Emergency Medicine Commons^™

Diagnostic Potential Of The Nmda Receptor Peptide Assay For Acute Ischemic Stroke, Svetlana A. Dambinova, Kerstin Bettermann, Theodore Glynn, Matthew Tews, David Olsen, Joseph D. Weissman, Richard K. Sowell

Faculty Articles

Background

The acute assessment of patients with suspected ischemic stroke remains challenging. The use of brain biomarker assays may improve the early diagnosis of ischemic stroke. The main goal of the study was to evaluate whether the NR2 peptide, a product of the proteolytic degradation of N-methyl-D-aspartate (NMDA) receptors, can differentiate acute ischemic stroke (IS) from stroke mimics and persons with vascular risk factors/healthy controls. A possible correlation between biomarker values and lesion sizes was investigated as the secondary objective.

Methods and Findings

A total of 192 patients with suspected stroke who presented within 72 h of symptom onset …

Safe Emergency Management Of Acute Ischemic Stroke: An Academic Community Hospital Decade Experience, John Castaldo, Richard S. Mackenzie Md, Peter J. Barbour Md, Lorraine Spikol, Yevgeniy Isayev, Yuebing Li Phd, Gary Clauser Md, John Margraf Md, Glenn Mackin Md, Faan, Facp, David Richardson, Gavin C. Barr, Jr. Md, Donna Jenny, Susan Nevada, Claranne Mathiesen

Department of Emergency Medicine

No abstract provided.

Near Fatal Posterior Reversible Encephalopathy Syndrome Complicating Chronic Liver Failure And Treated By Induced Hypothermia And Dialysis: A Case Report., Rashmi Chawla, Daniel Smith, Paul E Marik

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

INTRODUCTION: Posterior reversible encephalopathy syndrome is a clinico-neuroradiological entity characterized by headache, vomiting, altered mental status, blurred vision and seizures with neuroimaging studies demonstrating white-gray matter edema involving predominantly the posterior region of the brain. CASE PRESENTATION: We report a 47-year-old Caucasian man with liver cirrhosis who developed posterior reversible encephalopathy syndrome following an upper gastrointestinal hemorrhage and who was managed with induced hypothermia for control of intracranial hypertension and continuous veno-venous hemodiafiltration for severe hyperammonemia. CONCLUSION: We believe this is the first documented case report of posterior reversible encephalopathy syndrome associated with cirrhosis as well as the first report …

Narcotic Analgesics For Acute Migraine In The Emergency Room: Are We Meeting Headache Societies' Guidelines?, Mohammad Wasay, Khawaja Slaman Zaki, Saqib Uddin Khan, Rifat Rehmani

Department of Emergency Medicine

We analysed 161 patients with acute migraine in our emergency room (ER) to identify the use of narcotic analgesics as first-line treatment. Twenty-four percent of patients were treated with opioid analgesics and 76% patients were treated with non-opioid analgesics. Pain was completely relieved in 100 (62%) patients, partially relieved in 50 (31%) patients and was not relieved in 11 (7%) patients at the time of discharge. Pain relief was not related to the use of opioids vs. non-opioids. The treatment of acute migraine in our ER is in line with the guidelines of the Headache Societies and needs further improvement.