailey, Rowena Hann, Cesar Mendoza, Marian T Calfa, Rosario A Colombo","doi":"10.1093/omcr/omae120","DOIUrl":"https://doi.org/10.1093/omcr/omae120","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is an important cause of acute coronary syndrome among young women, especially in the postpartum period. Pregnancy-Associated SCAD (P-SCAD), an aggressive subtype, frequently involves multi-vessel dissection, decreased left ventricular function, and higher mortality. Here we present a rare case of postpartum pre-eclampsia complicated by multi-vessel SCAD in a 40-year-old multiparous Haitian black woman. Diagnosis was established with coronary angiography which revealed spontaneous dissection of the left anterior descendant, left circumflex, and right coronary arteries. Given the patient remained hemodynamically stable no percutaneous coronary intervention was indicated. She experienced recurrent anginal symptoms during her hospitalization that were managed with the addition of clopidogrel. The pathophysiology of P-SCAD is not well understood and thought to be related to an increased state of hemodynamic stress and hormonal fluctuation. The role of pre-eclampsia as a risk factor remains poorly defined and warrants further investigation.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 10","pages":"omae120"},"PeriodicalIF":0.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477234","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}
Vanita Shukla, Paul Webb, Bashayer AlMohaimeed, James Lee, Cyrus Boelman
{"title":"Rhythmic high-amplitude delta with superimposed spikes (RHADS): a treatment dilemma.","authors":"Vanita Shukla, Paul Webb, Bashayer AlMohaimeed, James Lee, Cyrus Boelman","doi":"10.1093/omcr/omae114","DOIUrl":"https://doi.org/10.1093/omcr/omae114","url":null,"abstract":"<p><p>Pathognomonic EEG patterns have been described in genetic conditions such as Angelman and Rett syndromes. EEG patterns along the ictal-interictal continuum have been increasingly recognized with the greater availability of continuous EEG monitoring; however, treatment decisions may be difficult with unpredictable clinical implications. Rhythmic High-Amplitude Delta Activity with Superimposed (Poly) Spikes (RHADS) has been described as a particular EEG pattern in POLG1 Alpers Syndrome. The balance between treating subclinical seizures and managing encephalopathy in these patients is challenging.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 10","pages":"omae114"},"PeriodicalIF":0.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477240","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}
Ayoub Kharkhach, Asmae Bali, Said Afqir, Tariq Bouhout, Badr Serji
{"title":"Mesonephric carcinoma of the cervix associated with ovarian serous carcinoma: a case report.","authors":"Ayoub Kharkhach, Asmae Bali, Said Afqir, Tariq Bouhout, Badr Serji","doi":"10.1093/omcr/omae117","DOIUrl":"https://doi.org/10.1093/omcr/omae117","url":null,"abstract":"<p><p>Malignant mesonephric tumor of the uterine cervix is an extremely uncommon subtype of cervical adenocarcinoma with rare, documented cases in the literature. In this report, we present a case of 58 yo, with abdominal pain and ascites that was found to have a synchronous presence of a mesonephric adenocarcinoma of the cervix and advanced serous ovarian carcinoma on the surgical specimen. The histological study identified a tumor showing a mix of tubular and ductal growth patterns. Immunohistochemical analyses were positive for cytokeratin, vimentin, calretinin and CD10. However, the tumor cells were negative for estrogen receptor and progesterone receptor. The patient received neoadjuvant chemotherapy with a combination of carboplatin and gemcitabine followed by optimal debulking surgery and was alive after 18 months of follow up. The management of this rare case remains unclear due to the absence of management guidelines.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 10","pages":"omae117"},"PeriodicalIF":0.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477238","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}
Raid Faraj, Thierno Hamidou Diallo, Mehdi Abdelali, Reda Lahjouji, Fatima-Azzahra Benmessaoud, Nawal Doghmi, Jamila Zarzur, Mohamed Cherti
{"title":"Regression of biventricular hypertrophy in acromegalic cardiomyopathy following management of excessive growth hormone secretion.","authors":"Raid Faraj, Thierno Hamidou Diallo, Mehdi Abdelali, Reda Lahjouji, Fatima-Azzahra Benmessaoud, Nawal Doghmi, Jamila Zarzur, Mohamed Cherti","doi":"10.1093/omcr/omae112","DOIUrl":"https://doi.org/10.1093/omcr/omae112","url":null,"abstract":"<p><p>Acromegalic cardiomyopathy is a significant cardiovascular complication associated with acromegaly, caused by excessive growth hormone production from a pituitary adenoma. Early diagnosis can be challenging due to its insidious nature. This case underscores the critical significance of timely medical intervention, illustrating favorable outcomes resulting from prompt therapeutic measures.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 10","pages":"omae112"},"PeriodicalIF":0.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477239","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}
Harem K Ahmed, Dilan S Hiwa, Soran H Tahir, Rawa M Ali, Dana T Gharib, Hoshmand R Asaad, Karokh F Hamahussein, Ayoob A Mohammed, Kayhan A Najar, Fahmi H Kakamad
{"title":"Crohn's disease presenting with pleural effusion: a case report.","authors":"Harem K Ahmed, Dilan S Hiwa, Soran H Tahir, Rawa M Ali, Dana T Gharib, Hoshmand R Asaad, Karokh F Hamahussein, Ayoob A Mohammed, Kayhan A Najar, Fahmi H Kakamad","doi":"10.1093/omcr/omae113","DOIUrl":"https://doi.org/10.1093/omcr/omae113","url":null,"abstract":"<p><p>Crohn's disease (CD) is a granulomatous inflammatory bowel disease. Around 25% of CD patients exhibit extraintestinal manifestations, though pulmonary involvement is rare. This study presents a case of CD causing pleural effusion. A 43-year-old man visited the pulmonology clinic with a dry cough for one-month, right-side pleuritic chest pain, and exertional dyspnea. He was treated with antihistamines and antitussive syrup, with incomplete relief. A chest CT scan showed bilateral mild pleural effusion. Given his occasional black stools and high serum calprotectin, a colonoscopy confirmed CD. Pulmonary manifestations may involve airway, parenchymal, and interstitial pathologies, but no distinctive pathological findings differentiate CD's pulmonary manifestations from other causes. In conclusion, isolated bilateral pleural effusion and the underlying pleuritis as a pulmonary manifestation of CD-characterized by dry cough and pleuritic chest pain, particularly preceding the diagnosis of CD-is extremely rare but possible.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 10","pages":"omae113"},"PeriodicalIF":0.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477236","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}
Oumaima Mesbah, Manal Jidal, Rachida Saouab, Jamal El Fenni
{"title":"Clinical report of metacarpal melorheostosis: a rare disease with \"the dripping candle wax\" appearance on different imaging modalities.","authors":"Oumaima Mesbah, Manal Jidal, Rachida Saouab, Jamal El Fenni","doi":"10.1093/omcr/omae115","DOIUrl":"https://doi.org/10.1093/omcr/omae115","url":null,"abstract":"<p><p>Melorheostosis is a rare benign bone dysplasia characterized by dysostosis and sclerosis. The classic \"dripping candle wax\" appearance on imaging is a typical finding for the diagnosis. The authors report the case of a patient presenting with a hard and painful mass on the dorsal side of the hand.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 10","pages":"omae115"},"PeriodicalIF":0.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477235","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}
Ofonime O Benjamin, Omolabake E Riman, Anthony Offiong, Walter O Egbara, Asukwo Onukak, Aje N Ogar, Bassey E Ekeng
{"title":"Disseminated histoplasmosis diagnosed on a blood smear in a Nigerian patient with non-Hodgkin's lymphoma.","authors":"Ofonime O Benjamin, Omolabake E Riman, Anthony Offiong, Walter O Egbara, Asukwo Onukak, Aje N Ogar, Bassey E Ekeng","doi":"10.1093/omcr/omae116","DOIUrl":"https://doi.org/10.1093/omcr/omae116","url":null,"abstract":"<p><p>Disseminated histoplasmosis is rarely reported in patients living with cancers in Nigeria. We report a 40-year-old woman who presented with left neck swelling and abdominal pain of two weeks duration. Clinical examination and radiological findings showed pallor, epigastric tenderness, generalized lymphadenopathy and hepatosplenomegaly. An initial diagnosis of sepsis and micronutrient deficiency was made following findings of macrocytosis, hypersegmented neutrophils and toxic granulations on blood smear. Intervention with antibiotics did not improve symptoms rather her clinical presentation worsened with the onset of fever, dizziness, easy fatiguability and generalized weakness. Histology of lymph node biopsy reported a diffuse large B-cell lymphoma. A repeat examination of the blood smear revealed budding yeast cells morphologically similar to <i>Histoplasma capsulatum</i>. This case emphasizes the need for a high index of suspicion of histoplasmosis in this at-risk population and the usefulness of a blood smear in diagnosing histoplasmosis.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 10","pages":"omae116"},"PeriodicalIF":0.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477237","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":"Iatrogenic acute type A aortic dissection during catheter ablation for idiopathic ventricular premature contraction.","authors":"Shinichi Ishida, Yoshio Takemoto, Ryutaro Kimata, Kei Yagami","doi":"10.1093/omcr/omae110","DOIUrl":"10.1093/omcr/omae110","url":null,"abstract":"<p><p>Acute aortic dissection type A during cardiac catheterization has been reported as a rare but fatal complication. We present a case of acute aortic dissection type A occurring during catheter manipulation in the ascending aorta during mapping of ventricular premature contraction via the retrograde approach. In the present case, transthoracic echocardiography showed no pericardial effusion and no flap of the aorta, but intracardiac echo clearly showed the flap. Enhanced computed tomography revealed the aortic dissection, which extended from the ascending aorta to the bilateral common iliac artery, and the false lumen was thrombosed completely. Emergent surgery was performed and the postoperative course was uneventful, and he was discharged with no complications. Aortic dissection is a rare complication of cardiac catheterization, and early detection could prevent a fatal outcome. It is important to detect the signs and symptoms as quickly as possible and perform various diagnostic examinations.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae110"},"PeriodicalIF":0.5,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298135","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}
Ghassan Bayat, Farah Haneyah, Laura Merjaneh, Sultaneh Haddad, Aboud Thaljah, Jack Zambakjian, Mike Ghabally
{"title":"Right pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema as rare complications after ERCP: a case report.","authors":"Ghassan Bayat, Farah Haneyah, Laura Merjaneh, Sultaneh Haddad, Aboud Thaljah, Jack Zambakjian, Mike Ghabally","doi":"10.1093/omcr/omae118","DOIUrl":"10.1093/omcr/omae118","url":null,"abstract":"<p><p>Endoscopic retrograde cholangiopancreatography is a complex procedure with a significant risk of severe consequences. We herein report a 56-year-old Middle Eastern female who was diagnosed with acute ascending cholangitis. Endoscopic retrograde cholangiopancreatography was performed with gallstone absorption and stent implanting. However, the patient developed significant pneumothorax; pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema of the abdomen, chest, right arm and shoulder, face and right orbital area. Radiological studies demonstrated no evidence of perforation on bowel obstruction. The patient was treated successfully with good results and post-operative follow-up was unremarkable. In conclusion, air leakage following endoscopic retrograde cholangiopancreatography without evidence of perforation is extremely rare. While pneumothorax development usually requires thoracostomy; pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema are usually treated conservatively.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2024 9","pages":"omae118"},"PeriodicalIF":0.5,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298137","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}