Clinical Images in Emergency Medicine: Cushing's Disease.

Case Presentation: A 22-year-old female presented to the emergency department with a two-month history of worsening fatigue, unintentional weight gain, and progressive facial swelling. Physical examination findings included hirsutism, moon facies, and abdominal striae. Subsequent brain magnetic resonance imaging revealed the presence of a 2.

Primary Infection Site as a Predictor of Sepsis Development in Emergency Department Patients.

Background: Sepsis is a life-threatening condition but predicting its development and progression remains a challenge.

Objective: This study aimed to assess the impact of infection site on sepsis development among emergency department (ED) patients.

Methods: Data were collected from a single-center ED between January 2016 and December 2019.

External Validation of an Artificial Intelligence Device for Intracranial Hemorrhage Detection.

Background: Artificial intelligence applications have gained traction in the field of cerebrovascular disease by assisting in the triage, classification, and prognostication of both ischemic and hemorrhagic stroke. The Caire ICH system aims to be the first device to move into the realm of assisted diagnosis for intracranial hemorrhage (ICH) and its subtypes.

Methods: A single-center retrospective dataset of 402 head noncontrast CT scans (NCCT) with an intracranial hemorrhage were retrospectively collected from January 2012 to July 2020; an additional 108 NCCT scans with no intracranial hemorrhage findings were also included.

An Assessment of Pediatric Residency Applicant Perceptions of "Fit" During the Virtual Interview Era.

Purpose: Residency recruitment events and interviews are widely considered an integral component of the residency match experience. Due to the COVID-19 pandemic, residency recruitment and interviewing throughout the 2020-2021 academic year were performed virtually, which created challenges for applicants' ability to discern "fit" to a program. Given this change, it is reasonable to suspect that applicants would be less able to discern program fit.

Impact of MRI timing on tumor volume and anatomic displacement for brain metastases undergoing stereotactic radiosurgery.

Background: The objective of this study was to evaluate the impact of the time interval between planning imaging and stereotactic radiosurgery (SRS) delivery on tumor volumes and spatial anatomic displacements of brain metastases (BM).

Methods: Consecutive patients diagnosed with BM treated with SRS over a 3-year period were evaluated. Only patients who underwent an institutionally standardized diagnostic MRI (MRI-1) and a treatment planning MRI (MRI-2) were included.

Is there a doctor on the plane? A review of in-flight emergencies for the on-board radiologist.

In-flight medical emergencies (IFME) are the acute on-service events involving illness or injury to a passenger with the potential for long-term health compromise. With the continuously rising number of flights available, both domestically and internationally, it is conceivable that the number of IFMEs will similarly continue to rise. Although most of these instances are relatively self-limited, the rare instance of a severe occurrence justifies preparation, both from in-flight staff and healthcare providers traveling on these flights.

Congenital Right Coronary Artery Fistula Causing an Aortic Steal: A Rare Anatomic Abnormality and a Review of the Literature.

Coronary artery fistulas are an uncommon anatomic anomaly with variable presentations. We present an asymptomatic seven-month-old black male with a large coronary artery fistula draining into the right ventricle, causing an aortic backflow on diastole. Despite this prominent alternative drainage pathway, coronary fistulas are commonly an incidental finding and, as in this case, may not require intervention.

Building a Brain Tumor Practice: Objective Analysis of Referral Patterns and Implications for the Growth of a Subspecialty Surgical Program.

Introduction Growth of surgical caseload among specialties with a large contribution margin is an important financial objective for hospitals. In this study, we examined the diversity of referral patterns to a neurosurgeon over an eight-year interval and examined practice attributes related to surgical growth. Methods The electronic records of all patients undergoing an intracranial surgical procedure between August 2011 and August 2019 by an academic neurosurgeon were reviewed retrospectively.

Primary Low-Grade Astrocytoma of the Spine With Secondary Cerebral Metastasis: A Case Report and Comprehensive Review of the Literature.

An astrocytoma is a subclassification of glioma, with primary spinal manifestations accounting for less than 10% of all spinal cord tumors, with the majority encompassing low-grade features. It is even more uncommon for such lesions to demonstrate intracerebral metastasis. We report such an occurrence in a 39-year-old female who initially presented with an intramedullary and intradural mass from T10-L1, as well as secondary metastasis to the mesial right temporal lobe and cerebellum upon clinical follow-up.

The role of the brain renin-angiotensin system (RAS) in mild traumatic brain injury (TBI).

There is considerable interest in traumatic brain injury (TBI) induced by repeated concussions suffered by athletes in sports, military personnel from combat-and non-combat related activities, and civilian populations who suffer head injuries from accidents and domestic violence. Although the renin-angiotensin system (RAS) is primarily a systemic cardiovascular regulatory system that, when dysregulated, causes hypertension and cardiovascular pathology, the brain contains a local RAS that plays a critical role in the pathophysiology of several neurodegenerative diseases. This local RAS includes receptors for angiotensin (Ang) II within the brain parenchyma, as well as on circumventricular organs outside the blood-brain-barrier.