Medicine
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Case Reports
Laparoscopic resection for appendiceal mucocele secondary to endometriosis: A case report.
This case report describes a patient who underwent laparoscopic resection of the mucocele of the appendix secondary to endometriosis, a rarity in clinical practice. ⋯ Although appendiceal mucoceles secondary to endometriosis are rare, laparoscopic surgery in which only the lesion was resected is a useful strategy for the treatment and pathological diagnosis of appendiceal mucoceles without findings of malignancy.
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A persistent primitive trigeminal artery (PPTA) is a rare embryonic cerebrovascular anomaly. Hemifacial spasm (HFS) refers to involuntary contractions of facial muscles caused by the compression of blood vessels against the root exit zone of the facial nerve. There have been no reported cases of PPTA causing neurovascular contact and HFS. Microvascular decompression surgery effectively treats HFS, but operating on strong PPTA vessels poses challenges. We aim to introduce a more efficient approach for overcomes these difficulties and facilitates surgery. ⋯ In cases where the vessel causing HFS is particularly strong and thick, the proximal Teflon transposition with interposition technique for transposition may be advantageous. This method could simplify and enhance the efficacy of microvascular decompression, without compromising the quality of surgical outcomes.
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Case Reports
Atrial myxoma embolization of the basilar artery presenting with a convulsive seizure: Case report.
Basilar artery occlusion (BAO) is a rare cause of convulsive seizure. Such patients who are treated for epilepsy will miss the optimal time for treatment. Atrial myxoma is a rare cause of stroke and should be surgically removed as soon as possible after diagnosis. ⋯ A small number of patients with BAO present with convulsive seizures. It is very important to make a timely diagnosis. Direct thrombaspiration may be the best choice for basilar artery cardioembolization, and thrombectomy for distal moderate vascular occlusion in posterior circulation is feasible. Atrial myxoma is a rare cause of cardioembolic stroke and should be resected as soon as possible to prevent further embolic complications.
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Lung-protective ventilation is now the norm for all patients, regardless of the presence of acute respiratory distress syndrome (ARDS), owing to the mortality associated with higher tidal volumes (TV). Clinicians calculate TV using recorded height from medical records and predicted body weight (PBW); however, the accuracy remains uncertain. Our study aimed to validate accurate TV settings for lung-protective ventilation by examining the correlation between the charted height and bedside measurements. ⋯ In the group where heights were overestimated, over half of the patients received TV prescriptions from healthcare providers that surpassed the TV of calculated 8 mL/kg PBW based on their measured height. The risk factors for height overestimation include female sex, Asian ethnicity, and missing driver's license data. Alternative height measurement methods should be explored to ensure precise ventilation settings and patient safety.
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Posterior reversible encephalopathy syndrome is a neurological condition characterized by headache, convulsions, altered consciousness, and visual disturbance with specific radiological features, which is characterized by contrast enhancement in the occipital lobe on T2-weighted image. We report a case of sudden visual impairment of both eyes 6 days after childbirth diagnosed as postpartum preeclampsia and posterior reversible encephalopathy syndrome (PRES) through radiological examination. ⋯ PRES in postpartum preeclampsia can cause rapid vision and symptoms, visual field loss, and accurate follow-up diagnosis with relevant imaging and clinical patterns can improve vision.