Post-concussive syndrome to primary central nervous system lymphoma: An insidious presentation.

Primary central nervous system lymphoma (PCNSL) and central neurogenic hyperventilation (CNH) are both rare occurrences, especially when associated with Epstein-Barr Virus (EBV). We report a case of an immunocompetent individual who presented to the emergency department (ED) with vague neurological symptoms found to have an EBV-associated PCNSL complicated by CNH. This rare occurrence had an insidious presentation initially mistaken for "post-concussive syndrome" at an outside ED. Insidious neurological malignancies, posterior strokes, intracranial hematomas, and other life-threatening pathologies should always be on the differential in patients presenting to the ED with falls with associated neurological symptoms, especially with unexplained blood gas abnormalities.

Gastrogastric intussusception in the setting of a small bowel obstruction.

Adult patients comprise 5% of all intussusceptions with 2 to 3 cases per million per year. Of those, only 10% of adult intussusceptions involve the stomach. Gastrogastric intussusceptions are most often associated with lead points caused by gastric neoplasms, with a few caused by hiatal hernias or ascites. Unlike children, adult intussusceptions are rarely idiopathic. Herein, a case is presented of a 65-year-old male who was found to have a gastrogastric intussusception in the setting of a small bowel obstruction with no evidence of neoplasm confirmed by biopsy. The patient initially presented to the emergency department with nausea, emesis, and epigastric pain. Given that almost all reported cases have been associated with gastric neoplasms, this case shows an unusual phenomenon of gastrogastric intussusception that has not reported before. Furthermore, our case offers a different etiology of gastrogastric intussusception in adults other than being due to a gastric neoplasm.