A Case Report Hemiparesis Caused by Ipsilateral Middle Cerebral Artery Infarction

As the corticospinal tract crosses at the medulla, supratentorial stroke generally influences the opposite extremity. However, new incidences of hemiparesis might occur in the ipsilateral brain if there was a previous infarction in the opposite brain or a congenital structural abnormality. The occurrence of ipsilateral hemiparesis after cerebral infarction is very rare; however, we report here the case of a patient who developed right hemiparesis that was identified as acute right middle cerebral artery infarction.

A Case Report Reversible Cerebral Vasoconstriction Syndrome with Thunderclap Headache During Swimming

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe thunderclap headache with multifocal segmental vasoconstriction of the cerebral arteries. RCVS can be diagnosed if the cerebral angiogram shows segmental stenosis and spontaneously resolves within weeks to months. RCVS is reversible, but might cause brain lesions such as subarachnoid hemorrhage or cerebral infarction. We report a 45-year-old woman with severe sudden onset frontal headache who was identified with reversible cerebral vasoconstriction syndrome.

A Clinical Analysis of Patient Exposure to Sulfuric Acid Injured

PURPOSE: This study was conducted to identify the characteristics associated with sulfuric acid injury in the emergency department. METHODS: Data were collected retrospectively from January 2007 to December 2015 on all sulfuric acid injuries presenting to the emergency department in Gu-mi Soonchunhyung University Hospital. Patients injured by sulfuric acid were recorded over a nine year study period and collected data included demographics, injury mechanism, injured body part, hospital care and final diagnosis. RESULTS: A total of 26 cases were identified. Most patients were male (88.5%) and the face was the most commonly injured body part. The most common mechanism of injury was splashing injury. A total of 16 (61.5%) patients were identified as having lesions worse than second degree burns. CONCLUSION: Sulfuric acid can cause severe and fatal skin burn. When working with sulfuric acid, acid proof protect clothing, goggles and glove should be worn. Furthermore, safety education and workplace environment improvement are necessary to reduce sulfuric acid injury.

A Clinical Analysis of Patients Who Visited Emergency Department due to Chemical Incident Occurred at Industrial Place: A Retrospective Study

PURPOSE: The purpose of this study is to understand what kinds of chemical substances have been used annually and to investigate incidents that occurred due to chemical hazard release and to analyze statistically clinically chemical injury patients who visited one regional emergency medical center in Gumi city with documented references review. METHODS: Annual chemical waste emission quantity (Kg/Year) (Cwep) was reproduced using national web site data governed by the Ministry of Environment and 5 years (from 1 .Jan. 2010 to 31. Dec. 2014) of medical records of chemical injury patients who visited our emergency department were reviewed retrospectively. By applying exclusion criteria, 446 patients of 460 patients were selected. RESULTS: Dichloromethane, Toluene, Trichloroethylene, and Xylene were always included within Top 5 of Cweq. Six cases of chemical incidents were reported and in 3 of 6 cases involving Hydrogen fluoride were included during the study period. Male gender and twenties were the most prevalent group. Injury evoking chemicals were Hydrogen fluoride, unknown, complex chemicals (over 2 substances) in sequence. The most frequent site of wounds and injuries was the respiratory tract. Gas among status, intoxication among diagnosis, and discharge among disposition was most numerous in each group. CONCLUSION: There have been no uniform clinical protocols for chemical wounds and injuries due to various kinds of chemicophysical properties and ignorance of antidotes. Therefore conduct of a multicenter cohort study and experiments for ruling out chemicals according to chemicophysical priority as well as development of antidotes and clinical protocols for chemical injury patients is needed.

Epileptic Seizure Revealing a Fahr's Syndrome with Pseudohypoparathyroidism: A Case Report

Fahr's disease is a rare disease characterized by idiopathic abnormal deposits of calcium in intracranial areas. Fahr's syndrome occurs secondarily to other diseases. Endocrine disorders, particularly parathyroid hormone disorders, are most commonly associated with Fahr's syndrome. Common clinical features of Fahr's disease or syndrome include movement disorder, phychiatric disorder, epileptic seizure, dementia, headache, dystonia, myoclonus, tremor, and parkinsonism. We report on a case of a 35-year-old woman with Fahr's syndrome who presented with epileptic seizure and pseudohypoparathyroidism.

A Case of Cardiac Arrest with Pulseless Ventricular Tachycardia Induced by Carthamus tinctorius L. (safflower) Seed Intoxication

Carthamus tinctorius L. is commonly known as safflower. This plant is cultivated mainly for its seed, which is used as essential oil and hot water extract. C. tinctorius has recently been shown to have antioxidant, analgesic, and anti-inflammatory activities. C. tinctorius seed is known as a relatively nontoxic material that is not associated with fatal adverse effects. We experienced a successful outcome in a 62-year-old male patient who was a victim of poisoning due to ingestion of C. tinctorius seed and undergone fatal adverse effects. He ate C. tinctorius seed mixed with alcohol and became lethargic state. In the emergency department, cardiac arrest with pulseless ventricular tachycardia occurred. He was treated by cardiopulmonary resuscitation with cardiac defibrillation. After return of spontaneous circulation, he was managed conservatively and was discharged without deficits approximately ten days after onset.

Ileocecal Vein Rupture Following Acupuncture

Among members of the public, acupuncture has a reputation for being safe. Since 1965, many case reports of serious or even life-threatening incidents caused by acupuncture have been reported in the literature. A 55 year old male was admitted with complaints of abdominal pain after acupuncture therapy at an oriental medicine hospital. Abdominal Computerized Tomography (CT) scan showed a mass measuring 9.8 cm with active bleeding. Emergency operation was performed. He was diagnosed as ileocecal vein rupture following acupuncture. We report here on a case of an iliocecal vein rupture following acupuncture therapy and we review the relevant literature.

Clinical Analysis of Electrical Burn Patients

BACKGROUND: Good documentation of electrical injuries at the time of presentation is very important to emergency management, so this study was designed to investigate the clinical characteristics and the outcomes of patients with electrical injury. METHODS: A review of 75 cases of electrical injuries admitted to our hospital via the emergency department over a 4 year period from 1996 to 1999 was conducted. RESULTS: There were 49 patients with high-voltage injuries and 19 patients with low-voltage injuries. All but 4 patients were males, with a mean age of 29.5 years. The most common type of injury was 14.5% TBSA in the high-voltage group and 2.5% in the low-voltage group. Forty-nine(72.1%) of the injuries were work related. The number of patient with compartment syndrome was 19, and fasciotomies were performed in all but one patient. Myoglobinuria was noted in 22 patients, but no patient developed acute renal failure due to myoglobinuria. In the high-voltage group, 10 limb amputations were performed. Complication were observed in 12 patients. The most common complication was neurological injury. The average length of hospital stay was 50.7 days in the high-voltage group and 13.8 days in the low-voltage group. The overall mortality rate was 4.3%. CONCLUSION: Prevention of electrical injuries is very important. Education and compliance with safety measures, as well as basic knowledge and precaution in dealing with electricity, are essential to avoid these injuries.

Adequacy of Siriraj Stroke Score in Differentiation of Stroke Patients

BACKGROUND: The differentiation between hemorrhagic(HS) and norhemorrhagic(NHS) stroke is the most important first step in the management of acute stroke because clinical management of the two disorders differs substantially. Neuroimaging studies are useful in diagnosing and distinctioning between HS and NHS. The use of clinical variables, such as Siriraj stroke scores(SSS), has led to good sensitivity, specificity and predictive values. The aim of our study was to evaluate the use of the SSS in the Korean population and assess whether it could aid to expedite treatment decisions. METHODS: We reviewed 111 cases of stroke patients admitted to our hospital via the emergency department over a 6 months period from July to December 1998. Levels of consciousness, vomiting, headache, and atheroma markers used in the SSS were applied to these patients who met the criteria for a stroke. RESULTS: Of the 111 patients, the SSS classified 83 with sensitivities of 81.1%(NHS) and 73.3%(HS) and positive predictive values of 84.3% and 68.8%, respectively. The overall accuracy rate was 78.3%. CONCLUSION: Our results suggest that the SSS is not reliable in distinguishing stroke types in the Korean population. Definite neuroimaging studies are needed prior to thrombolytic therapy.