Ugeskrift for laeger
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Ugeskrift for laeger · May 2012
Case Reports[Cardiac arrest caused by pulmonary embolus and treated with thrombolysis].
Resuscitation after cardiac arrest is unlikely if a reversible cause is not identified and treated. The potentially reversible causes can be described as hypoxia, hypovolaemia, hypo-/hyper-kalaemia/other metabolic disorders, hypothermia and tension pneumothorax, tamponade (cardiac), toxins and thrombus. ⋯ The patient was later confirmed to have had a massive pulmonary embolus. He was discharged to his home 13 days after cardiac arrest without any sign of neurological deficit.
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A 70 year-old man was admitted under the diagnosis of subarachnoid haemorrhage and presented with a history of ear pain, followed by acute onset of severe headache, nausea, vomiting, impaired consciousness, and fever. However, a computed tomography (CT) showed an acute mastoiditis and pneumocephalus, and a lumbar puncture confirmed the diagnosis meningitis. The increased middle ear pressure relative to the intracranial pressure had caused air and bacteria to penetrate intracerebrally. This case illustrates the importance of a rapid diagnostic workup in acute onset headache including a careful anamnesis, CT and lumbar puncture.