Organophosphate poisoning in a young child: a case report

ABSTRACT Unintentional ingestions are a common form of poisoning in children worldwide. Organophosphates are commonly used in households worldwide and are a common cause of childhood poisonings. This case report describes an unintentional ingestion of a child in East Africa. A thorough patient history and a high index of suspicion are needed in recognizing an organophosphate poisoning. Prompt patient stabilization and treatment improve outcomes. Neurologic sequela may occur and thus patient follow-up is recommended.

Carotid Artery Dissection as a Result of Penetrating Ear Trauma

Case Presentation: Here we present the case of a previously healthy 67-year-old female with carotid artery dissection as a result of penetrating ear trauma. Discussion: Carotid artery dissection can result from unusual mechanisms of injury and present without typical symptoms or exam findings. If left untreated, devastating neurologic sequela can occur. Physicians must have a low threshold to obtain vascular imaging to appropriately manage such cases.

Fatal Vertebral Artery Injury in Penetrating Cervical Spine Trauma

Study Design. This case illustrates complications to a vertebral artery injury (VAI) resulting from penetrating cervical spine trauma.Objectives. To discuss the management of both VAI and cervical spine trauma after penetrating gunshot wound to the neck.Summary of Background Data.Vertebral artery injury following cervical spine trauma is infrequent, and a unilateral VAI often occurs without neurologic sequela. Nevertheless, devastating complications of stroke and death do occur.Methods. A gunshot wound to the neck resulted in a C6 vertebral body fracture and C5–C7 transverse foramina fractures. Neck CT angiogram identified a left vertebral artery occlusion. A cerebral angiography confirmed occlusion of the left extracranial vertebral artery and patency of the remaining cerebrovascular system. Following anterior cervical corpectomy and stabilization, brainstem infarction occurred and resulted in death.Results. A fatal outcome resulted from vertebral artery thrombus propagation with occlusion of the basilar artery triggering basilar ischemia and subsequent brainstem and cerebellar infarction.Conclusions. Vertebral artery injury secondary to cervical spine trauma can lead to potentially devastating neurologic sequela. Early surgical stabilization, along with anticoagulation therapy, contributes towards managing the combination of injuries. Unfortunately, despite efforts, a poor outcome is sometimes inevitable when cervical spine trauma is coupled with a VAI.

Investigating Tourette Syndrome as a Neurologic Sequela of Rheumatic Fever

Sydenham's chorea is currently recognized as the only neurologic sequela of rheumatic fever. Recent evidence suggests that there may be a spectrum of neurobehavioral disturbances, particularly including tics and obsessive-compulsive disorder, that develops following streptococcal infection by the process of molecular mimicry, whereby antibodies directed against bacterial antigens cross-react with brain targets. This proposed postinfectious, immune-mediated condition has been termed “pediatric autoimmune neuropsychiatric disorders after streptococcal infection” (PANDAS). This article reviews research evidence in favor and also against the PANDAS concept and discusses the implications of the hypothesis.