scholarly journals An Unusual Cause of Altered Mental Status: Recurrent Cerebral Air Embolism

2016 ◽  
Vol 43 (2) ◽  
pp. 350-352
Author(s):  
James Kim ◽  
Iftikhar Ahmed ◽  
Trenton Myers ◽  
Graham Lee
Keyword(s):  
Mental Status ◽  
Air Embolism ◽  
Altered Mental Status ◽  
Cerebral Air Embolism

scholarly journals Cortical Blindness and Altered Mental Status following Routine Hemodialysis, a Case of Iatrogenic Cerebral Air Embolism

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Lawrence Lau ◽  
Kory London
Keyword(s):  
Mental Status ◽  
Air Embolism ◽  
Altered Mental Status ◽  
Cortical Blindness ◽  
Cerebral Veins ◽  
Dialysis Tubing ◽  
Cerebral Air Embolism ◽  
Left Thalamus ◽  
Air Embolus ◽  
Hyperbaric Therapy

Cerebral air embolism is a known complication from a myriad of iatrogenic causes. This case describes a 60-year-old female presenting from hemodialysis with altered mental status, bilateral homonymous hemianopia, and repetitive speech. A noncontrast head CT revealed air in the vein of Galen and the deep cerebral veins of the left thalamus and occipital sulcus, a complication from air being introduced into the patient via improper flushing of dialysis tubing. The retrograde flow of air bubbles in the upright patient during dialysis was likely responsible for the air embolus lodging in the cerebral vasculature. This patient was transferred to receive hyperbaric therapy, whereupon the patient survived with residual attention and spatial deficits.

Transient altered mental status and leptomeningeal enhancement associated with pembrolizumab: a case report

2021 ◽  
Author(s):  
Keng Lam ◽  
Sameer K. Kulkarni ◽  
Manya Khrlobyan ◽  
Pamela K. Cheng ◽  
Caroline L. Fong
Keyword(s):  
Case Report ◽  
Mental Status ◽  
Altered Mental Status ◽  
Leptomeningeal Enhancement

scholarly journals Recurrent noncirrhotic hyperammonemia causing acute metabolic encephalopathy in a patient with a continent ileocecal pouch: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
T. M. Skipina ◽  
S. Macbeth ◽  
E. L. Cummer ◽  
O. L. Wells ◽  
S. Kalathoor
Keyword(s):  
Emergency Department ◽  
Metabolic Acidosis ◽  
Mental Status ◽  
Rare Case ◽  
Liver Function Tests ◽  
Altered Mental Status ◽  
Potassium Citrate ◽  
Metabolic Encephalopathy ◽  
History Of ◽  
Normal Urine

Abstract Introduction Acute encephalopathy, while a common presentation in the emergency department, is typically caused by a variety of metabolic, vascular, infectious, structural, or psychiatric etiologies. Among metabolic causes, hyperammonemia is relatively common and typically occurs in the setting of cirrhosis or liver dysfunction. However, noncirrhotic hyperammonemia is a rare occurrence and poses unique challenges for clinicians. Case presentation Here we report a rare case of a 50-year-old Caucasian female with history of bladder cancer status post chemotherapy, radical cystectomy, and ileocecal diversion who presented to the emergency department with severe altered mental status, combativeness, and a 3-day history of decreased urine output. Her laboratory tests were notable for hyperammonemia up to 289 μmol/L, hypokalemia, and hyperchloremic nonanion gap metabolic acidosis; her liver function tests were normal. Urine cultures were positive for Enterococcus faecium. Computed tomography imaging showed an intact ileoceal urinary diversion with chronic ileolithiasis. Upon administration of appropriate antibiotics, lactulose, and potassium citrate, she experienced rapid resolution of her encephalopathy and a significant reduction in hyperammonemia. Her hyperchloremic metabolic acidosis persisted, but her hypokalemia had resolved. Conclusion This case is an example of one of the unique consequences of urinary diversions. Urothelial tissue is typically impermeable to urinary solutes. However, when bowel segments are used, abnormal absorption of solutes occurs, including exchange of urinary chloride for serum bicarbonate, leading to a persistent hyperchloremic nonanion gap metabolic acidosis. In addition, overproduction of ammonia from urea-producing organisms can lead to abnormal absorption into the blood and subsequent oversaturation of hepatic metabolic capacity with consequent hyperammonemic encephalopathy. Although this is a rare case, prompt identification and treatment of these metabolic abnormalities is critical to prevent severe central nervous system complications such as altered mental status, coma, and even death in patients with urinary diversions.

scholarly journals Altered mental status is an independent predictor of mortality in hospitalized COVID-19 patients

2021 ◽  
Author(s):  
Marjorie J. Kenerly ◽  
Priyank Shah ◽  
Hiten Patel ◽  
Rilee Racine ◽  
Yash Jani ◽  
...  
Keyword(s):  
Mental Status ◽  
Independent Predictor ◽  
Altered Mental Status

scholarly journals Postoperative cerebral air embolism with delayed abnormal brain MRI findings

2021 ◽  
Vol 22 ◽  
pp. 100305
Author(s):  
Yuwa Oka ◽  
Koji Tsuzaki ◽  
Mayu Kamei ◽  
Akihiro Kikuya ◽  
Toshiaki Hamano
Keyword(s):  
Brain Mri ◽  
Air Embolism ◽  
Mri Findings ◽  
Cerebral Air Embolism ◽  
Abnormal Brain

scholarly journals Altered mental status with mirror giant middle cerebral artery aneurysms: A case report

2021 ◽  
pp. 101154
Author(s):  
Kamil W. Nowicki ◽  
Jasmine L. Hect ◽  
Nallamai Muthiah ◽  
Arka N. Mallela ◽  
Benjamin M. Zussman
Keyword(s):  
Case Report ◽  
Middle Cerebral Artery ◽  
Mental Status ◽  
Cerebral Artery ◽  
Altered Mental Status ◽  
Middle Cerebral Artery Aneurysms
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