Paraplesia after surfing in a young female novice surfer: a case report on surfer's myelopathy.

BACKGROUND: Surfer's myelopathy is a non-traumatic spinal cord injury that was first described in a publication in 2004. However, most emergency physicians are not familiar with this rare disease. CASE PRESENTATION: The patient was a 19-year-old female novice surfer. She had experienced back discomfort without trauma during her surfing lessons. The discomfort turned to dysesthesia of both legs. She could not walk after 1 h and was brought to our hospital. Physical examination revealed weakness and dysesthesia of both legs, absent deep tendon reflexes, bilaterally positive Babinski reflex, and bladder and rectal disturbance. Spine magnetic resonance imaging revealed T2 prolongation from T7 to the medullary cone. She was diagnosed with surfer's myelopathy and treated conservatively. She recovered well and was discharged on day 28. CONCLUSION: Emergency physicians must be better informed about surfer's myelopathy. Novice surfers and instructors should be educated on the early signs and symptoms of this condition.

A case report of systemic embolic events associated with atrial fibrillation.

Case: An 82-year-old woman who had atrial fibrillation was found unconscious and was brought to the emergency department by ambulance. Her Glasgow Coma Scale score was 3, and an electrocardiogram showed ST segment elevation in V3 and V4. Cardiac ultrasonography showed left ventricular asynergy in the anterior wall, septum, and apex. Although dissection of the aorta was suspected, contrast computed tomography showed multiple arterial thromboses, including bilateral common carotid arteries and poor contrast in the left ventricle. Diffusion-weighted images of magnetic resonance imaging showed a diffuse high-intensity area in both cerebral cortices. Outcome: The diagnosis was multiple arterial thromboembolisms associated with atrial fibrillation. There was no available treatment because of massive multiple lesions and the patient died within 24 h of presentation. Conclusion: Extracranial systemic embolic events other than cerebral embolism could be critical complications associated with atrial fibrillation.