Spontaneous Carotid Artery Dissection Presenting as Trigeminal Neuralgia in the Emergency Department

Introduction: Carotid artery dissection (CAD) is a critical diagnosis in the emergency department (ED). Trigeminal neuralgia, while not uncommon, may cause the patient significant discomfort but generally is not attributed to severe morbidity and mortality.Case Report: We present a case of spontaneous CAD presenting with the classic intermittent “lightning-like” jaw and head pain suggestive of trigeminal neuralgia that was ultimately diagnosed utilizing computed tomography angiogram after multiple visits to the ED.Discussion: Coincidentally the patient had been started on anticoagulation a few days prior and no additional intervention was required.Conclusion: This case report discusses current recommendations for diagnosis, treatment, and long-term prognosis of CAD

Overview of the LBNE Neutrino Beam

The Long Baseline Neutrino Experiment (LBNE) will utilize a neutrino beamline facility located at Fermilab. The facility is designed to aim a beam of neutrinos toward a detector placed at the Deep Underground Science and Engineering Laboratory (DUSEL) in South Dakota. The neutrinos are produced in a three-step process. First, protons from the Main Injector hit a solid target and produce mesons. Then, the charged mesons are focused by a set of focusing horns into the decay pipe, towards the far detector. Finally, the mesons that enter the decay pipe decay into neutrinos. The parameters of the facility were determined by an amalgam of the physics goals, the Monte Carlo modeling of the facility, and the experience gained by operating the NuMI facility at Fermilab. The initial beam power is expected to be {approx}700 kW, however some of the parameters were chosen to be able to deal with a beam power of 2.3 MW

Atypical Presentation of Median Arcuate Ligament Syndrome in the Emergency Department

Celiac artery compression syndrome, also called median arcuate ligament syndrome (MALS), is a rare condition in which the diaphragmatic crura compresses the celiac axis. This results in a constellation of primarily gastrointestinal (GI) symptoms including nausea, vomiting, postprandial abdominal pain, and weight loss. It is typically a diagnosis of exclusion and may be detected via several imaging techniques including ultrasound and computed tomography angiography. We present an atypical case of MALS detected in the emergency department (ED). We review the symptomatology, diagnostic workup, and treatment options here, as well as discuss implications concerning revisits to the ED for recurrent GI symptoms

Atypical Presentation of Median Arcuate Ligament Syndrome in the Emergency Department

Celiac artery compression syndrome, also called median arcuate ligament syndrome (MALS), is a rare condition in which the diaphragmatic crura compresses the celiac axis. This results in a constellation of primarily gastrointestinal (GI) symptoms including nausea, vomiting, postprandial abdominal pain, and weight loss. It is typically a diagnosis of exclusion and may be detected via several imaging techniques including ultrasound and computed tomography angiography. We present an atypical case of MALS detected in the emergency department (ED). We review the symptomatology, diagnostic workup, and treatment options here, as well as discuss implications concerning revisits to the ED for recurrent GI symptoms

An Unusual Presentation of Acute Weakness: Acute Inflammatory Demyelinating Polyneuropathy in a Patient with Psychiatric Illness

We report an unusual presentation of Guillain-Barré wherein a patient with an extensive history of psychiatric illness had a dream that his legs were crushed in an earthquake and awoke from the dream with paresthesias and rapid paralysis of bilateral lower extremities. This article discusses an atypical presentation of pathology and diagnostic evaluation for a form of Guillain-Barré called Acute Inflammatory Demyelinating Polyneuropathy (AIDP)