Ugeskrift for laeger
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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.
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Ugeskrift for laeger · Apr 2012
Comparative Study[Ibuprofen is more effective than paracetamol in lowering the temperature in febrile children].
In Denmark, the traditional choice for treating fever and pain in children is paracetamol. In other countries ibuprofen or a combination of paracetamol and ibuprofen is preferred. ⋯ It is concluded that ibuprofen seems to be more effective in reducing fever when compared to paracetamol. The two types of medications are equally effective when it comes to treating pain in children.
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This article is an introduction to Eagle syndrome as a differential diagnosis in patients with lateral neck pain, a symptom, which is often difficult to diagnose and where the accepted treatment covers a variety of forms. This was the case for a 51 year-old man with lateral neck pain and a crunchy sensation/sound when he turned his head. ⋯ The patient had severe symptoms and was treated with an operation by which part of the ossificated stylohyoid ligament was removed. The operation relieved him of all his symptoms.
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Ugeskrift for laeger · Apr 2012
Case Reports[Extravasation of contrast following coronary angiography can be misinterpretated as subarachnoid haemorrhage].
Brain parenchymal extravasation of contrast has been described after infusion of larger amounts of iodinated X-ray contrast agent. We describe a case in which a patient after infusion of 500 ml iomeprole 350 mg/ml developed neurological symptoms and a subsequent cerebral computed tomography (CT) scan was interpreted as subarachnoid haemorrhage. The patient was fully recovered within 48 hours, and a follow-up CT scan 26 hours later showed no signs of haemorrhage. In patients with sudden onset of neurological symptoms after infusion of large quantities of contrast media and a CT scan showing signs of subarachnoid haemorrhage, spinal puncture or magnetic resonance imaging should be considered prior to interventional procedures in order to verify the diagnosis.