BMJ Case Reports最新文献_第10页

Transient cortical blindness following occipital lobe retraction in a pineal region meningioma resection. 松果体区脑膜瘤切除术后枕叶后短暂性皮质性失明。

IF 0.6

BMJ Case Reports Pub Date : 2025-06-27 DOI: 10.1136/bcr-2025-264865

Nicholas Zhe Wei Yip, Catriona Barbour-Hastie, Peter Barron, Justin B McKee, Chandrasekaran Kaliaperumal

{"title":"Transient cortical blindness following occipital lobe retraction in a pineal region meningioma resection.","authors":"Nicholas Zhe Wei Yip, Catriona Barbour-Hastie, Peter Barron, Justin B McKee, Chandrasekaran Kaliaperumal","doi":"10.1136/bcr-2025-264865","DOIUrl":"10.1136/bcr-2025-264865","url":null,"abstract":"A woman in her 50s experiences complete cortical blindness following a successful resection of a pineal region meningioma, most likely secondary to intraoperative bilateral occipital lobe retraction. The post-operative MRI did not demonstrate any ischaemia. The index presentation was worsening recurrent falls and cognitive decline from a large mass in the pineal recess resulting in triventriculomegaly, managed successfully with an endoscopic third ventriculostomy 7 months prior. The enlarging mass was resected via a parieto-occipital interhemispheric approach with a 7 hour operative time and no complications. Immediately post-operatively, she experienced cortical blindness lasting 3 days, improving over 3 weeks to then normal visual function by 8 months. This raises awareness of intraoperative occipital lobe retraction increasing the risk of transient cortical blindness post-operatively, along with the known risk factors of increased age and tentorial angles. Future research with functional MRI is required to further investigate cases of post-operative cortical blindness.","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511495","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

Early detection of the submucosal placement of a nasogastric tube. 鼻胃管粘膜下放置的早期发现。

IF 0.6

BMJ Case Reports Pub Date : 2025-06-27 DOI: 10.1136/bcr-2024-264462

Paul Rozenbroek, Nusrat Mohamed, Carsten E Palme, Murray Stokan, Tim Manzie

引用次数: 0

Point-of-care ultrasound in portal vein thrombosis associated with metastatic dermatofibrosarcoma protuberans. 转移性隆突性皮肤纤维肉瘤相关门静脉血栓形成的即时超声诊断。

IF 0.6

BMJ Case Reports Pub Date : 2025-06-27 DOI: 10.1136/bcr-2025-264892

Mohamad Zulkhairi Che Mat, Wan Syahmi Bin Wan Mohamad, Muhammad Aslam Ayob, Mohd Hashairi Fauzi

引用次数: 0

Monostotic fibrous dysplasia of calcaneus. 跟骨单一纤维发育不良。

IF 0.6

BMJ Case Reports Pub Date : 2025-06-26 DOI: 10.1136/bcr-2025-266910

Priya Maheshwari, Rajesh Ratan, John Ashutosh Santoshi, Prateek Behera

{"title":"Monostotic fibrous dysplasia of calcaneus.","authors":"Priya Maheshwari, Rajesh Ratan, John Ashutosh Santoshi, Prateek Behera","doi":"10.1136/bcr-2025-266910","DOIUrl":"10.1136/bcr-2025-266910","url":null,"abstract":"This report presents a case of fibrous dysplasia (FD) of the calcaneus in a patient in her 20s who initially experienced swelling followed by pain in her heel during weight-bearing activities. She visited multiple local clinics, leading to ineffective treatments.Upon presentation to a tertiary care hospital, a thorough clinical examination and radiological imaging (radiographs and CT scan) revealed a well-circumscribed, ground-glass appearance in the calcaneus, consistent with FD. Histopathological examination confirmed the diagnosis, showing curvilinear trabeculae of woven bone arranged in a Chinese letter pattern, surrounded by a fibroblastic stroma.The patient underwent surgical management, which included excisional biopsy, extended curettage and bone grafting using ipsilateral iliac crest bone mixed with beta-tricalcium phosphate. Postoperative immobilisation was managed with a below-knee cast for 6 weeks, and follow-up radiographs showed successful graft consolidation without any cortical breach.This case highlights the importance of accurate diagnosis, the potential for misdiagnosis in cases of FD, especially when seen at unusual locations, and the effectiveness of curettage and bone grafting for large bone defects. Early recognition through appropriate clinical evaluation and radiological imaging can prevent delays in treatment and lead to better outcomes.","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Muscular polyarteritis nodosa: a diagnostic and therapeutic challenge. 结节性肌性多动脉炎：诊断和治疗的挑战。

IF 0.6

BMJ Case Reports Pub Date : 2025-06-26 DOI: 10.1136/bcr-2025-265020

Emily Semple, Florence Vallelian, Andreas Hötker, Tibor Hortobagyi

引用次数: 0

Steering critical paediatric airway obstruction: insights from juvenile onset laryngeal papillomatosis. 指导关键儿科气道阻塞：从青少年发病喉乳头状瘤病的见解。

IF 0.6

BMJ Case Reports Pub Date : 2025-06-26 DOI: 10.1136/bcr-2024-264717

Bheemas B Atlapure, Dalim Kumar Baidya, Habib Md Reazaul Karim, Hanifa Akhtar

{"title":"Steering critical paediatric airway obstruction: insights from juvenile onset laryngeal papillomatosis.","authors":"Bheemas B Atlapure, Dalim Kumar Baidya, Habib Md Reazaul Karim, Hanifa Akhtar","doi":"10.1136/bcr-2024-264717","DOIUrl":"10.1136/bcr-2024-264717","url":null,"abstract":"Juvenile onset laryngeal papillomatosis is a relatively rare, benign, chronic, yet aggressive tumour caused by the human papillomavirus. We report the case of a toddler boy weighing 15 kg, referred from another health centre with a history of noisy breathing and occasional chest discomfort. CT suggested subglottic stenosis. On presentation, the child was having both inspiratory and expiratory stridor and tachypnoea, and emergency intervention was deemed necessary. With informed consent from the parents, difficult airway management was readied, including a plan for the cannot intubate and cannot oxygenate (CICO) scenario. Check video laryngoscopy (VL) using a Karl-Storz C-MAC system under ketamine and sevoflurane sedation while preserving spontaneous ventilation revealed dynamic airway obstruction with limited space even to negotiate a 3 mm endotracheal tube (ETT). Therefore, shearing the mass with forceps by the surgeon under C-MAC laryngoscopy was planned and performed on the spot. The trachea was finally intubated using a 3 mm ETT to allow further elimination of the tumorous mass. Spontaneous breathing with continuous positive pressure was preserved during the procedure. Episodes of desaturation were managed. Further surgical procedure was completed without any complications, and the child was extubated smoothly. This case highlights the critical importance of multidisciplinary teamwork, sound sense and practicality in managing complex paediatric airway obstruction at the level of the laryngeal inlet, where airway dynamics are unpredictable.","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pembrolizumab-induced Triple M Overlap Syndrome, example of indiscriminate immune activation. pembrolizumab诱导的三重M重叠综合征，无差别免疫激活的例子。

IF 0.6

BMJ Case Reports Pub Date : 2025-06-26 DOI: 10.1136/bcr-2024-263332

Ben Schroeder, Emily Bosak, Nitish Nandu, Mary Mikhael

引用次数: 0

Metronidazole-induced toxicity of the central and peripheral nervous system. 甲硝唑对中枢和周围神经系统的毒性作用。

IF 0.6

BMJ Case Reports Pub Date : 2025-06-26 DOI: 10.1136/bcr-2025-264904

Diego Villagrán Sancho, Carlota Villar Rodríguez, Antonio Cristóbal Luque Ambrosiani, Pablo Baena-Palomino

{"title":"Metronidazole-induced toxicity of the central and peripheral nervous system.","authors":"Diego Villagrán Sancho, Carlota Villar Rodríguez, Antonio Cristóbal Luque Ambrosiani, Pablo Baena-Palomino","doi":"10.1136/bcr-2025-264904","DOIUrl":"10.1136/bcr-2025-264904","url":null,"abstract":"A woman in her 80s was admitted with a growing feeling of dizziness, tingling and vomiting that began a week before. The neurological examination showed dysarthria, downbeat nystagmus and gait ataxia. At the time, she was taking antibiotics (1 g amoxicillin and 500 mg metronidazole every 8 hours) following surgery for a mandibular abscess a month earlier.Brain MRI showed T2 and FLAIR hyperintensities in dentate nuclei and splenium of the corpus callosum, findings described in metronidazole neurotoxicity. Metronidazole was discontinued, with resolution of all symptoms except lower limb paraesthesias.Given the ageing population and the increasing use of pharmacological treatments for multiple conditions, drug-induced neurological complications are receiving growing attention, yet they often remain underrecognised. Metronidazole neurotoxicity is a rare adverse effect that should be considered especially during prolonged treatments. The most frequent debut resembles this case, with cerebellar dysfunction as the most common central nervous system toxicity and concomitant polyneuropathy frequently associated.","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From acute flaccid paralysis (AFP)-Guillain-Barre Syndrome (GBS) and myelitis to progressive encephalopathy : acute disseminated encephalomyelitis (ADEM) atypical presentation of rabies following dog bite. 从急性弛缓性麻痹(AFP)-格林-巴利综合征（GBS）和脊髓炎到进行性脑病：急性播散性脑脊髓炎（ADEM）犬咬伤后狂犬病的非典型表现。

IF 0.6

BMJ Case Reports Pub Date : 2025-06-25 DOI: 10.1136/bcr-2025-265661

Vykuntaraju K Gowda, Archana Varghese, Nivedita P Doddamani, Viveka Santhosh Reddy Challa, Reeta S Mani, Sunitha Palasamudram Kumaran

{"title":"From acute flaccid paralysis (AFP)-Guillain-Barre Syndrome (GBS) and myelitis to progressive encephalopathy : acute disseminated encephalomyelitis (ADEM) atypical presentation of rabies following dog bite.","authors":"Vykuntaraju K Gowda, Archana Varghese, Nivedita P Doddamani, Viveka Santhosh Reddy Challa, Reeta S Mani, Sunitha Palasamudram Kumaran","doi":"10.1136/bcr-2025-265661","DOIUrl":"https://doi.org/10.1136/bcr-2025-265661","url":null,"abstract":"Rabies encephalitis is a rare but severe complication following dog bites, particularly when appropriate prophylaxis is not administered. We present the case of a tween girl, the firstborn child of a non-consanguineous married couple, who developed neurological symptoms following a category three dog bite. The child had received four doses of the rabies vaccine but did not receive Rabies Immunoglobulin (RIG). She initially presented with progressive lower limb weakness followed by urinary retention, which eventually progressed to encephalopathy and dystonia. Initial diagnosis of Guillain-Barre syndrome, later as transverse myelitis, and acute disseminated encephalomyelitis was considered. Investigations, including cerebrospinal fluid (CSF) analysis, MRI, and Rabies virus neutralising antibody (RVNA) titers, led to a diagnosis of rabies encephalitis. This case emphasises the importance of clinical suspicion for rabies in children presenting with progressive lower limb weakness and the necessity of timely and complete post-exposure prophylaxis to prevent such rare but fatal outcomes.","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thyroglossal duct cyst in the suprasternal region in an adolescent. 青少年胸骨上区甲状舌管囊肿。

IF 0.6

BMJ Case Reports Pub Date : 2025-06-25 DOI: 10.1136/bcr-2025-265798

Anandit Bal, Aditya Arvind Manekar, Mukund Namdev Sable, Santosh Kumar Mahalik

引用次数: 0