BMJ case reports
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Eagle syndrome (symptoms associated with an elongated styloid process (SP)) is commonly divided into two presentations. First, the so-called classic Eagle syndrome where patients can present with unilateral sore throat, dysphagia, tinnitus, unilateral facial and neck pain and otalgia. Second, there is the vascular or stylocarotid form of Eagle syndrome in which the elongated SP is in contact with the extracranial internal carotid artery. ⋯ A surgical resection of the SP was performed on the former patient. Both patients were treated with anticoagulation and recovered well. A literature search only revealed two prior descriptions of carotid dissection in the context of an elongated SP.
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The surgical principles for the treatment of flail chest have yet to be fully established. Furthermore, the relationship between flail chest and lung hernias is unclear. We report here a rare case of chondrosternal traumatic disruption and lung hernia that was treated with a novel technique using titanium rib bridges and clips, which successfully reduced the hernia defect and provided stability to the chest wall. This procedure was beneficial in minimising the patient's ventilation time and time away from work.
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Case Reports
Rehabilitation following intracerebral haemorrhage secondary to extracorporeal membrane oxygenation (ECMO).
Extracorporeal membrane oxygenation (ECMO) was first used in adults with severe respiratory failure in the 1970s. Its use has been steadily increasing since the 1990s after a trial demonstrated improved survival. There are currently seven centres in the UK offering ECMO to adults. ⋯ She was transferred to a tertiary centre and suffered bitemporal and right parietal haemorrhages on ECMO in late February. She was repatriated to our unit for rehabilitation in April 2012. Her rehabilitation needs represent the complexity of this patient group with multiple medical, behavioural and physical challenges.
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Review Case Reports
High dose of prokinetics for refractory hiccups after chemotherapy or the return to a simple drug.
Hiccups in patients with cancer might be difficult to treat, impacting negatively on the quality of life. Many therapies are available, but they are usually started empirically, and often they are unsuccessful. We report a case of a man with metastatic colon cancer who after the first cycle of chemotherapy developed persistent hiccups refractory to neuroleptics and low dose of metoclopramide. ⋯ This case shows how searching for potential causes helps start the right treatment immediately, and therefore it is relevant for the prompt relief from this bothersome symptom. So far, no cases reporting high doses of prokinetics to treat persistent hiccups after chemotherapy have been published. This option should be taken into account when developing hiccups and gastro-oesophageal reflux after chemotherapy, especially if low doses of prokinetics have already been tried.