Nederlands tijdschrift voor geneeskunde
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An 80-year-old man was admitted because of head trauma following a fall down a staircase. Initial CT-imaging of the brain showed only global atrophy, but repeated CT-imaging 4 days later revealed a subdural hygroma. Because of the discrepancy between the radiological deterioration and the unchanged neurological condition, we refrained from neurosurgical evacuation. ⋯ The pathophysiology is not well known. Differentiating subdural hygroma (cerebrospinal fluid (CSF) accumulation in the subdural space) from external hydrocephalus (excessive CSF accumulation in the subarachnoid space) is important in view of the therapeutic consequences. Because CT-imaging usually cannot differentiate between these 2 conditions, we recommend the use of MRI.
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Ned Tijdschr Geneeskd · Mar 2007
Comment[Palliative care is more than palliative antitumour treatment and symptom management].
Nowadays, many palliative treatments are available for advanced cancer. These treatments provide relief of symptoms and add months to life, but their price is high, both literally and figuratively. ⋯ This 'conspiracy of silence' makes it hard to say 'we don't have any further treatment'. Instead of saying 'we have no further treatment', patients should be offered palliative care as a positive choice to achieve the best quality of life, not only with physical but also with psychological, social and spiritual support.
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Ned Tijdschr Geneeskd · Mar 2007
Case Reports[Diagnostic image (313). A woman with peracute abdominal pain in the right lower quadrant].
A 29-year-old woman presented with peracute pain in the right lower quadrant of her abdomen, which at diagnostic laparoscopy appeared to be related to hematoperitoneum caused by bleeding ofa corpus rubrum.