Contained Rupture of a Thoracic Aortic Aneurysm: A Rare and Life-Threatening Cause of Dysphagia.

Dysphagia is commonly seen in the elderly and has both benign and malignant causes. A difficulty in swallowing due to the esophageal compression by the aorta, or dysphagia aortica, is a rare entity, little described in literature. However, diagnostic error or diagnostic and treatment delays of aortic dysphagia can be fatal. Herein, we report a case of dysphagia aortica caused by the contained rupture of a descending aneurysmatic thoracic aorta, presenting at the emergency department with acute dysphagia and diffuse chest pain, successfully treated by thoracic endovascular aneurysm repair.

Thrombolysis in an Acute Ischemic Stroke Patient on Direct Anticoagulant Therapy Outside of the Traditional Time Window: A Case Report.

A stroke is a life-threatening medical condition that could be disabling if left untreated. Intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) can be effective when initiated in an acute stroke, but their benefit is time-dependent and their use may be restricted by contraindications (CIs) such as anticoagulation therapy. The critical therapeutic time window, which was previously limited to 4.5-6 hours, is now extended to 24 hours in selected patients due to the development of advanced neuroimaging techniques. Herein, we discuss the case of a 50-year-old patient on rivaroxaban who developed acute ischemic stroke (AIS) and was treated successfully with intravenous recombinant tissue plasminogen activator thrombolysis more than six hours after the time he was last seen well (LSW). Our case demonstrates the importance of advanced neuroimaging techniques in identifying AIS candidates for IVT and/or MT with late or unknown time windows as well as the importance of case-by-case assessment when challenged by theoretical contraindications for thrombolysis.

COVID-19 masquerading as a non-convulsive status epilepticus.

Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), more and more atypical presentations of COVID-19 are being reported. Here, we present and discuss non-convulsive status epilepticus (NCSE) as presenting symptom of SARS-CoV-2 infection at the Emergency Department.