Pneumomediastinum Associated with Pneumopericardium and Epidural Pneumatosis

Spontaneous pneumomediastinum is a relatively rare benign condition. It may rarely be associated with one or combination of pneumothorax, epidural pneumatosis, pneumopericardium, or subcutaneous emphysema. We present a unique case with four of the radiological findings in a 9-year-old male child who presented to our emergency department with his parents with complaints of unproductive cough, dyspnea, and swelling on chest wall. Bilateral subcutaneous emphysema was palpated on anterior chest wall from sternum to midaxillary regions. His anteroposterior and lateral chest radiogram revealed subcutaneous emphysema and pneumomediastinum. His thorax computed tomography to rule out life-threatening conditions revealed bilateral subcutaneous, mediastinal, pericardial, and epidural emphysema without pneumothorax. He was transferred to pediatric intensive care unit for close monitorization and conservative treatment. He was followed-up by chest radiographs. He was relieved from symptoms and signs around the fifth day and he was discharged at the seventh day. Diagnosis of pneumomediastinum is often made based on physical findings and plain radiographs. It may not be as catastrophic as it is seen. Close cardiopulmonary monitorization is mandatory for complications and accompanying conditions. Most patients with uncomplicated spontaneous pneumomediastinum respond well to oxygen and conservative management without any specific treatment

Incidental Finding in a Headache Patient: Intracranial Lipoma

[West J Emerg Med. 2014;15(4):361-362.

Geçici İskemik Atak Şeklinde Ortaya Çıkan Deli Bal Zehirlenmesi

Deli bal zehirlenmesi Türkiye'nin Doğu Karadeniz bölgesinde üretilen balın yenmesinden kaynaklanan klinik bir durumdur. Bu bal, Rhodendron Ponticum bitkisinin nektarından üretilir.Deli bal yenmesini takiben, sersemlik hissi, güçsüzlük, terleme, bulantı, kusma, tükrük salgılama,kognitif fonksiyonlarda baskılanma, senkop, bulanık görme, ağız çevresinde veya ekstremitelerdeparestezi, siyanoz veya konvulziyondan biri veya iki ya da daha fazlasının birlikte görülmesiyleortaya çıkan bu kolinerjik sendromdan grayanotoksin sorumludur. Hipotansiyon ve bradikardi ensık görülen zehirlenme bulgularıdır. Semptomlar genellikle intravenöz sıvı replasmanı ve atropineiyi cevap verir ve 24 saat içinde düzelir. Bu yazı kapsamında, sağ tarafında güçsüzlükle başvuran67 yaşındaki hastada, geçici iskemik atağı taklit eden deli bal zehirlenmesi olgusu sunulmuşturMad honey poisoning is a clinical state resulting from the ingestion of honey produced in theBlack Sea region of Turkey. This honey is produced from the nectar of the RhododendronPonticum plant. Grayanotoxin is responsible for this cholinergic syndrome, presenting with eitherone or a combination of two or more of lightheadedness, weakness, diaphoresis, nausea, vomiting, salivation, depressed cognitive function, syncope, blurred vision, paresthesia in the perioralregion or extremities, cyanosis and convulsions shortly following ingestion of mad honey.Hypotension and bradycardia are the most commonly seen signs of toxicity. Symptoms usuallyrespond well to intravenous fluid replacement and atropine, and relieve within 24 hours. In thispaper, we report a case of mad honey poisoning in a 67 years old patient who presented withweakness on his right side, mimicking transient ischemic attac

Isolated abducens nerve palsy due to pituitary apoplexy after mild head trauma

YAVASI, OZCAN/0000-0001-8641-7031WOS: 000361839300056PubMed: 26314216Pituitary apoplexy is a relatively rare condition. Cranial nerve palsies may develop due to compression of the surrounding structures by the rapidly expanding tumor. While the most commonly affected nerve is the oculomotor nerve, abducens nerve palsy may also occur less commonly. A 68-year-old male patient was admitted to the emergency department with complaints of severe headache, nausea, vomiting, and diplopia after head trauma due to falling. His magnetic resonance imaging evaluation demonstrated a large pituitary adenoma and bleeding into the tumor, which was acutely expanding and leading to compression of the abducens nerve laterally. Isolated abducens palsy due to posttraumatic pituitary apoplexy is a rare clinical condition, and as the symptoms and signs are nonspecific, it can commonly remain clinically undiagnosed. in this article, our aim was to draw attention to a clinical condition in which unfavorable complications may develop if the diagnosis is overlooked

Incidental Finding in a Headache Patient: Intracranial Lipoma

[West J Emerg Med. 2014;15(4):361-362.

Unilateral Isolated Hypoglossal Nerve Palsy Caused by Gunshot Injury

WOS: 000427989400073PubMed: 29381638Cranial nerve palsies after gunshot injury are not uncommon. However, in the literature, only 1 patient with isolated hypoglossal nerve paralysis caused by gunshot has been published. the authors describe a 34-year-old man suffering from unilateral isolated hypoglossal nerve palsy caused by gunshot injury as a second reported patient. the bullet entered maxillary sinus, and caused condylar fracture, then ended up C1-2 interspace. the bullet was surgically removed by a posterior approach. It is important to pay attention to hypoglossal nerve injury when confronted with a gunshot wound. the authors recommend early and sufficient surgical decompression