The West Virginia medical journal
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Intrathecal morphine infusions have historically been used in patients with short life expectancies. More recently, patients with pain from a benign source have benefited from this therapy. ⋯ At West Virginia University Hospital, we have implanted more than 700 intrathecal drug delivery systems (IT-DDS) since 1989, and have encountered two cases of granulomatous masses developing at the tip of the intrathecal catheter. This report describes these illustrative cases and provides a review of the literature.
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Case Reports
Malignant optic nerve glioma (glioblastoma multiforme): A case report and literature review.
Primary gliomas of the optic nerve are very rare. We report a case of a 59-year-old male with sudden vision loss diagnosed with malignant optic nerve glioblastoma multiforme. ⋯ The patient died eight weeks after initial presentation. In addition to our case, 30 previously reported cases of malignant optic nerve glioma are reviewed.
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Case Reports
Ethylene glycol intoxication: Disparate findings of immediate versus delayed presentation.
Ethylene glycol is a common household substance responsible for a large number of ingestions in the U. S. each year. In 2001, nearly 5,000 ethylene glycol exposures were reported with more than 1,600 patients requiring medical treatment. ⋯ A less well-known pattern may be seen in those for whom care is delayed. We present a patient with delayed presentation of ethylene glycol ingestion and review the physiology and biochemistry that underlies this different presentation. Unfortunately, without history or strong laboratory evidence, ethylene glycol ingestion may be easily overlooked in individuals with delayed presentation.