Acute temporal lobe infarction in a young patient associated with marijuana abuse: An unusual cause of stroke.

BACKGROUND: Cardiovascular or cerebrovascular events associated with drug abuse have been frequently reported, particularly in young patients. The drugs include generally cocaine, heroin, and amphetamines. Although marijuana is among the widely used narcotics in the world, stroke associated with the marijuana use is infrequently reported. METHODS: Stroke caused by the use of marijuana was investigated in a 23-year-old man and the importance of inquiry of drug abuse in case of stroke was emphasized. RESULTS: The patient was treated for 7 days in a follow-up, but he was not recovered. The patient was discharged in his existing condition and was directed for physiotherapy and rehabilitation. CONCLUSION: Ischemic stroke is associated with drug abuse and/or substance use, mainly cannabinoids and amphetamines, particularly in young patients.

Conditions that mimic stroke in elderly patients admitted to the emergency department.

BACKGROUND: Stroke is the most common neurologic cause for patient admission to the emergency department (ED) and the risk of stroke increases with age. This study aimed to determine the clinical and demographical characteristics of stroke-mimicking patients 65 years or older who were admitted to the ED for stroke. METHODS: After the retrospective file examination, patients 65 years and older who were admitted to the ED with an established final diagnosis of stroke as a result of history, physical examination, imaging, and required consultations were included in the study. RESULTS: After scanning 671 records of patients 65 years or older, 87.3% (n=586) were diagnosed with stroke and 12.7% (n=85) received different diagnoses mimicking stroke. Of these 85 patients, 91.8% (n=78) and 8.2% (n=7) were prediagnosed with ischemic stroke and transient ischemic attack, respectively, by the ED physicians. After complete evaluations and consultations, the patients with stroke were typically diagnosed with vertebrobasilar insufficiency (n=16, 18.8%). Of the patients, 76.5% (n=65) were discharged after treatment and follow-up in the ED, and 21.1% (n=18) were hospitalized. CONCLUSIONS: In older patients, stroke-mimicking conditions can cause signs and symptoms indistinguishable from true stroke, representing about 12.7% of elderly patients admitted to an ED with these diagnoses.

General characteristics of patients with electrolyte imbalance admitted to emergency department.

BACKGROUND: Fluid and electrolyte balance is a key concept to understand for maintaining homeostasis, and for a successful treatment of many metabolic disorders. There are various regulating mechanisms for the equilibrium of electrolytes in organisms. Disorders of these mechanisms result in electrolyte imbalances that may be life-threatening clinical conditions. In this study we defined the electrolyte imbalance characteristics of patients admitted to our emergency department. METHODS: This study was conducted in the Emergency Department (ED) of Uludag University Faculty of Medicine, and included 996 patients over 18 years of age. All patients had electrolyte imbalance, with various etiologies other than traumatic origin. Demographic and clinical parameters were collected after obtaining informed consent from the patients. The ethical committee of the university approved this study. RESULTS: The mean age of the patients was 59.28±16.79, and 55% of the patients were male. The common symptoms of the patients were dyspnea (14.7%), fever (13.7%), and systemic deterioration (11.9%); but the most and least frequent electrolyte imbalances were hyponatremia and hypermagnesemia, respectively. Most frequent findings in physical examination were confusion (14%), edema (10%) and rales (9%); and most frequent pathological findings in ECG were tachycardia in 24%, and atrial fibrillation in 7% of the patients. Most frequent comorbidity was malignancy (39%). Most frequent diagnoses in the patients were sepsis (11%), pneumonia (9%), and acute renal failure (7%). CONCLUSIONS: Electrolyte imbalances are of particular importance in the treatment of ED patients. Therefore, ED physicians must be acknowledged of their fluid-electrolyte balance dynamics and general characteristics.

General characteristics of patients with electrolyte imbalance admitted to emergency department / 世界急诊医学杂志（英文）

@#BACKGROUND: Fluid and electrolyte balance is a key concept to understand for maintaining homeostasis, and for a successful treatment of many metabolic disorders. There are various regulating mechanisms for the equilibrium of electrolytes in organisms. Disorders of these mechanisms result in electrolyte imbalances that may be life-threatening clinical conditions. In this study we defined the electrolyte imbalance characteristics of patients admitted to our emergency department. METHODS: This study was conducted in the Emergency Department (ED) of Uludag University Faculty of Medicine, and included 996 patients over 18 years of age. All patients had electrolyte imbalance, with various etiologies other than traumatic origin. Demographic and clinical parameters were collected after obtaining informed consent from the patients. The ethical committee of the university approved this study. RESULTS: The mean age of the patients was 59.28±16.79, and 55% of the patients were male. The common symptoms of the patients were dyspnea (14.7%), fever (13.7%), and systemic deterioration (11.9%); but the most and least frequent electrolyte imbalances were hyponatremia and hypermagnesemia, respectively. Most frequent findings in physical examination were confusion (14%), edema (10%) and rales (9%); and most frequent pathological findings in ECG were tachycardia in 24%, and atrial fibrillation in 7% of the patients. Most frequent comorbidity was malignancy (39%). Most frequent diagnoses in the patients were sepsis (11%), pneumonia (9%), and acute renal failure (7%). CONCLUSIONS: Electrolyte imbalances are of particular importance in the treatment of ED patients. Therefore, ED physicians must be acknowledged of their fluid-electrolyte balance dynamics and general characteristics.