Neurologist
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Case Reports
Epidural abscess of the cervical spine with atypical manifestations: a report of two cases.
Epidural abscess of the cervical spine is a medical and surgical emergency, especially when it is located at cervical area, considering this critical anatomic location. Although there is the so-called triad of epidural abscess (fever, local pain, and neurologic deficits), these are not sensitive enough to detect spinal abscess early and prevent significant morbidity and mortality. ⋯ A high index of suspicion is most important in making a rapid, correct diagnosis of spinal epidural abscess (SEA) when a patient presents with local spinal pain and has risk factors like DM. The classic symptom triad of SEA is not sensitive enough for early detection, so a erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and CRP can be used to improve the accurate diagnosis. Spinal MRI should be performed as soon as possible. When patients present with neurologic deficits, surgical intervention is essential if there is no contraindication.
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Review Case Reports
Neuralgic amyotrophy, diagnosed with magnetic resonance neurography in acute stage: a case report and review of the literature.
We present a case of neuralgic amyotrophy (NA) diagnosed with magnetic resonance neurography (MRN) in the acute stage. ⋯ MRN should be the preferred imaging modality for the diagnosis of acute NA. This might not only help early diagnosis and guide treatment but also prevent unnecessary testing.
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Control of hypertension is a well-established goal of primary prevention of stroke, but management of blood pressure in patients with a previous stroke or in the setting of acute stroke is complicated by the effect blood pressure changes may have on cerebral perfusion. ⋯ Current data support the use of blood pressure reduction in the secondary prevention of stroke in patients with cerebrovascular disease. In the setting of acute stroke, however, data are limited and blood pressure management must be tailored to the specific clinical situation.