Connecticut medicine
-
Germinoma accounts for two-thirds of germ cell tumors and about 40% of all pineal region neoplasms. This case illustrates an unusual manifestation of metatastic germinoma with spread to ventricles and meninges without a pineal mass. A 24-year-old man presented with nausea, vertigo, and left facial droop. Cerebrospinal fluid aspirate showed malignant cells most suggestive of a germinoma.
-
Connecticut medicine · Oct 2004
Case ReportsSuccessful treatment of hydromorphone-induced neurotoxicity and hyperalgesia.
There has been an increase in opioid consumption world wide in the last decade. There has also been a disturbing increase in the number of reports of neuroexcitatory opioid-related side effects observed in patients receiving large doses of systemically administered morphine and its structural analogue, hydromorphone. It is now becoming clearer that patients receiving long-term opioid therapy can develop unexpected pain. We describe an interesting case of successful management of hydromorphone-induced neurotoxicity and hyperalgesia produced by short-term therapy with rapidly escalating doses of systemic hydromorphone.
-
Connecticut medicine · Oct 2004
Case ReportsAccelerated idioventricular rhythm in a healthy teenager post circumcision.
Accelerated idioventricular rhythm (AIVR) is a ventricular arrhythmia, most commonly seen in adults with underlying cardiac disease. Few cases of AIVR have been reported in the adult population in the absence of cardiac pathology. ⋯ Extensive evaluation with echocardiogram, cardiac MRI, exercise stress test, and Holter monitoring did not reveal any gross abnormalities except for mitral valve prolapse. Our patient was asymptomatic at all times and did not have any serious cardiac problems.