Neurology
Acute monocular vision loss: Don’t lose sight of the differentialAn 83-year-old man woke up one morning unable to see out of his left eye; 6 hours earlier it had been normal.
- Ring-enhancing cerebral lesions
The patient has poorly controlled HIV, seizures, and brain lesions. Is Histoplasma or Toxoplasma the cause of the lesions?
- When should brain imaging precede lumbar puncture in cases of suspected bacterial meningitis?
Few patients need it. Empiric antibiotic and corticosteroid therapy must not be delayed.
- Thrombotic microangiopathies: Similar presentations, different therapies
Effective management depends on prompt diagnosis and targeted therapy.
- Severely frail elderly patients do not need lipid-lowering drugs
Statins have no role as primary prevention in this population, and a minor role as secondary prevention.
- Statin therapy in the frail elderly: A nuanced decision
Clinicians—and patients—may reasonably feel there is value in statin therapy—even in advanced frailty.
- Worsening migraine due to neurocysticercosis
When a woman with a history of migraine had new symptoms, MRI revealed a tapeworm scolex in her brain.
- Imaging suggestive, but symptoms atypical
Pseudosubarachnoid hemorrhage is an artifact of CT imaging.
- An unexpected cause of shoulder pain
The patient’s scapula protruded abnormally during forward flexion and abduction of the arm.