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The diagnostic challenge of coma blisters.
JAAD Case Rep
February 2025
Department of Dermatology, Howard University College of Medicine, Washington, District of Columbia.
High False-Negative Rate of Intraoperative Neurophysiologic Monitoring in Blood Blister-Like Aneurysm Surgery: Insights from a Retrospective Case Series.
World Neurosurg
February 2025
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address:
Article Synopsis
- The study investigates the use of intraoperative neurophysiological monitoring (IONM) during surgeries for blood-blister-like aneurysms (BBA), which are complicated due to high risks of complications and death.
- Researchers monitored patients using somatosensory and transcranial motor evoked potentials (SSEPs/tcMEPs) to assess neurological outcomes, revealing a low sensitivity (37.5%) but high specificity (100%) for detecting ischemic events during surgery.
- Results indicate that while IONM can accurately identify healthy brain function, it has a high rate of false negatives, particularly in complex surgical procedures, highlighting the need for careful interpretation and further studies.
Osmotic demyelination syndrome: revisiting the diagnostic criteria through two fatal cases.
BMC Neurol
November 2024
Department of Anatomical, Histological, Forensic and Orthopedic Sciences, "Sapienza" University of Rome, Rome, 00185, Italy.
Background: Osmotic Demyelination Syndrome (ODS) encompasses Central Pontine Myelinolysis and Extrapontine Myelinolysis, both of which are serious neurological conditions linked to the overly rapid correction of hyponatremia. Despite growing evidence, the exact etiology of ODS remains incompletely understood. The present paper describes two case studies, aiming to provide a comprehensive overview of the pathological findings and clinical outcomes associated with ODS.
View Article and Find Full Text PDFVasogenic Edema Covering the Brain Surface in a Case of Severe Meningoencephalitis Due to Varicella-Zoster Virus Infection.
Cureus
July 2024
Department of Neurology, Kobe City Medical Center General Hospital, Kobe, JPN.
Meningoencephalitis caused by varicella-zoster virus (VZV) is a serious condition requiring prompt antiviral treatments, but magnetic resonance imaging (MRI) findings are often normal, limiting early diagnostic utility. We report a case of severe VZV-associated meningoencephalitis characterized by diffuse T2 hyperintense lesions covering the brain surface on MRI, presumed to be vasogenic edema. An immunocompetent 78-year-old Japanese woman presented with a disturbance of consciousness preceded by seven days of headache.
View Article and Find Full Text PDFComa Blister After Trazodone Misuse: A Case Report.
Am J Dermatopathol
October 2024
Department of Dermatology, Tulane University School of Medicine, New Orleans, LA.
Article Synopsis
- Coma blisters are fluid-filled bumps that can occur on the skin when someone is in a prolonged state of unconsciousness, and they can form due to various drug intoxications, primarily barbiturates in adults.
- New evidence suggests that other substances, including trazodone, may also trigger these blister-like lesions even in noncomatose individuals.
- This case highlights the importance of understanding how certain drugs can lead to these skin issues, which can help doctors recognize and stop medications that might cause them.
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