Month: December 2018

Sunday Scaries

Concussion – Part 2 (Sunday Scary)

Last week, I reviewed diagnosis of a concussion and management as well as patient education. And like always, when you read it, you then have a few patients that week with that diagnosis What i wanted to continue with this week is the importance of educating our patients on the SECOND injury. This is the patient that doesn't listen to your brain rest and physical activity restrictions, goes out and gets hit on the noggin a second time. Second Impact Syndrome Rare and potentially fatal complication that involves diffuse cerebral edema secondary to a recurrent or

by Alyssa Cocchiara, DO
Sunday Scaries

Concussion – Part 1 (Sunday Scary)

THE CASE: 20-something year old male comes into the dept with bruising and swelling to his face. Pt states he was jumped yesterday and had followed up at a CITYMD but refused transfer to the ED for further imaging. Today he has come to the ED because his face is swollen and he is in pain with a slight headache. On physical exam, Pt had good ROM of his neck w/o pain, conjunctival hemorrhages bilaterally without any corneal abrasions under wood's lamp, a little slow in answering questions. CT of face showing no acute fractures just gross edema, and no abnormalities on CT of

by Samir
Sunday Scaries

Wernicke’s Encephalopathy – Sunday Scary

THE CASE: One of our not so regular alcoholic with pmhx of DM presented to the ED with eye pain with concerns for acute angle glaucoma. Upon discharge up to the eye clinic the patient states he was unable to walk. Muscle strength 5/5 and good reflexes.What was going on here?? Was this man faking it to get an admission or was there something else going on?? WERNICKE'S ENCEPHALOPATHY vs WERNICKE-KORSAKOFF SYNDROME Wernicke's Encephalopathy -Opthalmoplegia (nystagmus and lateral rectus palsy), ataxia, and disturbances of consciousness or mental activity (ALL 3 seen i

by Alyssa Cocchiara, DO